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Chest, Vol 92, 1113-1115, Copyright © 1987 by American College of Chest Physicians

ARTICLES

Malignant course of a benign anomaly: myocardial bridging

OH Kracoff, I Ovsyshcher and M Gueron
Division of Cardiology, Soroka University Hospital, Beer-Sheva, Israel.

A 35-year-old man, with recent onset angina, developed recurrent episodes of syncope due to ventricular tachycardia. His coronary angiogram showed normal coronary arteries and myocardial bridging of the left anterior descending causing severe systolic milking effect. Extensive invasive and noninvasive investigations did not reveal cardiac pathology other than the myocardial bridging. Electrophysiologic studies, not previously reported in myocardial bridging, demonstrated inducible sustained ventricular tachycardia at a rate of 280 beats/min. The possible relationship between the arrhythmia and the myocardial bridge is suggested. Combined medical treatment with amiodarone and diltiazem proved to be an effective alternative to surgical myotomy of the bridge.


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