cardiovascular-agents and Myocardial-Bridging

Myocardial noncompaction, namly isolated noncompaction of the left ventricular myocardium (NVM), is a rare congenital disease. It can be either seen in the absence of other cardiac anomalies, or associated with other congenital cardiac defects, mostly stenotic lesions of the left ventricular outflow tract. A myocardial bridge (MB) is thought being associated with coronary heart disease, such as coronary spasm, arrhythmia, and so on. The significance of MB in association with other congenital cardiac conditions is unknown.We report a novel case who was presented NVM and MB. A 34-year-old man complained of chest prickling-like pain and dizzy for 1 year. His blood pressure was 110/70 mm Hg. Echocardiograph revealed increased trabeculations below the level of papillary muscle of left ventricle (LV); deep intertrabecular recesses in the endocardial wall of LV particularly in apex free wall; and LV ejection fraction of 57%. A coronary computerized tomography scan showed that part, 38.9 cm, of left descending artery tunnel was surrounding by cardiac muscles rather than resting on top of the myocardium.The therapeutics interventions included lifestyle cares, agents of anti-ischemia and improvement myocardial cell metabolism. The patient was followed up for 2.6 years, and his general condition was stable.This case indicates that NVM can be developed with MB, and the complete diagnosis of NVM and MB should be made by different image studies.

Topics: Adult; Cardiovascular Agents; Coronary Angiography; Echocardiography; Heart Ventricles; Humans; Isolated Noncompaction of the Ventricular Myocardium; Male; Myocardial Bridging; Risk Reduction Behavior; Tomography, X-Ray Computed; Treatment Outcome

The authors present a case of a 70-year-old woman in whom clinical picture of an acute coronary syndrome with ST segment elevation was suggestive of takotsubo cardiomyopathy (TC). Chest pain, extensive ECG changes and typical TC left ventricular contraction pattern were preceded by emotional and physical stress, while in coronary angiography no atherosclerotic lesions were found. There was however left anterior descending coronary artery myocardial bridging with total systolic compression. Following treatment with beta-blocker and diltiazem, spectacular left ventricle function improvement, with near total recovery after 6 months was observed. Magnetic resonance imaging detected the presence of subendocardial late gadolinium enhancement indicative of postmyocardial scar.

Topics: Adrenergic beta-Antagonists; Aged; Cardiovascular Agents; Diagnosis, Differential; Diltiazem; Drug Therapy, Combination; Female; Humans; Magnetic Resonance Imaging; Myocardial Bridging; Myocardial Infarction; Takotsubo Cardiomyopathy; Ventricular Dysfunction, Left

Topics: Angioplasty, Balloon, Coronary; Cardiomyopathy, Hypertrophic; Cardiovascular Agents; Coronary Angiography; Coronary Artery Disease; Drug Therapy, Combination; Drug-Eluting Stents; Echocardiography; Humans; Male; Middle Aged; Myocardial Bridging; Platelet Aggregation Inhibitors; Predictive Value of Tests; Treatment Outcome; Ultrasonography, Interventional

The apical ballooning syndrome is a relatively rare and underrecognized transient cardiomyopathy precipitated by emotional or physical stress. The role of myocardial bridging in its cause is unknown and extremely rarely reported. We present a case of a 68-year-old woman with apical ballooning syndrome and transient myocardial bridging of the left anterior descending coronary artery, clinically manifested as pulmonary edema. Ischemic ECG changes and mild elevation of cardiac biomarkers were present. She recovered well on medical treatment, and follow-up echocardiography revealed complete recovery of the left ventricular systolic function, whereas repeated coronary angiography after 1 year showed no signs of myocardial bridging. To the best of our knowledge, this is the first report of transient myocardial bridging in a patient with Takotsubo cardiomyopathy with documented normalization of the left ventriculogram and disappearance of left anterior descending coronary artery myocardial bridging.

Topics: Aged; Biomarkers; Cardiovascular Agents; Coronary Angiography; Echocardiography; Electrocardiography; Female; Humans; Myocardial Bridging; Pulmonary Edema; Radionuclide Ventriculography; Takotsubo Cardiomyopathy; Treatment Outcome; Up-Regulation

The aim of this study was to investigate the long-term prognosis of non-interventionally followed patients with myocardial bridge and angiographic milking of the left anterior descending (LAD) coronary artery.. All of the coronary angiography records from May 2000 to November 2007 were reevaluated and patients who had more than 70% narrowing during systole on LAD were eligible for the present study. Follow-up was carried out by physical examination, echocardiography, and treadmill exercise testing. The clinical situations of the patients, medical treatment at the time of follow-up, and experienced events (death, myocardial infarction, or revascularization) were recorded.. There were 59 eligible patients (44 male, 74.6%). The mean age of the patients was 54 +/- 11 years. The bridges were located in the proximal, mid, and distal portion of the LAD in 17 (28.8%), 20 (33.9%), and 22 (37.3%) patients, respectively. Distributions of the narrowing degree were as follows: between 70% to 89% in 33 (56%) patients and 90% to 100% in 26 (44%) patients. Mean follow-up duration of the group was 37 +/- 13 months (range 15-65 mo). The clinical presentation during follow-up was stable angina in 9 (15.3%) cases, atypical angina in 12 (20.3%), atypical chest pain in 13 (22%), dyspnea in 3 (5.1%), and syncope in 3 (5.1%) cases. There were no experienced events and/or hospitalizations related to cardiac disease. Echocardiographic examination revealed normal systolic ventricular function. Only 17 (28.8%) patients continued to use medication. Most of them were on beta-blocker therapy.. Patients with myocardial bridges and angiographic milking of the LAD coronary artery have a good long-term prognosis.

Topics: Adult; Aged; Angina Pectoris; Cardiovascular Agents; Cineangiography; Coronary Angiography; Coronary Stenosis; Dyspnea; Echocardiography; Exercise Test; Female; Follow-Up Studies; Humans; Male; Middle Aged; Myocardial Bridging; Myocardial Ischemia; Registries; Severity of Illness Index; Syncope; Time Factors; Treatment Outcome