Three-vessel myocardial bridging: A possible cause of myocardial stunning

The authors report a rare clinical case of myocardial bridging of the three major coronary arteries, which manifested in an unusual way with severe biventricular dysfunction in the context of tachycardia. For the diagnosis, the authors relied on non-invasive multimodality cardiac imaging, including...

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Bibliographic Details
Published in:Revista portuguesa de cardiologia 2019-03, Vol.38 (3), p.225.e1-225.e5
Main Authors: Almeida, Ana Rita, Pereira, Ana Rita, Morgado, Gonçalo, Loureiro, Maria José, Ferreira, Filipa, Cruz, Inês, Lopes, Luís Rocha, Pereira, Hélder
Format: Article
Language:English
Subjects:
Adult
Atordoamento miocárdico
Bridging miocárdico
Computed Tomography Angiography
Coronary Angiography - methods
Coronary Vessels - diagnostic imaging
Diagnosis, Differential
Echocardiography
Female
Heart failure
Humans
Imaging, Three-Dimensional
Insuficiência cardíaca
Magnetic Resonance Imaging, Cine
Myocardial bridging
Myocardial Bridging - complications
Myocardial Bridging - diagnosis
Myocardial stunning
Myocardial Stunning - diagnosis
Myocardial Stunning - etiology
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Summary:The authors report a rare clinical case of myocardial bridging of the three major coronary arteries, which manifested in an unusual way with severe biventricular dysfunction in the context of tachycardia. For the diagnosis, the authors relied on non-invasive multimodality cardiac imaging, including cardiac magnetic resonance, computed tomography angiography and myocardial perfusion scintigraphy. The implementation of targeted medical and neurohormonal therapy resulted in the recovery of ventricular function and clinical improvement. Os autores descrevem um caso clínico raro de bridging miocárdico dos três territórios coronários, que se apresentou de forma invulgar com disfunção biventricular grave em contexto de taquicardia. Para o diagnóstico os autores basearam-se em exames de imagem cardíaca não invasivos, como a ressonância magnética cardíaca, a angiografia tomográfica computorizada e a cintigrafia de perfusão miocárdica. A instituição de terapêutica médica dirigida e neuro-hormonal permitiu a recuperação da função ventricular e a melhoria clínica.
ISSN:0870-2551
2174-2030
2174-2049
DOI:10.1016/j.repc.2017.09.030