Inferior wall myocardial infarction and myocardial bridging of left anterior descending coronary artery in a young patient – case report

Kamceva, Gordana and Nikolov, Sasko and Jordanova, Slavica and Vasilev, Blagoja and Trajkovska, Radojka and Dokuzova, Stojka (2022) Inferior wall myocardial infarction and myocardial bridging of left anterior descending coronary artery in a young patient – case report. In: Symposium with international participation "Highlights in Cardiovascular Diseases", 04-06 Nov 2022, Skopje, North Macedonia.

	Text 2-02082024.pdf Download (1MB)
	Text Gordana Kamceva Mihailova.pdf Download (270kB)

Abstract

Introduction: Myocardial bridging is considered a relatively benign condition, but serious complications such as angina pectoris, myocardial infarction, stress cardiomyopathy, ventricular arrhythmia, and sudden cardiac death can still occur. In rare cases, acute myocardial infarction and myocardial bridging may occur as a distinct feature in one patient. We describe a young man with acute myocardial infarction on inferior wall associated with myocardial bridging of the left anterior descending coronary artery, who was diagnosed and evaluated by electrocardiography, echocardiography, and coronary angiography.
Case report: A 40-year-old man called the emergency room for chest pain, pain in the left upper arm, with difficulty breathing and malaise, for the last three days. His vital signs were: arterial blood pressure TA=140/90mmHg, heart rate SF=98/min, respiratory rate of 18 breaths/min and oxygen saturation 98%. Diagnostic tests included CK=641 (29-200 U/L), CK-MB=84.99 U/L (normal < 25 U/L), and hs troponin=4987.4 ng/mL (0-34.2 ng/mL). ECG: ST-segment elevation in inferior leads. Echocardiography: Normal dimensions of the left ventricle (LVDd=55mm, LVDs=39mm) with proper systolic function and diastolic function with normal kinetics and EF 60%. Hypokinesia of the inferior wall and base of the interventricular septum. Normal dimensions of right ventricle = 24mm, left atrium = 37mm, ascending aorta = 38mm. Mild mitral and tricuspid regurgitation. Coronarography: TRA(r). RD2. LMN: b.o. TIMI 3 LAD: mid massive muscle bridge TIMI 3 Cx: b.o.TIMI3 RCA: mid/dist 100% thrombus, TIMI 3 Intervention (G.C. JR 4.0, 6F; FloppyMS): Thromboaspiration: Elliminate catheter 6F, NoII POBA to RCA mid/dist: balloon 2,5x20mm,12atm, NoI. RESULT: RCA mid/dist 100%  50% TIMI 3.
Conclusion: Diagnosis and appropriate treatment of this pathology are important.
The patient was referred to a cardiac surgery facility where coronary artery bypass ACBPx1 (LRA-PDA) was performed, as well as LAD surgical myotomy.
Key words: acute myocardial infarction, myocardial bridging, young patient, coronary artery bypass, surgical myotomy

Item Type:	Conference or Workshop Item (Poster)
Subjects:	Medical and Health Sciences > Clinical medicine
Divisions:	Faculty of Medical Science
Depositing User:	Gordana Kamceva
Date Deposited:	12 Feb 2024 13:58
Last Modified:	12 Feb 2024 13:58
URI:	https://eprints.ugd.edu.mk/id/eprint/33537

Actions (login required)

View Item