Focal Coronary Atherosclerosis Proximal to Myocardial Bridging

Heribert Schunkert
2003 Circulation  
A 61-year-old man presented for evaluation of retrosternal chest pain. Coronary angiography displayed an eccentric stenosis of the proximal left anterior descending coronary artery (LAD; Figure 1 ). Otherwise, the coronary vasculature revealed only minimal irregularities. The LAD was successfully revascularized by primary implantation of a 3.5ϫ12 mm stent. The post-interventional angiogram revealed no residual stenosis. Interestingly, exten-sive myocardial bridging involving the mid-LAD as well
more » ... the mid-LAD as well as a prominent first diagonal branch was observed distal to the lesion (Figure 2, Movie) . This case is remarkable because it exemplifies focal coronary atherosclerosis proximal to myocardial bridging. This phenomenon presumably results from turbulent blood flow and elevated wall stress at vessel sites proximal to myocardial bridging.
doi:10.1161/01.cir.0000061021.27026.dd pmid:12695284 fatcat:zt56g7dy6jhgjglhiqxkkcpixy