Resumen

PENA OLIVA, Sándor; GOIRE GUEVARA, Geordan  y  SALAS FABRE, Abel. Long myocardial bridging in the left anterior descending artery causing acute coronary syndrome. CorSalud [online]. 2020, vol.12, n.2, pp. 227-231.  Epub 01-Jun-2020. ISSN 2078-7170.

Coronary arteries usually run along the outer surface of the heart. In some cases, small segments of them take a "tunneled" intramuscular course forming the so-called myocardial bridging. This anatomical feature may lead to a sudden systolic narrowing of the "tunneled" segment (milking effect), thereby impairing coronary blood flow in both systole and diastole; which further reduces coronary reserve. Myocardial bridging mainly affects the middle-distal segments of left anterior descending (LAD) artery and may cause anything from chest pain to sudden death. So far, it seems that the use of beta-blockers and anti-calcium agents is the most effective therapeutic option for symptomatic cases. We now report a case where the clinical presentation of this anatomical feature was an acute coronary syndrome. Timely, accurate angiographic diagnosis allowed for adequate therapeutic adjustments to improve the patient's symptomatology

Palabras clave : Myocardial bridging; Intramyocardial course of coronary artery; Milking; Acute coronary syndrome.

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