Abstract
A 28-year-old man without coronary risk factors was admitted to the hospital with
acute coronary syndromes (ACS). The angiogram and intravascular ultrasound revealed
myocardial bridge (MB) in the mid-left anterior descending artery and flow-limiting
plaque located 15.4 mm proximal to MB. The culprit lesion was treated only with drug-coated
balloon, considering the patient’s extremely young age. This case suggests that an
accelerated formation of plaque caused by MB appeared to contribute to the development
of ACS; thus, MB should be considered as an important cause of ACS in young patients
with low cardiovascular risk.
Résumé
Un homme âgé de 28 ans ne présentant aucun facteur de risque coronarien a été hospitalisé
pour un syndrome coronarien aigu (SCA). L’angiogramme et l’échographie intravasculaire
ont révélé la présence d’un pont myocardique (PM) dans la partie médiane de la branche
descendante antérieure de l’artère coronaire gauche, ainsi qu’une plaque réduisant
le flux sanguin située à 15,4 mm en amont du PM. Compte tenu de l’âge extrêmement
jeune du patient, la lésion en cause a été traitée uniquement par l’insertion d’un
ballonnet imprégné de médicament. Ce cas donne à penser que la formation accélérée
d’une plaque causée par le PM pourrait contribuer à l’apparition d’un SCA. Par conséquent,
le PM devrait être considéré comme une cause importante du SCA chez les jeunes patients
présentant un faible risque de maladie cardiovasculaire.
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References
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- Update on myocardial bridging.Circulation. 2002; 106: 2616-2622
- Myocardial bridge and acute plaque rupture.J Investig Med High Impact Case Rep. 2016; 4 (2324709616680227)
- Functional versus anatomic assessment of myocardial bridging by intravascular ultrasound: impact of arterial compression on proximal atherosclerotic plaque.J Am Heart Assoc. 2016; 5e001735
- Clinical value of drug-coated balloon angioplasty for de novo lesions in patients with coronary artery disease.Int J Cardiol. 2016; 222: 113-118
Article info
Publication history
Published online: August 20, 2018
Accepted:
August 12,
2018
Received:
June 7,
2018
Footnotes
See page 1687.e15 for disclosure information.
Identification
Copyright
© 2018 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
