Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0151744 (myocardial ischemia)
 31,282 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Myocardial bridging causes myocardial ischemia during supraventricular tachycardia. We present a case of Wolff-Parkinson-White syndrome combined with myocardial bridging. The patient complained of angina pectoris during paroxysmal supraventricular tachycardia because of severe constriction of the left anterior descending coronary artery during systole. A myocardial scintigram revealed myocardial ischemia in the anteroseptal wall during paroxysmal supraventricular tachycardia. Myotomy to prevent myocardial bridging and interruption of the accessory conduction pathway was successfully accomplished in a one-stage operation.
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PMID:Surgical repair of Wolff-Parkinson-White syndrome complicated with myocardial bridging. 198 50

Myocardial bridging and systolic milking may be involved in myocardial ischemia, myocardial infarction, and sudden death. We describe a patient whose milking effect progressed significantly over a two-year period. We conclude that bridging and milking effect can progress over a relatively short period. In those patients with prior reports of insignificant bridging and milking on coronary arteriograms and continued angina-like chest pain, a repeated catheterization may be warranted.
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PMID:Progression of the milking effect of the coronary artery. 722 15

Myocardial bridging is an uncommon condition where a major coronary artery is bridged by a band of muscle and narrows during systole, particularly during rapid heart rates. We present a patient with typical angina and angiographically proven 60% systolic bridging of the left anterior descending artery distal to the first perforator. Postexercise SPECT 201TI scanning demonstrated a severe reduction of perfusion to the septum and a moderate reduction of perfusion to the anterior wall of the left ventricle. Redistribution images demonstrated good reversibility of the perfusion defects indicating reversible myocardial ischemia. This case provides additional supportive evidence that myocardial bridging may cause myocardial ischemia.
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PMID:Thallium-201 myocardial SPECT in myocardial bridging. 776 22

We report here a case of a patient who underwent percutaneous intervention to the left anterior descending artery, complicated by thrombus formation within the myocardial bridge distal to the lesion. There was complete angiographic resolution of thrombus and restoration of the normal antegrade blood flow after infusion of glycoprotein IIb/IIIa antagonist (abciximab). Our observation may suggest that the presence of myocardial bridging distal to coronary lesions should be considered seriously in preprocedural evaluation of the lesions as a potential risk factor for intracoronary thrombus formation. The main coronary arteries and the proximal segments of their major branches lie free on the epicardial surface of the heart. However, in some instances these vessels may penetrate into the muscle being surrounded by the myocardium, with the overlying muscle referred to as a "bridge". Myocardial bridging appears to be a congenital anomaly, due to failure of exteriorization of the primitive coronary intratrabecular arterial network. It occurs in 5-86% of patients in autopsy studies, and it is observed as systolic coronary artery narrowing in 0.5-12% of patients undergoing coronary arteriography. Although the gross anatomist had long recognized that the epicardial coronary artery might on occasion course directly through a segment of cardiac muscle, the physiological significance of this phenomenon was considered benign. This is partly because traditional teaching concerning coronary blood flow delivery to the left ventricular myocardium emphasized the primacy of the diastolic phase of the cardiac cycle. However, myocardial bridging is not always a benign finding, with recent reports suggesting an association with myocardial ischemia, infarction, vasospasm, cardiac arrythmias, and sudden death.
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PMID:Stent procedure complicated by thrombus formation distal to the lesion within a muscle bridge. 947 97

Myocardial bridging is a congenital anomaly of the left anterior descending coronary artery (LAD), which is associated with myocardial ischemia and infarction, cardiac arrhythmias, and sudden cardiac death. Two cases are reported of symptomatic myocardial bridging refractory to medical management treated by minimally invasive coronary artery bypass grafting without cardiopulmonary bypass. We conclude that minimally invasive coronary artery bypass techniques are appropriate alternatives to endovascular stent placement, muscle bridge division, or aortocoronary grafting with cardiopulmonary bypass for the management of symptomatic myocardial bridging.
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PMID:Minimally invasive coronary artery bypass grafting for myocardial muscle bridging. 1127 86

Myocardial bridging (MB) of coronary arteries has been considered as an incidental angio-graphic finding; however, several reports suggest its association with angina pectoris, myocardial ischemia, and even infarction. In this study the authors aimed to assess exercise-induced QRS changes in patients with isolated MB and to compare those with coronary artery disease (CAD) and healthy subjects. The study population consisted of 17 patients with angiographically proven MB (group 1), 16 patients with left anterior descending (LAD) artery stenosis (group 2), and 14 healthy subjects (group 3). Each subject underwent treadmill exercise testing according to Bruce protocol. In each subject amplitude of the Q, R, and S waves in leads aVF and V(5) was measured manually before and immediately after exercise. The Athens QRS score was calculated by subtracting the Q-, R-, and S-wave differences in leads aVF and V(5). Baseline characteristics of each group were similar. There was no difference among the groups with respect to exercise testing parameters (peak heart rate, blood pressure, test duration, etc). In group 1, ST-segment depression ratio was found to be higher than that of group 3 but lower than that of group 2. In group 1, exercise QRS score was found to be lower than that of group 3 while it was higher than that of group 2 (2.9 +/- 2.3 vs 6.5 +/- 3.2 p = 0.001 and 2.9 +/- 2.3 vs 2.6 +/- 2.4 p = 0.001, respectively). In patients with MB exercise, QRS score was significantly lower than in those with normal coronary flow while it was higher in those with CAD. This may result from exercise-induced ischemia at the area perfused by the bridged artery.
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PMID:Exercise-induced QRS amplitude changes in patients with isolated myocardial bridging: a marker of myocardial ischemia. 1588 93

Myocardial bridging is a common congenital coronary abnormality recognized primarily with systolic narrowing or 'milking effect' shown by coronary angiography. We report the case of a 58-year-old man with signs and symptoms of myocardial ischemia who underwent transthoracic echocardiography and coronary angiography. The present case suggests the clinical role of transthoracic echocardiography in demonstrating characteristic coronary flow abnormalities in patients with muscular bridge in the region of the mid LAD.
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PMID:Noninvasive assessment of myocardial bridging in the left coronary artery by transthoracic Doppler echocardiography. 1660 14

Myocardial bridging of a coronary artery is an anatomic anomaly in which a major epicardial coronary artery extends intramurally into the myocardium for a part of the vessel's course. The left anterior descending coronary artery (LAD) is most frequently involved. Myocardial bridging is often asymptomatic, although myocardial pathology, arrhythmias and sudden cardiac death have been reported. In this study we quantitated the degree of myocardial intersitial fibrosis in histological sections of the anterior wall of the left ventricle obtained from the hearts of 6 individuals with myocardial bridging of the LAD and compared it to age-, weight-, and sex-matched controls without bridging. We found that patients with the bridging of the LAD had 33% increased myocardial interstitial fibrosis as compared to the control group (P=0.0006). Our data suggest that myocardial bridging may be an independent risk factor for development of myocardial ischemia and interstitial fibrosis.
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PMID:Myocardial bridging of coronary arteries: A risk factor for myocardial fibrosis? 1872 80

Myocardial bridging is a congenital variation that may lead to angina, myocardial ischemia, and even sudden death. We report the use of magnetic resonance imaging first-pass myocardial perfusion in evaluation of hemodynamic effects of myocardial bridging in a symptomatic case.
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PMID:Magnetic resonance imaging first-pass myocardial perfusion in evaluation of hemodynamic effects of myocardial bridging. 1837 16

Myocardial bridging is a congenital anomaly in which a segment of a coronary artery runs intramuscularly. Although traditionally considered as a benign condition, myocardial bridging may be associated with clinically important complications such as myocardial ischemia, acute coronary syndromes and sudden death. We report the case of a highly symptomatic 36 years old patient with a myocardial bridge in left anterior descending coronary artery in which surgical treatment was proposed. Previous to surgery a non invasive coronariography with cardiac CT was practised in order to define the anatomy.
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PMID:Myocardial bridging: light in the tunnel. 1946 62


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