Increased use of beta-agonists leading to non-ST-segment elevation myocardial infarction in a patient with hemodynamically significant myocardial bridging.
Myocardial bridging is not uncommon. However, hemodynamic instability in the setting of myocardial bridging is rare. We describe an unusual case of a 47-year-old woman whose increased use of inhaled albuterol led to a non-ST-segment elevation myocardial infarction and unmasking of hemodynamically significant myocardial bridging. We detail its diagnosis through myocardial perfusion imaging and coronary angiography. To our knowledge, this is the first time previously undiagnosed myocardial bridging has led to a myocardial infarction in the setting of inhaled albuterol use.
Gold
Daniel R
DR
Department of Internal Medicine, Division of Cardiology, North Shore University Hospital, Manhasset, NY, USA. dgold@nshs.edu
Zolli
Janet R
JR
Makaryus
Amgad N
AN
D000318:Adrenergic beta-Agonists / Q000009:adverse effects*; D000420:Albuterol / Q000009:adverse effects*; D001249:Asthma / Q000188:drug therapy; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000601:surgery; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000139:chemically induced* / Q000175:diagnosis; D015899:Tomography, Emission-Computed, Single-Photon
D000318:Adrenergic beta-Agonists; D000420:Albuterol