A case of myocardial bridging as a rare cause of chest pain in children.
Asymptomatic myocardial bridging is a frequently seen pathology in adult patients, often in association with hypertrophic cardiomyopathy. Left anterior descending coronary artery is mostly affected. We report on a 14-year-old boy with repeated angina-like pain, disturbances of repolarization in the ECG and elevated values for Troponin T. After exclusion of a myocarditis in the MRI, myocardial bridging was detectable in coronary angiography and confirmed by myocardial perfusion imaging with 430 MBq (99m)Tc-Tetrofosmin at rest and under physical stress. After surgical myotomy, improvement of the cardiac symptoms could be noted and myocardial perfusion imaging studies at rest and under stress demonstrated reversal of the myocardial ischemia. Myocardial bridging is a rare and important differential diagnosis for angina-like pain in childhood without hypertrophic cardiomyopathy.
Department of Pediatric Cardiology, Saarland University Medical Center, Kirrberger Str., 66421, Homburg/Saar, Germany. martin.poryo@uks.eu.
Martin
M
Poryo
Department of Nuclear Medicine, Saarland University Medical Center, Homburg/Saar, Germany.
Fadi
F
Khreish
Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg/Saar, Germany.
Hans-Joachim
HJ
Schäfers
Department of Pediatric Cardiology, Saarland University Medical Center, Kirrberger Str., 66421, Homburg/Saar, Germany.
Hashim
H
Abdul-Khaliq
D000293:Adolescent; D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000209:etiology*; D017023:Coronary Angiography; D003326:Coronary Circulation; D003937:Diagnosis, Differential; D004562:Electrocardiography; D006801:Humans; D008297:Male; D054084:Myocardial Bridging / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D055414:Myocardial Perfusion Imaging; D011237:Predictive Value of Tests; D016896:Treatment Outcome
Angina; Hypertrophic cardiomyopathy; Myocardial bridging; Myocardial perfusion imaging