<- Home <- Arhive <- Vol. 29, Issue 3, September 2021



Rom J Leg Med29(3)278-281(2021)
DOI:10.4323/rjlm.2021.278
© Romanian Society of Legal Medicine


MYOCARDIAL BRIDGE, A “FORGOTTEN” CAUSE OF CARDIAC DEATH - CASE REPORT AND REVIEW OF THE LITERATURE

D. Butcovan, V. Scripcaru, A. Scripcaru, G. Tinica


Abstract: Background. The muscular bridge is a congenital anomaly in which a segment of the coronary artery has an intramuscular pathway under a “myocardial bridge”.
Case presentation. We report here a case of rare heart disease with three myocardial bridges that affect the three major coronary arteries, in a 44-year-old man, known with benign hypertension, who presented with retrosternal, temporary and repetitive chest pain. Death occurred by cardiorespiratory arrest refractory to treatment. The diagnosis of myocardial bridge was set on necropsy by microscopic examination of the heart, which showed patent epicardial coronary arteries without atherosclerotic lesions and the presence of superficial and deep intramyocardial routes. Intramyocardial arterioles, with irregular thickened walls and intraluminal thrombi, were also present. Also, myocardial cells presented chronic and ischemic lesions.
Conclusions. This case illustrates a very rare cause of myocardial infarction in a young patient with unobstructed coronary arteries. Potential causes of acute myocardial infarction, MINOCA type (coronary artery spasm, microvascular causes, etc.) support the diagnosis of histologically confirmed acute myocardial ischemia.
Keywords: myocardial bridges, congenital anomaly, heart disease, cardiac death



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