An interesting case of Myocardial Bridging in a 71 yr old
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Myocardial bridging (MB) is an anomaly in which the myocardium overlies the intramural course of segments of the epicardial coronary arteries. The frequency of MB ranges from 5.4% to 85% in autopsy series and from 0.5% to 29.4% on coronary angiography. It has been accepted that MB might affect the cardiovascular system. In addition, the presence of MB is associated with myocardial infarction[14-17] and sudden cardiac death. Myocardial ischemia due to compression of the coronary artery by MB and/or coronary spasm at the MB segments has been considered a major factor responsible for MB-related cardiac events. In this study, we report a case of angina pectoris at both rest and during exercise due to both coronary spasm and MB-related myocardial ischemia, which was documented using a pressure wire.

Case Report:
A 71-year-old male had felt chest oppression on effort, such as when carrying heavy baggage, for 1 year. Recently, his chest symptoms had occurred more frequently. One month before admission he felt chest squeezing at rest in the early morning. He presented at our institution for an evaluation of his chest symptoms in May 2014. Coronary risk factors such as smoking, hypertension, and diabetes mellitus were all absent, although he had a low level of high-density lipoprotein (HDL) cholesterol. His mother had angina pectoris. He had undergone operations for appendicitis and prostate cancer at the ages of 25 and 69 years, respectively.....