Variant angina associated with coronary artery endothelial dysfunction and myocardial bridge: a case report and review of the literature.

Abstract

The association of variant angina (VA) and myocardial bridges is a rare finding. We describe a case of VA with recurrent coronary spasm triggered by different stimuli at the site of a myocardial bridge. The interplay of endothelial dysfunction, coronary vasoconstriction and myocardial bridging was detected by intracoronary acetylcholine test and IVUS. We speculate that mechanical stimulation at the bridge site caused endothelial dysfunction and enhanced local susceptibility to vasoconstrictor stimuli. Variant angina should always be suspected in cases of ST-elevation acute coronary syndrome without any significant angiographic coronary stenosis.

• Authors: Federico Nardi, Edoardo Verna, Gioel Gabrio Secco, Andrea Rognoni, Angelo Sante Bongo, Gabriele Iraghi, Stefano Bertuol, Alessandro Lupi
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 50 Issue 21 Pg. 2601-6 ( 2011) ISSN: 1349-7235 [Electronic] Japan
• PMID: 22041365 (Publication Type: Case Reports, Journal Article, Review)

Topics

• Adult
• Angina Pectoris, Variant (complications, diagnosis, physiopathology)
• Coronary Vessels (pathology)
• Endothelium, Vascular (pathology)
• Humans
• Male
• Myocardial Bridging (complications, diagnosis, physiopathology)