RESULTS: On admission in our Department, the exercise cyclo ergometer test was significant for > 3 mm ST segment depression in the anterior and lateral leads (V3, V4, V5, V6) associated with
chest pain. The coronary angiography revealed a 40%
stenosis of the distal tract of the right coronary artery (RCA), a 30%
stenosis of the proximal tract of the left anterior descending artery (LAD) and 40% of the proximal tract of the first diagonal branch. A 30%
stenosis in the middle tract of the left circumflex coronary artery (LCX) was then detected. A marked systolic localized narrowing (90%) on the middle tract of the LAD, after the second diagonal branch (a myocardial bridge) was also detected. After eight months, the exercise cyclo ergometer test using a standard Bruce protocol was normal and, after sixteen months, no significant
coronary artery disease (< 50%) and no
myocardial bridging were detected by the coronary 64-multislice spiral computed tomography. Two years later, the patient was readmitted to our Department because of angina-like
chest pain during light exertion in the last two months. The coronary angiography of the right system revealed a 30%
stenosis of the proximal tract and a 50%
stenosis of the distal tract of the RCA. The coronary angiography of the left system showed a 30%
stenosis of the proximal tract of the LAD and 85% of the middle tract of the first diagonal branch. A 40%
stenosis in the middle tract of the left circumflex coronary artery (LCX) was then detected. No MB of the middle tract of the LAD was detected, and a bare
metal stent (Presillion 2.5 x 12 mm) was deployed in the middle tract of the first diagonal branch.
CONCLUSIONS: