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Symptomatic myocardial bridges in children: a case report with review of literature

Published online by Cambridge University Press:  23 June 2011

Jayendra Sharma*
Affiliation:
Division of Pediatric Cardiology, Pediatric Cardiac Surgery, Morgan Stanley Children's Hospital, New York-Presbyterian Medical Center, Columbia University, New York, NY 10032, United States of America
William Hellenbrand
Affiliation:
Division of Pediatric Cardiology, Pediatric Cardiac Surgery, Morgan Stanley Children's Hospital, New York-Presbyterian Medical Center, Columbia University, New York, NY 10032, United States of America
Charles Kleinman
Affiliation:
Division of Pediatric Cardiology, Pediatric Cardiac Surgery, Morgan Stanley Children's Hospital, New York-Presbyterian Medical Center, Columbia University, New York, NY 10032, United States of America
Ralph Mosca
Affiliation:
Department of Pediatrics, Pediatric Cardiac Surgery, Morgan Stanley Children's Hospital, New York-Presbyterian Medical Center, Columbia University, New York, NY 10032, United States of America
*
Correspondence to: Dr J. Sharma, MD, FACC, 45, Wiltshire Road, Scarsdale, NY 10583, United States of America. Tel: +1 718 206 7138; Fax: +1 718 206 7144; E-mail: [email protected]

Abstract

Myocardial bridge is a rare congenital coronary anomaly in children, usually seen in the setting of hypertrophic cardiomyopathy and in left ventricular hypertrophy. Most myocardial bridges are believed to represent a benign anatomical variant; however, symptomatic myocardial bridge is a distinct subgroup of pathological variant, linked to myocardial ischaemia, ventricular arrhythmia, and sudden cardiac death. We present a case of a symptomatic myocardial bridge in a 5-year-old boy with mild hypertrophic cardiomyopathy who underwent supra-arterial myotomy, automatic defibrillator placement, and long-term Beta-blocker therapy. We also present 10 years of follow-up with a review of literature regarding symptomatic myocardial bridges in the paediatric age group.

Type
Review Article
Copyright
Copyright © Cambridge University Press 2011

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References

1.Reyman, HC. Disertatio de vasis cordis propriis. Med Diss Univ Gottingen, 7th September 1737; 1–32.Google Scholar
2.Bourassa, MG, Butriaru, A, Lesperance, J, Tardif, JC. Symptomatic myocardial bridges: overview of ischemic mechanism and current diagnostic and treatment strategies. JACC 2003; 41: 351359.CrossRefGoogle ScholarPubMed
3.Portmann, W, Iwig, J. Die intramurale koronarie im Angiogramm. Fortschr Roentgenstr 1960; 92: 129132.CrossRefGoogle Scholar
4.Grondin, P, Bourassa, MG, Noble, J, Petitclerc, R, Dydra, I. Successful course after supraarterial myotomy for myocardial bridging and milking effect of the left anterior descending artery. Ann Thorac Surg 1977; 24: 422.CrossRefGoogle ScholarPubMed
5.Hillman, ND, Mavroudis, C, Becker, CL, Duffy, CE. Supraarterial decompression myotomy for myocardial bridging in a child. Ann Thorac Surg 1999; 68: 244246.CrossRefGoogle ScholarPubMed
6.Sebening, C, Gorenflo, M, Ulmer, HE, Brockmeier, K. Myocardial bridging of the anterior interventricular coronary artery in setting of hypertrophic cardiomyopathy in children and adolescent. Cardiol Young 2002; 12: 414416.CrossRefGoogle Scholar
7.Downar, J, Williams, WG, McDonald, C, Wigle, ED, McCrindle, BW. Outcomes after “unroofing” of a myocardial bridge of the left anterior descending coronary artery in children with hypertrophic cardiomyopathy. Pedia Cardiol 2004; 25: 390393.CrossRefGoogle ScholarPubMed
8.Daana, M, Wexler, I, Milgalter, E, Rein, A, Perles, Z. Symptomatic myocardial bridging in a child without hypertrophic cardiomyopathy. Pediatrics 2006; 117: 333335.CrossRefGoogle Scholar
9.Mohlenkamp, S, Hort, W, Ge, J, Erbol, R. Update on myocardial bridging. Circulation 2002; 106: 26162622.CrossRefGoogle ScholarPubMed
10.Yetman, AT, McCrindle, BW, MacDonald, C, Freedom, RM, Gow, R. Myocardial bridging in children with hypertrophic cardiomyopathy – a risk factor for sudden cardiac death. N Eng J Med 1998; 339: 12011209.CrossRefGoogle Scholar
11.Mohiddin, SA, Begley, D, Shih, J, Fananapazir, L. Myocardial bridging does not predict sudden death in children with hypertrophic cardiomyopathy but is associated with more severe cardiac disease. JACC 2000; 36: 22702278.CrossRefGoogle Scholar
12.Ferreira, AG Jr, Trotter, SE, Konig, B, Decourt, LV, Fox, K, Olsen, EG. Myocardial bridges: morphological and functional aspects. Br Heart J 1991; 66: 364367.CrossRefGoogle ScholarPubMed
13.Yetman, AT, Hamilton, RM, Benson, LN, McCrindle, BW. Long term outcome and prognostic determinants in children with hypertrophic cardiomyopathy. JACC 1998; 32: 19431950.CrossRefGoogle ScholarPubMed
14.Kursaklioglu, H, Barcin, C, Ivisov, A, Kose, S, Amasyali, B, Isik, E. Angiographic restenosis after myocardial bridge stenting. Jpn Heart J 2004; 45: 581589.CrossRefGoogle ScholarPubMed