Long-term prognosis of patients with myocardial bridge and angiographic milking of the left anterior descending coronary artery

  • I. L
  • J.A. B
  • R. L
  • et al.
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Abstract

Introduction. Myocardial bridging with systolic compression (milking) of the left anterior descending coronary artery may be associated with myocardial ischemia. Little information is available about the long-term prognosis of patients with this coronary anomaly. Material and methods. A review was made of coronary angiographies of patients diagnosed as ischemic heart disease made between 1994 and 1999 in two centers. The long-term follow-up of patients with myocardial bridging and systolic compression of the left anterior descending coronary artery was analyzed. Data were collected by reviewing medical records and completed by telephone interview. Results. Prevalence: 0.72%. Milking was observed in 60 patients, but 25 of them were excluded due to associated hypertrophic cardiomyopathy, severe valvular disease, or coronary artery disease. The clinical follow-up was available for all patients (median: 43 months, range: 12-80 months). Mean age 55.7 years (SD = 11.9). Men 74%. Clinical presentation: angina 26 patients, atypical chest pain with positive non-invasive test 8, acute myocardial infarction 1. During follow-up, 1 patient died of sudden cardiac death. Seven patients continued to present stable angina CCS class I-II, coronary angiography was repeated in 5 patients, and one required percutaneous revascularization for symptoms. In 63% of cases, antianginal drugs were still needed at the end of follow-up period (beta-blockers or calcium antagonists). Conclusions. Patients with myocardial bridging and systolic compression of the left anterior descending artery have a good long-term prognosis, although more than half of them continue regular treatment with antianginal drugs. In a small percentage of cases percutaneous intervention must be performed and ischemic heart disease may appear in more aggressive forms (acute myocardial infarction or sudden death).

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I., L., J.A., B., R., L. P., E., P., F., P., M., V., … J.L., M. U. (2002). Long-term prognosis of patients with myocardial bridge and angiographic milking of the left anterior descending coronary artery. Revista Espanola de Cardiologia, 55(4), 359–364. Retrieved from http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed5&NEWS=N&AN=2002192183

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