EXTENSIVE ANTERIOR MYOCARDIAL INFARCTION AND VENTRICULAR SEPTAL RUPTURE CAUSED BY MYOCARDIAL BRIDGE

Abstract

A 45-year-old man was referred to our hospital for angina pectoris 2 days after an anterolateral myocardial infarction. On admission, he had a blood pressure of 100/70 mm Hg and holosystolic murmur at the left sternal border. Transthoracic echocardiography showed akinesia in the apicoseptal, apicoinferior, and apicoposterior regions of the left ventricle, with large apical aneurysm and clot. There was also a large apical ventricular septal defect (VSD) with a significant left-to-right shunt. During cardiac catheterization, the only abnormality found beside the VSD was myocardial bridging in the mid part of the left anterior descending coronary artery and ostial lesion in the first diagonal artery. The patient was scheduled for bypass surgery and VSD closure.