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From the Department of Cardiology, PitibSalphri2re University Hospital Paris, France A 74-year-old female presented with unstable angina pectoris and dyspnea. The T waves were inverted in leads V3 -v6. There was no enzymatic evidence of myocardial infarction. Left ventricular hypertrophy with normal left ventricular systolic function were seen with echocardiography.Coronary angiography of the left anterior descending coronary artery showed a 50% diameter stenosis in the proximal segment followed by a long myocardial bridge (Fig. I). A 3.5- X 34-mm XT stent (C.R. Bard Inc., Murray Hill, NJ, USA) was deployed at 14 atm to cover the entire length of the proximal intermediate stenosis and the myocardial bridge (Fig. 2). The procedure was uneventful and the patient was discharged 2 days later. On 3-three month follow-up, she had no angina pectoris, the electrocardiogram was normal, and a submaximal stress test showed no evidence of ischemia. Discussion Myocardial bridging not only produces a characteristic systolic compression of the bridge segment, but also delays diastolic relaxation; in most cases a persistent diastolic diameter of approximately 35% remains.' Intracoronary Doppler velocimetry shows retrograde systolic flow and increased diastolic blood velocity with a protodiastolic flow velocity overshoot due to the decreased filling of
Journal of Interventional Cardiology – Wiley
Published: Oct 1, 1999
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