Case report on surgical deroofing of left anterior descending artery in middle aged symptomatic patient and literature review

Abstract

Background: Myocardial bridging, previously considered benign, has been associated with cardiovascular complications. We present a case of severe left anterior descending (LAD) bridging in a 40-year-old male with refractory chest pain.

Case Presentation: The patient experienced atypical chest pain despite treatment with antihypertensive medication. Invasive coronary angiography revealed severe LAD bridging. Surgical deroofing of the LAD was performed, resulting in complete resolution of symptoms.

Management & Results: Diagnostic modalities such as angiography and computed tomography angiography (CTA) aid in detecting myocardial bridging. Medical therapy involving beta blockers and calcium channel blockers is the first-line approach. Surgical intervention may be considered in refractory cases. Successful deroofing of the LAD in our patient resulted in symptom resolution.

Conclusion: Myocardial bridging should be considered as a potential cause of chest pain, and surgical intervention can be effective in relieving symptoms. Further research is needed to optimize diagnostic strategies and treatment approaches for myocardial bridging.