Rahul Choudhary^1,, Dinesh Gautam¹, Rajeev Bagarhatta¹, Vijay Pathak¹

The myocardial bridge (MB) is an anomaly of the coronary arteries that usually affect the left anterior descending artery (LAD). It mainly affect middle aged patients at low risk for CAD, but can manifest as unstable or stable angina, AMI and sudden death, with the latter two being rare. We report a case of 40 year-old-man, who presented with complaint of severe crushing chest pain associated with sweating and nausea just half hour after blood donation. The electrocardiography (ECG) was consistent with an acute infero-lateral myocardial infarction. Coronary angiography revealed substantial myocardial bridging in the 2nd posterolateral branch and some degree of bridging in the 1st posterolateral branch. An empirical diagnosis of symptomatic myocardial bridging with superimposed coronary vasospasm, probably precipitated by autonomic disturbance after blood donation, was made and patient discharged on oral β-blocker therapy. Although association of AMI after blood donation in a patient having myocardial bridge involving left anterior descending artery is reported, there is no reported case of such co-occurrence with right coronary artery myocardial bridge.

myocardial bridge, myocardial infarction, right coronary artery, coronary angiography, β-blocker