Myocardial CT perfusion imaging for pre- and postoperative evaluation of myocardial ischemia in a patient with myocardial bridging: A case report

RATIONALE: Although myocardial bridging (MB) is usually considered as benign, initial medical therapy and following surgical treatment in drug-refractory cases has been widely accepted for managing symptomatic MB. Before the patient proceeds to percutaneous or surgical intervention, however, the presence of objective ischemia in the corresponding myocardial territory should be documented. PATIENT CONCERN AND INTERVENTION: We herein report a 43-year-old male complaining of chest pain in whom cardiac CT with myocardial perfusion (cCTP) showed an MB of left anterior descending artery (LAD) with preoperative perfusion defect in corresponding myocardium and normalization of perfusion after supra-arterial myotomy. DIAGNOSIS: Myocardial bridging-induced ischemia. LESSONS: This case illustrates the potential utility of cCTP for the simultaneous assessment of MB and its hemodynamic significance for treatment planning and post-therapeutic evaluation although further research is needed to establish the clinical usefulness of this technique.