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Myocardial Bridging Leading to Cardiac Collapse in a Marathon Runner

Myocardial bridging (MB) is a congenital coronary anomaly, which is defined as cardiac muscle overlying a portion of a coronary artery. Although traditionally considered benign in nature, increasing attention is being given to specific subsets of MB. Sports medicine recognizes MB as a cause of sudde...

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Autores principales: Alexandre, André, Vieira, Pinheiro, Dias-Frias, André, Pereira, Anaisa, Campinas, Andreia, Sá-Couto, David, Brochado, Bruno, Sá, Isabel, Silveira, João, Torres, Severo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9317123/
https://www.ncbi.nlm.nih.gov/pubmed/35877561
http://dx.doi.org/10.3390/jcdd9070200
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author Alexandre, André
Vieira, Pinheiro
Dias-Frias, André
Pereira, Anaisa
Campinas, Andreia
Sá-Couto, David
Brochado, Bruno
Sá, Isabel
Silveira, João
Torres, Severo
author_facet Alexandre, André
Vieira, Pinheiro
Dias-Frias, André
Pereira, Anaisa
Campinas, Andreia
Sá-Couto, David
Brochado, Bruno
Sá, Isabel
Silveira, João
Torres, Severo
author_sort Alexandre, André
collection PubMed
description Myocardial bridging (MB) is a congenital coronary anomaly, which is defined as cardiac muscle overlying a portion of a coronary artery. Although traditionally considered benign in nature, increasing attention is being given to specific subsets of MB. Sports medicine recognizes MB as a cause of sudden death among young athletes. We present a case of a 30-year-old man who suddenly collapsed during a marathon running. Diagnostic workup with coronary computed tomography angiography revealed the presence of three simultaneous myocardial bridges in this patient, possibly explaining the exercise-induced syncope. The other diagnostic tests excluded seizures, cranioencephalic lesions, ionic or metabolic disturbances, acute coronary syndromes, cardiomyopathies, myocarditis, or conduction disturbances. Exertional syncope is a high-risk complaint in the marathon runner. In the context of intense physical activity, the increased sympathetic tone leading to tachycardia and increased myocardial contractility facilitates MB ischemia. In this illustrative case, the patient’s syncope might probably be associated with an ischemia-induced arrhythmia secondary to MB and potentiated by dehydration in the context of prolonged stress (marathon running). In conclusion, this case highlights that MB may be associated with dangerous complications (myocardial ischemia and life-threatening ventricular arrhythmias), particularly during intense physical activity and in the presence of a long myocardial bridge.
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spelling pubmed-93171232022-07-27 Myocardial Bridging Leading to Cardiac Collapse in a Marathon Runner Alexandre, André Vieira, Pinheiro Dias-Frias, André Pereira, Anaisa Campinas, Andreia Sá-Couto, David Brochado, Bruno Sá, Isabel Silveira, João Torres, Severo J Cardiovasc Dev Dis Case Report Myocardial bridging (MB) is a congenital coronary anomaly, which is defined as cardiac muscle overlying a portion of a coronary artery. Although traditionally considered benign in nature, increasing attention is being given to specific subsets of MB. Sports medicine recognizes MB as a cause of sudden death among young athletes. We present a case of a 30-year-old man who suddenly collapsed during a marathon running. Diagnostic workup with coronary computed tomography angiography revealed the presence of three simultaneous myocardial bridges in this patient, possibly explaining the exercise-induced syncope. The other diagnostic tests excluded seizures, cranioencephalic lesions, ionic or metabolic disturbances, acute coronary syndromes, cardiomyopathies, myocarditis, or conduction disturbances. Exertional syncope is a high-risk complaint in the marathon runner. In the context of intense physical activity, the increased sympathetic tone leading to tachycardia and increased myocardial contractility facilitates MB ischemia. In this illustrative case, the patient’s syncope might probably be associated with an ischemia-induced arrhythmia secondary to MB and potentiated by dehydration in the context of prolonged stress (marathon running). In conclusion, this case highlights that MB may be associated with dangerous complications (myocardial ischemia and life-threatening ventricular arrhythmias), particularly during intense physical activity and in the presence of a long myocardial bridge. MDPI 2022-06-24 /pmc/articles/PMC9317123/ /pubmed/35877561 http://dx.doi.org/10.3390/jcdd9070200 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Alexandre, André
Vieira, Pinheiro
Dias-Frias, André
Pereira, Anaisa
Campinas, Andreia
Sá-Couto, David
Brochado, Bruno
Sá, Isabel
Silveira, João
Torres, Severo
Myocardial Bridging Leading to Cardiac Collapse in a Marathon Runner
title Myocardial Bridging Leading to Cardiac Collapse in a Marathon Runner
title_full Myocardial Bridging Leading to Cardiac Collapse in a Marathon Runner
title_fullStr Myocardial Bridging Leading to Cardiac Collapse in a Marathon Runner
title_full_unstemmed Myocardial Bridging Leading to Cardiac Collapse in a Marathon Runner
title_short Myocardial Bridging Leading to Cardiac Collapse in a Marathon Runner
title_sort myocardial bridging leading to cardiac collapse in a marathon runner
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9317123/
https://www.ncbi.nlm.nih.gov/pubmed/35877561
http://dx.doi.org/10.3390/jcdd9070200
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