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(Circulation. 1997;95:2455.)
© 1997 American Heart Association, Inc.

Myocardial Bridges

Manfred Zehender, MD

Abteilung Innere Medizin III, Klinikum der Albert-Ludwigs Universität, Freiburg, Germany.

Correspondence to Manfred Zehender, MD, Abt. Innere Medizin III, Klinikum Der Albert-Ludwigs Universität, Hugstetterstr. 55, D-7800 Freiburg, Germany.

	Introduction

 
In a 36-year old long-distance runner with a history of palpitations and presyncope, an episode of sudden cardiac death occurred during competitive mountain racing. Endless-loop Holter monitoring (A) demonstrated rare episodes of nonsustained ventricular tachycardia, an episode of acceleration, and finally spontaneously terminating ventricular tachycardia followed by marked ST-segment alteration. Coronary angiography (B and C) excluded coronary artery disease but demonstrated a tunneled epicardial coronary artery (myocardial bridges) (C, arrows).

View larger version (46K): [in this window] [in a new window]   Figure 1.

View larger version (112K): [in this window] [in a new window]   Figure 2.

View larger version (100K): [in this window] [in a new window]   Figure 3.

	Footnotes

 
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner, MC 4-265, Houston, TX 77030.