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(Circulation. 2002;105:130.)
© 2002 American Heart Association, Inc.

Images in Cardiovascular Medicine

Coronary Thrombosis and Myocardial Bridging

Christophe Bauters, MD; Akram Chmait, MD; Olivier Tricot, MD; Nicolas Lamblin, MD; Eric Van Belle, MD; Jean Marc Lablanche, MD

From the Hôpital Cardiologique, CHRU de Lille, France.

Correspondence to Christophe Bauters, Service de Cardiologie C, Hôpital Cardiologique, CHRU de Lille, 59037 Lille Cedex, France. E-mailcbauters@chru-lille.fr

A 28-year-old man presented with heavy chest pain that had lasted for 4 hours. Previously, he had been healthy, and he had no risk factors for coronary artery disease. Physical examination was unremarkable. The ECG showed an anterior myocardial infarction. Recombinant tissue plasminogen activator, heparin, and aspirin were administered, and the patient was referred to our center for emergency coronary angiography. A large intraluminal filling defect was observed in the left anterior descending artery (LAD) (Figures 1A and 1B), which was suggestive of an extensive intracoronary thrombus. Other coronary arteries appeared normal. The patient received abciximab therapy for 24 hours and enoxaparin for 10 days; he was then discharged on aspirin (160 mg daily) and clopidogrel (75 mg daily).

View larger version (165K): [in this window] [in a new window]   Figure 1. A and B, Emergency angiography showing large thrombus in the LAD. C and D, Control angiography at 3 months showing complete disappearance of the filling defect.

At 3 months, the patient was asymptomatic; systematic control angiography showed complete disappearance of the thrombus (Figures 1C and 1D), with no residual stenosis. The LAD was widely patent, with a typical image of myocardial bridging (Figure 2).

View larger version (88K): [in this window] [in a new window]   Figure 2. Myocardial bridging of the left anterior descending artery (arrows) in diastole (A) and systole (B).

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