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Angina Pectoris Due to Severe Muscular Bridge in Hypertrophic Cardiomyopathy

M ah Topcuolu, MD, Ayhan Usal, MD¹, Cem Kayhan, MD, Aladdin Pekedis, MD, Acar Tokcan, MD, Abdi Bozkurt, MD¹, Mehmet Kanadasi, MD¹, Tümer Ulus, MD

Department of Cardiovascular Surgery 1 Department of Cardiology Cukurova University School of Medicine Adana, Turkey

For reprint information contact: M ah Topcuolu, MD Department of Cardiovascular Surgery Cukurova University School of Medicine Balcali, Adana 01330, Turkey Tel: 90 322 338 6627 Fax: 90 322 338 6656 Email: sahtopcu{at}pamuk.cc.cu.edu.tr

We report the case of a 39-year-old male with hypertrophic cardiomyopathy who complained of angina pectoris. The patient was treated with a beta blocker and a calcium antagonist without effect. Myocardial scintigraphy revealed anterior ischemia. Cardiac catheterization and ventriculography revealed severe systolic narrowing of the left anterior descending coronary artery and no significant pressure gradient across the left ventricular outflow tract. Myotomy was performed on a muscular bridge over the left anterior descending coronary artery and the patient's angina was relieved. In young patients with hypertrophic cardiomyopathy who develop angina refractory to medical therapy, a coexisting muscular bridge should be sought.