Key result
Coronary angiography reveals a PDA myocardial bridge in a 60-year-old female with apical HCM.
Why the study?
When obstructive coronary disease is excluded in apical hypertrophic cardiomyopathy presenting with chest pain, myocardial bridging remains an important consideration.
Case Report (n=1)
In patients with apical hypertrophic cardiomyopathy and angina-like symptoms without obstructive coronary disease, evaluation for myocardial bridging should be considered.
Consider myocardial bridging in apical HCM with chest pain after CAD exclusion; case extends sparse reports but leaves open prospective validation.
Chest pain with apical hypertrophic cardiomyopathy (HCM) warrants concern for acute coronary syndrome (ACS). When obstructive coronary disease is excluded, myocardial bridging should remain an important consideration. We report a 60-year-old female with apical HCM and multiple prior evaluations for a mix of typical and atypical chest pain who presented with worsening dyspnea on exertion and stable intermittent chest pain. Coronary angiography revealed a myocardial bridge involving the posterior descending artery (PDA). Given the increased prevalence of myocardial bridging in the HCM population and its association with increased risk of myocardial ischemia, workup for angina-like symptoms should incorporate evaluation for a myocardial bridge.
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Shah et al. (2026) conducted a case report in Apical hypertrophic cardiomyopathy with myocardial bridging (n=1). Myocardial bridging of the posterior descending artery was evaluated on Diagnosis of myocardial bridge. Coronary angiography in a 60-year-old female with apical hypertrophic cardiomyopathy and chest pain revealed a myocardial bridge involving the posterior descending artery.
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