Key result
A man in his early 50s with median arcuate ligament syndrome presented with recurrent myocardial infarction and ultimately succumbed to sudden cardiac death after opting for conservative treatment.
Case Report (n=1)
Median arcuate ligament syndrome can present atypically with recurrent myocardial infarction, potentially due to linked intestinal and cardiac ischemia.
Suggests cardiac risk in median arcuate ligament syndrome; case report leaves open whether intervention prevents events.
Median arcuate ligament (MAL) syndrome, otherwise known as celiac artery compression syndrome, is rare and is characterized by celiac artery compression by the median arcuate ligament. We report a unique case of MAL syndrome with recurrent myocardial infarction as the primary manifestation, and offer new pathophysiological insights. A man in his early 50s experienced recurrent upper abdominal pain, electrocardiographic changes, and elevated troponin concentrations, which suggested myocardial infarction. Contrast-enhanced computed tomography showed considerable celiac artery stenosis due to MAL syndrome. The patient was diagnosed with MAL syndrome and acute myocardial infarction. He declined revascularization owing to economic constraints, and opted to have conservative treatment with Chinese herbal extracts and medications. He succumbed to sudden cardiac death during a subsequent abdominal pain episode. The findings from this case show that MAL syndrome can present with recurrent myocardial infarction rather than typical intestinal angina symptoms. The pathophysiological link may involve intestinal and cardiac ischemia. An accurate diagnosis and appropriate management of MAL syndrome require careful evaluation and investigation.
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Gao et al. (2024) conducted a case report in Median arcuate ligament (MAL) syndrome and recurrent myocardial infarction (n=1). Conservative treatment with Chinese herbal extracts and medications was evaluated on Sudden cardiac death. A man in his early 50s with median arcuate ligament syndrome presented with recurrent myocardial infarction and ultimately succumbed to sudden cardiac death after opting for conservative treatment.
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