Key result
Blood transfusion and medical therapy resolve acute MI driven by profound anemia and myocardial bridging.
Why the study?
Myocardial bridging usually has a benign prognosis but can cause myocardial ischemia, infarction, and sudden cardiac death in some cases.
Case Report (n=1)
No
Myocardial bridging can precipitate acute myocardial infarction in the setting of profound anemia, which may be successfully managed conservatively with blood transfusion rather than PCI.
May support transfusion-first approach in anemia-triggered MI with bridging; hypothesis-generating and requires validation beyond this case.
BACKGROUND: Systolic compression of a coronary artery by overlying myocardial tissue is termed myocardial bridging. Myocardial bridging usually has a benign prognosis, but some cases resulting in myocardial ischemia, infarction and sudden cardiac death have been reported. We are reporting a case of myocardial bridging which was complicated with acute myocardial infarction associated with inappropriate blood donation. CASE PRESENTATION: A 33 year-old-man was admitted to our emergency with acute anteroseptal myocardial infarction after a blood donation. The electrocardiography showed sinus rhythm and was consistent with an acute anteroseptal myocardial infarction. We decided to perform primary percutanous intervention (PCI). Myocardial bridging was observed in the mid segment of the left anterior descending coronary artery on coronary angiogram. PCI was canceled and medical follow up was decided. Blood transfusion was made because he had a deep anemia. A normal hemoglobin level and clinical reperfusion was achieved after ten hours by blood transfusion. At the one year follow up visit, our patient was healthy and had no cardiac complaints. CONCLUSIONS: Myocardial bridging may cause acute myocardial infarction in various clinical conditions. Although the condition in this case caused profound anemia related acute myocardial infarction, its treatment and management was unusual.
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Akdemir et al. (2002) conducted a case report in Acute myocardial infarction and myocardial bridging (n=1). Blood transfusion and medical management was evaluated on Clinical recovery and resolution of ischemia. Appropriate blood transfusion and medical management successfully resolved an acute myocardial infarction caused by profound anemia in a patient with myocardial bridging.
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