Detection of myocardial bridging induced ischaemia during cardiac catheterization by dobutamine-stress electrocardiographic body surface mapping

摘要

A 30-year-old female presented with chronic atypical chest pain. Exercise sesta-mibi showed mild anterior is-chaemia. Coronary angiography did not reveal coronary artery disease, but there was a long segment of myocardial bridging (MB) (Panel A) in the distal left anterior descending artery. There was dynamic (30% diameter) stenosis during systole at rest (Panel 8). To further evaluate the significance of the MB, intravenous dobutamine was infused (5-20 pig/kg/min) which resulted in increased systolic compression (>50% stenosis) (Panel C; see Supplementary material online, Movie S1). The drug study was performed in conjunction with an 80-lead electro-cardiographic (ECG) body surface map (PRIME ECG~R (Verathon, Inc., Bothell, WA, USA), which did not show ST-segment deviation at rest (Panel D).