A rare case of myocardial bridging as a cause of complete heart block: A diagnostic challenge

Complete heart block (CHB) is a disruption in electrical impulses to travel from atria to ventricles and can rarely be caused by myocardial bridging (MB), where cardiac tissue compresses a coronary artery during systole. The incidence of MB ranges from 0.5 % to 16 % in coronary angiography patients....

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Main Authors: Ibrahim Fathallah, Ayham Qatza, Ahmed Al-Talep, Reham Yousef, Rami Asef Hasn
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Radiology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S1930043325000019
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author Ibrahim Fathallah
Ayham Qatza
Ahmed Al-Talep
Reham Yousef
Rami Asef Hasn
author_facet Ibrahim Fathallah
Ayham Qatza
Ahmed Al-Talep
Reham Yousef
Rami Asef Hasn
author_sort Ibrahim Fathallah
collection DOAJ
description Complete heart block (CHB) is a disruption in electrical impulses to travel from atria to ventricles and can rarely be caused by myocardial bridging (MB), where cardiac tissue compresses a coronary artery during systole. The incidence of MB ranges from 0.5 % to 16 % in coronary angiography patients. This case report presents a 30-year-old female presented with dizziness, shortness of breath, and chest pain, diagnosed with third-degree AV block. Echocardiography revealed interventricular septal thickening and mild mitral regurgitation. Coronary angiography identified myocardial bridging in the mid LAD artery causing significant systolic stenosis. After ruling out reversible causes, a dual-chamber permanent pacemaker was implanted due to persistent heart block. The patient remained stable postprocedure, with decreasing cardiac biomarkers, and was discharged symptom-free with a follow-up appointment scheduled. MB can lead to serious cardiovascular events, including myocardial infarction and CHB. Clinicians must recognize the risks associated with MB and maintain a high suspicion for CHB to ensure timely management. Further studies are needed to clarify the CHB-MB relationship and improve patient outcomes.
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series Radiology Case Reports
spelling doaj-art-3ea475ac27764e50b77484af3f4635692025-08-20T02:47:45ZengElsevierRadiology Case Reports1930-04332025-04-012041882188710.1016/j.radcr.2025.01.003A rare case of myocardial bridging as a cause of complete heart block: A diagnostic challengeIbrahim Fathallah0Ayham Qatza1Ahmed Al-Talep2Reham Yousef3Rami Asef Hasn4Faculty of Medicine, Al-Baath University, Homs, Syria; Corresponding author.Faculty of Medicine, Hama University, Hama, SyriaFaculty of Medicine, Al-Baath University, Homs, SyriaFaculty of Pharmacy, Damascus University, Damascus, SyriaDepartment of Cardiology, Albasel Hospital, Tartous University, Tartous, Syria; Faculty of Medicine, Tishreen University, Latakia, SyriaComplete heart block (CHB) is a disruption in electrical impulses to travel from atria to ventricles and can rarely be caused by myocardial bridging (MB), where cardiac tissue compresses a coronary artery during systole. The incidence of MB ranges from 0.5 % to 16 % in coronary angiography patients. This case report presents a 30-year-old female presented with dizziness, shortness of breath, and chest pain, diagnosed with third-degree AV block. Echocardiography revealed interventricular septal thickening and mild mitral regurgitation. Coronary angiography identified myocardial bridging in the mid LAD artery causing significant systolic stenosis. After ruling out reversible causes, a dual-chamber permanent pacemaker was implanted due to persistent heart block. The patient remained stable postprocedure, with decreasing cardiac biomarkers, and was discharged symptom-free with a follow-up appointment scheduled. MB can lead to serious cardiovascular events, including myocardial infarction and CHB. Clinicians must recognize the risks associated with MB and maintain a high suspicion for CHB to ensure timely management. Further studies are needed to clarify the CHB-MB relationship and improve patient outcomes.http://www.sciencedirect.com/science/article/pii/S1930043325000019Complete heart blockMyocardial bridgingCatheterizationCase report
spellingShingle Ibrahim Fathallah
Ayham Qatza
Ahmed Al-Talep
Reham Yousef
Rami Asef Hasn
A rare case of myocardial bridging as a cause of complete heart block: A diagnostic challenge
Radiology Case Reports
Complete heart block
Myocardial bridging
Catheterization
Case report
title A rare case of myocardial bridging as a cause of complete heart block: A diagnostic challenge
title_full A rare case of myocardial bridging as a cause of complete heart block: A diagnostic challenge
title_fullStr A rare case of myocardial bridging as a cause of complete heart block: A diagnostic challenge
title_full_unstemmed A rare case of myocardial bridging as a cause of complete heart block: A diagnostic challenge
title_short A rare case of myocardial bridging as a cause of complete heart block: A diagnostic challenge
title_sort rare case of myocardial bridging as a cause of complete heart block a diagnostic challenge
topic Complete heart block
Myocardial bridging
Catheterization
Case report
url http://www.sciencedirect.com/science/article/pii/S1930043325000019
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