Hidden culprit: Unveiling recurrent chest pain masked by myocardial bridge

A 52-year-old female presented to us in the emergency medicine department with a history of recurrent left precordial and retrosternal chest pain of dull aching type but not radiating to the left arm or neck, sometimes accompanied by sweating. These episodes had been occurring for 3 years, with each...

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Main Authors: Anil Dev Gopalakrishna, Mamatha Tittamegalapalya Ramalingaiah
Format: Article
Language:English
Published: Manipal College of Medical Sciences, Pokhara 2025-01-01
Series:Asian Journal of Medical Sciences
Subjects:
Online Access:https://ajmsjournal.info/index.php/AJMS/article/view/4359
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author Anil Dev Gopalakrishna
Mamatha Tittamegalapalya Ramalingaiah
author_facet Anil Dev Gopalakrishna
Mamatha Tittamegalapalya Ramalingaiah
author_sort Anil Dev Gopalakrishna
collection DOAJ
description A 52-year-old female presented to us in the emergency medicine department with a history of recurrent left precordial and retrosternal chest pain of dull aching type but not radiating to the left arm or neck, sometimes accompanied by sweating. These episodes had been occurring for 3 years, with each episode lasting for more than 1 h. The patient had a history of diabetes and hypertension and was on medications. She was evaluated outside; oesophago-gastro-duodenoscopy was done. It showed normal. She was on analgesics and on proton pump inhibitor. Our patient had persistent chest pain and was admitted for the same symptoms. After serial electrocardiogram (ECG) and serial troponin levels were noted to be normal. Hence, coronary angiogram was done. It showed a myocardial bridge lesion in the left anterior descending artery. It is a rare cause of chest pain, often we tend to narrow diagnosis once ECG and trop t negative. Significant obstruction can lead to myocardial ischemia, arrhythmia, and even sudden cardiac death. Early consideration in the working diagnosis enables early detection and treatment. This case report aims to enhance clinical decision making, improve patient outcome, and stimulate further research in this intriguing field.
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institution Kabale University
issn 2467-9100
2091-0576
language English
publishDate 2025-01-01
publisher Manipal College of Medical Sciences, Pokhara
record_format Article
series Asian Journal of Medical Sciences
spelling doaj-art-1e6adabcfb6f4abb96b2c9aa5dcba5162025-01-02T05:27:57ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762025-01-01161132135https://doi.org/10.71152/ajms.v16i1.4359Hidden culprit: Unveiling recurrent chest pain masked by myocardial bridgeAnil Dev Gopalakrishna 0https://orcid.org/0000-0002-2533-4838Mamatha Tittamegalapalya Ramalingaiah 1https://orcid.org/0000-0003-2027-8141Associate Consultant, Department of Emergency Medicine, Fortis Hospital, Bengaluru, Karnataka, India Associate Professor, Department of General Medicine, ESI Post Graduate Institute of Medical Science and Research, Bengaluru, Karnataka, IndiaA 52-year-old female presented to us in the emergency medicine department with a history of recurrent left precordial and retrosternal chest pain of dull aching type but not radiating to the left arm or neck, sometimes accompanied by sweating. These episodes had been occurring for 3 years, with each episode lasting for more than 1 h. The patient had a history of diabetes and hypertension and was on medications. She was evaluated outside; oesophago-gastro-duodenoscopy was done. It showed normal. She was on analgesics and on proton pump inhibitor. Our patient had persistent chest pain and was admitted for the same symptoms. After serial electrocardiogram (ECG) and serial troponin levels were noted to be normal. Hence, coronary angiogram was done. It showed a myocardial bridge lesion in the left anterior descending artery. It is a rare cause of chest pain, often we tend to narrow diagnosis once ECG and trop t negative. Significant obstruction can lead to myocardial ischemia, arrhythmia, and even sudden cardiac death. Early consideration in the working diagnosis enables early detection and treatment. This case report aims to enhance clinical decision making, improve patient outcome, and stimulate further research in this intriguing field.https://ajmsjournal.info/index.php/AJMS/article/view/4359myocardial bridge; chest pain; coronary angiogram
spellingShingle Anil Dev Gopalakrishna
Mamatha Tittamegalapalya Ramalingaiah
Hidden culprit: Unveiling recurrent chest pain masked by myocardial bridge
Asian Journal of Medical Sciences
myocardial bridge; chest pain; coronary angiogram
title Hidden culprit: Unveiling recurrent chest pain masked by myocardial bridge
title_full Hidden culprit: Unveiling recurrent chest pain masked by myocardial bridge
title_fullStr Hidden culprit: Unveiling recurrent chest pain masked by myocardial bridge
title_full_unstemmed Hidden culprit: Unveiling recurrent chest pain masked by myocardial bridge
title_short Hidden culprit: Unveiling recurrent chest pain masked by myocardial bridge
title_sort hidden culprit unveiling recurrent chest pain masked by myocardial bridge
topic myocardial bridge; chest pain; coronary angiogram
url https://ajmsjournal.info/index.php/AJMS/article/view/4359
work_keys_str_mv AT anildevgopalakrishna hiddenculpritunveilingrecurrentchestpainmaskedbymyocardialbridge
AT mamathatittamegalapalyaramalingaiah hiddenculpritunveilingrecurrentchestpainmaskedbymyocardialbridge