Review Article
Acute Myocardial Infarction Mimicking Takotsubo Cardiomyopathy in A Patient with Myocardial Bridging - A Case Report and Literature Review
Jianlong Wang, Nana Feng, Zuolan Wang
and Jingjin Che
Correspondence Address :
Jingjin Che
Department of Cardiology
Tianjin Institute of Cardiology
Second Hospital of Tianjin Medical University
People's Republic of China
Tel: +86-22-88328648, Fax: +86-22-28261158
E-mail: jingjinche@aliyun.com
Received on: September 28, 2017, Accepted on: October 18, 2017, Published on: October 27, 2017
Citation: Jianlong Wang, Nana Feng, Zuolan Wang, Jingjin Che (2017). Acute Myocardial Infarction Mimicking Takotsubo Cardiomyopathy in A Patient with Myocardial Bridging - A Case Report and Literature Review
Copyright: 2017 Jingjin Che, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
It was reported that 1-5% of acute ST segment elevation myocardial infarction (ASTEMI) had no concrete atherosclerotic plaque and thrombus in relevant coronary artery. Takotsubo cardiomyopathy (TTC) and coronary spasm are two main causes of this situation. TTC have possessed these features: chest pain induced by emotional stress; prominent ST segment elevation in extensive precordial leads, but disproportionately mild elevation of myocardial marker in peripheral blood; no concrete occlusion or stenosis lesion in coronary arteries. Furthermore TTC is usually spontaneously reversible, and heart function returns to normal after a few weeks, therefore absence of irreversible myocardial damage is considered as one of criteria to the diagnosis of TTC. The pathophysiology of TTC is not well understood [1,2], and TTC may be due to multi-vessel coronary artery spasm, coronary microvascular dysfunction, myocarditis, catecholamine toxicity or even an apical-basal gradient in β(2) adrenergic receptors. Myocardial bridging (MB) of coronary artery can also cause myocardial injury. Furthermore, MB was proposed as a potential substrate in the pathogenesis of TTC by some cases [3,4]. Here we reported acute myocardial infarction mimicking TTC in the patient with intermittent exacerbation of MB in coronary angiography simultaneously, suggesting that the MB might be associated with the acute ST segment elevation myocardial infarction but the case is similar to the features of TTC, strongly supporting the association between TTC and MB.
Keywords: Takotsubo cardiomyopathy, Myocardial bridging, Acute myocardial infarction