Coronary artery occlusion and myocardial infarction caused by vasospasm within a myocardial bridge.

Myocardial bridging is a common congenital coronary anomaly that is clinically silent in the majority of cases. Case reports suggest myocardial ischemia and infarction can be caused by myocardial bridging. The proposed mechanisms by which myocardial bridging causes myocardial ischemia include compromised coronary blood flow, endothelial dysfunction, thrombus formation and a strong association with coronary vasospasm. We reported a case of myocardial infarction caused by both myocardial bridging and coronary vasospasm. We reviewed the literature and suggest that coronary stenting may have a role in treating myocardial ischemia due to myocardial bridging and coronary spasm that is refractory to medical management.