"Functional myocardial bridging" and "hyperkinetic state": a rare association as a cause of acute myocardial infarction.

An 82-year-old female was admitted to the catheterization laboratory for investigation of acute antero-lateral myocardial infarction with evidence of severe left ventricular dysfunction. Angiographically, she was found to have normal coronary arteries, with the exception of the presence of myocardial bridging in the left anterior descending coronary artery. This was recognized as a "functional" variation of anatomical bridging, in which a systolic coronary compression is caused by abnormal muscular septal hypertrophy. We describe this condition as an unusual cause of myocardial infarction and outline its treatment with beta-blockade therapy, using only esmolol, an ultra-short-acting drug. The patient recovered successfully, with complete recovery of ventricular function and the disappearance of this "functional condition", as shown in an angiographic check-up done prior to hospital discharge. A subsequent long-term follow-up was favorable.