Complicaciones hemodinámicas graves relacionadas con puente miocárdico: caso clínico

This study presented a clinical case of cardiogenic shock secondary to a myocardial bridge in an intensive care unit, aiming to highlight the relevance of this uncommon cause and to review the related scientific literature. An observational, retrospective, and descriptive methodology was adopted, consisting of the pathophysiological analysis of the case and a narrative review of academic publications from indexed databases. The bibliometric analysis helped identify current trends in the management of cardiogenic shock, emphasizing the growing interest in advanced hemodynamic support techniques. The case involved a 72-year-old female patient with a history of hypertension and ischemic heart disease, admitted to the intensive care unit with chest pain and dyspnea, who developed a refractory cardiogenic shock. Coronary angiography revealed a myocardial bridge in the left anterior descending artery with an 85% systolic compression. Clinical management focused on pharmacological optimization with beta-blockers and temporary inotropic support, achieving hemodynamic stabilization and symptom resolution. This case underscored the importance of considering myocardial bridging as a potential cause of cardiogenic shock, especially in patients without significant atherosclerotic coronary disease. It was concluded that a comprehensive diagnostic evaluation, including coronary angiography and Doppler echocardiography, is essential to differentiate this condition from an acute coronary syndrome and avoid unnecessary treatments. The study recommended a conservative management approach as first-line therapy, reserving invasive interventions for refractory cases, and called for further research to optimize therapeutic strategies in these scenarios.