Symptomatic Myocardial Bridging Presenting as Wellens Pattern and Successfully Treated with Surgery: A Case Report

Abstract: Myocardial bridging is an uncommon congenital anomaly that can have detrimental cardiac consequences when undiagnosed and untreated. Myocardial bridging occurs when the epicardial coronary artery tunneled through the myocardium. Despite it is presence since birth, it may remain asymptomatic and clinically manifest later, in the third to fourth decades of life. Wellens patterns are an unusual presentations of myocardial bridging, and there are only a few case reports exist in English literature. We report a case of 44-year-old man who presented with a one-week history of exertional chest pain. The ECG showed a symmetrically deep T wave inversion from V2 to V6. Emergent coronary angiography showed myocardial bridging involving the LAD artery and proximal portion of the first diagonal branch with severe luminal compression up to 100% during systole. The patient successfully underwent cardiac surgery, in which the LIMA was grafted to the LAD and D1.