Efficacy of calcium channel blockers in the treatment of the myocardial bridging: a pilot study.

Background: Myocardial Bridging(MB)isdefinedasasegmentofamajor epicardial coronary artery, the"tunnelled artery", that goes intramurally through the myocardium beneaththemusclebridge. Matherials and Methods: A69-year-oldmale patient with a story of arterial hypertension and dyslipidemia in treatment with converting en - zyme inhibitors (ACE-I), antiplatelet therapy and HMG-CoA reductase inhibitors and calcium channel blockers, presented with anginal-like chest pain and dyspnea.The coronary angiogra - phy showed a myocardial bridging and no hemo - dynamicallysignificantcoronaryarterydisease. Results: On admission in our Department, the exercise cyclo ergometer test was significant for > 3 mm ST segment depression in the anterior and lateral leads (V3,V4,V5,V6) associated with chest pain.The coronary angiography revealed a 40% stenosis of the distal tract of the right coro - nary artery (RCA), a 30% stenosis of the proxi- mal tract of the left anterior descending artery (LAD) and 40% of the proximal tract of the first diagonal branch. A 30% stenosis in the middle tract of the left circumflex coronary artery (LCX) was then detected. A marked systolic localized narrowing (90%) on the middle tract of the LAD, after the second diagonal branch (a myocardial bridge)wasalsodetected. After eight months, the exercise cyclo er - gometer test using a standard Bruce protocol was normal and, after sixteen months, no signifi- cant coronary artery disease (< 50%) and no my - ocardial bridging were detected by the coronary 64-multislicespiralcomputedtomography.