Myocardial Bridging: Nyeri Dada Atipikal pada Pria Paruh Baya

Thea Saphira Mugiarto, Dewi Ayu Paramita

Abstract

Myocardial bridging merupakan anomali kongenital; prevalensinya 5-86%, rata-rata 25%. Beberapa data otopsi menunjukkan bahwa myocardial bridging didapatkan pada lebih dari 50% subjek, sehingga ada yang menganggap myocardial bridging merupakan variasi anatomi. Myocardial bridging dapat memiliki signifikansi kardiovaskular, tergantung kedalaman segmen arteri koroner yang tertanam di dalam miokardium. Gejala dapat berupa nyeri dada, berdebar-debar, mudah lelah, serta manifestasi kardiologis lainnya. Obat ß-blocker merupakan terapi lini pertama karena memiliki efek kronotropik dan inotropik negatif. Revaskularisasi sebaiknya dilakukan hanya pada pasien dengan gejala berat yang refrakter terhadap perawatan medis optimal. Pilihan tindakan bedah meliputi miotomi supraarterial dan/atau CABG. Laporan kasus ini mengenai pria 40 tahun dengan nyeri dada karena myocardial bridging, diagnosis ditegakkan setelah pemeriksaan
angiografi.

 

Myocardial bridging is a congenital anomaly, its prevalence ranged from 5-86% with a mean of 25%. Autopsy data show that myocardial bridging can occur in more than 50% subjects, so it can be considered myocardial bridging as an anatomical variation. Symptoms can include chest pain, palpitation, fatigue, and other cardiac manifestations. The first line therapy is ß-blockers with negative chronotropic and inotropic effects. Revascularization should be limited to patients with
severe symptoms refractory to maximal medical care; the surgical options are supra-arterial myotomy and/or CABG. This case report is a 40 year-old male with chest pain caused by myocardial bridging, diagnosed after angiography.

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