Myocardial bridge detected by changes in ECG before induction: A case report

Lee, Jun Seop; Lee, Guie Yong; Lee, Heeseung; Kim, Chi Hyo; Han, Jong In; Kim, Jong Hak

Case Report

Anesthetic Pharmacology

Anesthesia and Pain Medicine 2012;7(3):226-229.
Published online July 31, 2012.

Myocardial bridge detected by changes in ECG before induction: A case report

Jun Seop Lee, Guie Yong Lee, Heeseung Lee, Chi Hyo Kim, Jong In Han, Jong Hak Kim

Department of Anesthesiology and Pain Medicine, Ewha Womans University School of Medicine, Seoul, Korea. lgyanes@ewha.ac.kr

Abstract

Myocardial bridge, in which some of the epicardial coronary arterial segments are embedded in the muscle, has clinical significance because serious cardiac diseases such as angina, cardiac ischemia, myocardial infarction, and sudden cardiac death can occur. However, anesthetic management for the perioperative period for patients with myocardial bridge has remained controversial. We present a case of anesthetic management for total gastrectomy in a previously healthy 56-year-old male patient, who exhibited T-wave inversion and ST-segment depression in ECG monitoring on arrival to the operating room. While delaying the operation for further study, he was diagnosed as having myocardial bridge on a 3D-coronary CT. After confirmation of the normal coronary angiography, the patient underwent total gastrectomy uneventfully. There is no substitute for vigilance regarding the anesthesiologist.

Key Words: Coronary CT, ECG, General anesthesia, Myocardial bridge