Double myocardial bridge causing acute myocardial infarction in a premenopausal woman.

Myocardial bridging is a congenital abnormality which is characterized by an intramuscular course of a segment of the coronary artery. The presence of myocardial bridging influences coronary vasculature due to mechanical compression and systolic milking. The symptoms and complications of myocardial bridging depend on the number and depth of the tunneled artery segments, the grade of systolic narrowing and the heart rate, and include myocardial ischemia, coronary spasm or acute coronary syndrome. Dual myocardial bridges are rare. We present a case of an acute myocardial infarction in a premenopausal woman due to double myocardial bridging which was identified on coronary angiography. Myocardial perfusion single photon emission tomography (SPECT) was performed for the evaluation of infarct size and residual ischemia.