Dipyridamole 201Tl myocardial SPECT in the assessment of a patient with myocardial bridging and concomitant atherosclerotic coronary artery disease.

Myocardial bridging (MB) is a common congenital condition in which a major coronary artery is covered by a bridge of muscle and narrows during systole. We present a patient with typical angina, severe MB of the left anterior descending artery and atherosclerotic coronary artery disease. In this case, dipyridamole 201Tl SPECT myocardial perfusion imaging, besides detecting coronary artery disease, provided supportive evidence that severe MB can cause myocardial ischemia and was useful for the assessment of the interventional outcome, as well as having played a key role in the clinical decision-making process.