Postextrasystolic potentiation of vessel compression in myocardial bridging: detection by intravascular sonography.

We present the case of 67-year-old man with exertional chest pain. Coronary angiography revealed myocardial bridging of the left anterior descending coronary artery (LAD) with mild systolic vessel compression. An intracoronary Doppler sonographic examination of the LAD showed a fingertip-shaped antegrade flow pattern with a steep acceleration of coronary flow velocity during early diastole, followed by a steep deceleration and then a plateau in the coronary flow velocity during mid and late diastole. An intravascular sonographic examination using a 30-MHz transducer catheter showed eccentric vessel compression during systole and substantial augmentation of vessel compression after an incidental extrasystole. Both intracoronary Doppler sonography and intravascular sonography provided important information that helped us to identify myocardial bridging in this patient.