Iranian Heart Journal

Iranian Heart Journal

Inferior ST-Segment Elevation in an Asymptomatic Young Patient With Left Anterior Descending Artery Myocardial Bridging: A Case Report

Document Type : Case Report

Authors
Ahmed Elmi Abdi 1
Can Baba Arin 2
Mohamed Omar Hassan 1
1 Department of Cardiology, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia.
2 Cardiology Department, Health Science University, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital Istanbul, Turkey.
Abstract
Background: Myocardial bridging (MB) is a congenital coronary anomaly in which a segment of an epicardial coronary artery courses intramyocardially, resulting in dynamic systolic compression. MB, albeit usually considered benign, has been associated with myocardial ischemia and electrocardiographic abnormalities in selected patients. Nonetheless, establishing a causal relationship may be challenging.

Case Presentation: A 33-year-old asymptomatic man with no prior cardiovascular disease was found to have inferior ST-segment elevation on routine electrocardiographic evaluation. Physical examination, transthoracic echocardiography, and laboratory findings were unremarkable. Coronary angiography demonstrated an MB involving the midsegment of the left anterior descending artery without evidence of obstructive coronary artery disease. The MB represented one potential explanation for the electrocardiographic findings; however, other mechanisms such as coronary vasomotor dysfunction could not be excluded because physiologic and vasoreactivity testing were not performed.

Conclusions: This case illustrates an uncommon coexistence of inferior ST-segment elevation and an MB of the left anterior descending artery. Although a causal relationship cannot be established, MB should be considered among the differential diagnoses after exclusion of obstructive coronary artery disease. (Iranian Heart Journal 2026; 27(4): 91-95)
Keywords
myocardial bridging
ST-segment elevation
left anterior descending artery
coronary anomaly
electrocardiography
non-obstructive coronary artery disease
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Iranian Heart Journal
Volume 27, Issue 4
Autumn 2026
Pages 91-95