Myocardial bridging on left anterior descending coronary artery evaluated by multidetector computed tomography.

We report on two cases of patients with myocardial R interval. The best data sets of axial images for evalubridging on left anterior descending artery (LAD), studied with multidetector computed tomography study (MDCT). Patient no. 1 was a 65-year-old man, who presented at our cath lab with stable angina pectoris. Patient was a previous smoker and had no history of systemic hypertension. Echocardiogram showed a normal left ventricular function with no myocardial hypertrophy or any valvular disease. At coronary angiography, circumflex and right coronary arteries were both found stenotic in their mid segments and successfully treated with multiple stenting. Coronary angiography also documented a ‘‘milking’’ effect on mid LAD, highly specific for myocardial bridging. MDCT was performed 6 days after intervention by means of a Somatom Volume Zoom Plus 4 equipment (Siemens, Forchheim, Germany). Patient was in sinus rhythm and was premedicated with Esmolol (15 Ag/kg bolus intravenously) and Nitroglycerin (5 mg sublingual). Scans were obtained during breathhold with 4 1-mm collimation, 1.25-mm slice thickness and a 0.6-mm reconstruction interval. Iodinated contrast medium (Iomeron, 400 mg I/ml, Bracco, Milano, Italy) was injected intravenously in a biphasic manner (60 ml at 4 ml/s followed by 90 ml at 2.5 ml/s), after a test bolus, in order to determine the best injection delay. Retrospective ECG-gated reconstructions were generated at 50%, 60% and 70% of the R-