# Myocardial Bridging and Cardiac Arrest

## TL;DR

This paper reports a case of myocardial bridging causing cardiac arrest and highlights its potentially dangerous effects, even without obstructive heart disease.

## Contribution

The study adds a new clinical case and emphasizes the need to reconsider myocardial bridging as a non-benign condition.

## Key findings

- Myocardial bridging can lead to sudden cardiac arrest even in the absence of obstructive coronary disease.
- Ventricular fibrillation is the common arrest rhythm in MB-associated cardiac arrest cases.
- Most reported cases involve the left anterior descending artery and predominantly affect men.

## Abstract

Myocardial bridging (MB) is a congenital coronary anomaly in which a segment of an epicardial artery tunnels through the myocardium. Although frequently considered benign, MB has been increasingly linked to ischemia, malignant arrhythmias, and sudden cardiac death.

We describe a case of a 39-year-old woman with mid–left anterior descending artery MB who presented with sudden chest pain followed by cardiac arrest. Coronary angiography revealed MB without obstructive disease. Despite prolonged resuscitation and hypoxic brain injury, she achieved functional recovery after intensive care.

We compared our patient with 10 previously published cases of MB-associated cardiac arrest. Patients were typically men with ventricular fibrillation as the universal arrest rhythm, and the left anterior descending artery was most commonly involved, with variable outcomes.

MB should not be regarded as uniformly benign. Recognition of its malignant potential—particularly in patients with no obstructive coronary disease—is critical for diagnosis, management, and secondary prevention.