Myocardial bridging of coronary arteries: Sudden unexpected deaths in a 24–year–old man

Myocardial bridging is a congenital anomaly, mostly found incidentally in men, and primarily involved in the left anterior descending coronary artery. In some cases its association with certain cardiac complications and resultant sudden deaths has been reported. However, its role as a cause of death is rare and still controversial. The author reported the case of sudden unexpected death in a 24–year–old man with previous healthy history. Unlike previous reported cases which almost exclusively involved in a single bridge, the present case had all branches of coronary artery running deeply and lengthy through the myocardium, thus aggravating cardiac complications and rendering the death in this young man. Since no other possible causes of death could be found in the present case except for all branches of the coronary artery embedding into the myocardium with hypertrophic cardiomyopathy associated pathologic lesions, his death was attributable to fatal arrhythmia secondary to acute transient occlusion of myocardial bridging of the coronary arteries.