Myocardial Bridging: Laporan Kasus

Said Qadaru Alaydrus, Muhammad Rizki

Sari


Myocardial bridging adalah suatu kondisi di mana arteri koroner yang terdistribusi ke permukaan epikardial, dilapisi oleh miokardium pada segmen intramyocardial dari arteri koroner epikardial. Lokasi, panjang, dan tingkat keparahan bridging bervariasi antar pasien dan dapat bervariasi pada pasien yang sama dari satu pemeriksaan ke pemeriksaan lainnya. Tingkat kondisi ini biasanya tidak luas dan parah. Myocardial bridging dapat terjadi pada pasien dengan dan tanpa penyakit arteri koroner. Diagnosis myocardial bridging dibuat ketika sebagian dari arteri koroner epikardial (biasanya arteri koroner desenden anterior kiri (LAD)) ditemukan seluruhnya atau sebagian besar berada di dalam miokardium (intramyocardial). Ini dapat didokumentasikan selama angiografi koroner diagnostik, CT angiografi, secara intraoperatif, atau pada pemeriksaan postmortem. Terapi medis – Pengobatan farmakologis meliputi beta blockers, ivabradine, dan kemungkinan nondihydropyridine calcium channel blockers. Agen-agen ini mengurangi denyut jantung dan kontraktilitas miokard. Revaskularisasi dapat dilakukan tetapi memiliki risiko fraktur stent di lokasi myocardial bridging. Terapi bedah harus disiapkan untuk pasien dengan gejala persisten, di mana perubahan iskemik jelas, dan bagi mereka yang memiliki penanda risiko tinggi (seperti aritmia ventrikel yang mengancam jiwa, kematian mendadak, atau infark miokard non-fatal), di mana uji coba terapi medis telah gagal.


Kata Kunci


Myocardial bridging; Revaskularisasi; Angina; Korangiografi

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Referensi


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DOI: https://doi.org/10.33024/jikk.v12i6.21037

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