【摘要】 药物治疗和手术治疗是心肌桥的两种主要治疗方法。然而，关于冠状动脉旁路移植术（CABG）和心肌桥松解术的应用仍存在争议。本病例报道1例心肌桥患者在CABG后发生心肌梗死。患者因持续胸痛、胸闷、呼吸短促2 h就诊于兰州市第一人民医院，体格检查未见明显阳性征象。心电图显示广泛的前壁心肌梗死。实验室检查肌红蛋白140.1 ng/ml；肌钙蛋白I为2.59 ng/ml。未发现其他异常。初步诊断为急性广泛前壁心肌梗死。急诊冠状动脉造影显示左前降支中段心肌桥。行左乳内动脉-左前降支急诊CABG，病情好转出院。在术后7年再次发生心肌梗死，再次给予药物二级预防治疗。患者现在正在接受持续的随访。CABG是治疗心肌桥的有效方法。但根据本文报道的病例，建议仔细评估患者是否可以从CABG中获益。更多还原

【Abstract】 Medical therapy and surgical intervention are the two primary approaches for treating myocardial bridge.However,there remains controversy regarding the use of coronary artery bypass grafting(CABG) and myocardial bridge unroofing.Here,we report a case of myocardial infarction following CABG in a patient with a myocardial bridge.The patient was admitted to Lanzhou First Peopie’ s Hospital with persistent chest pain,chest tightness,and shortness of breath lasting 2 hours.Physical examination revealed no significant abnormalities.Electrocardiography(ECG) indicated extensive anterior wall myocardial infarction.Laboratory findings showed myoglobin levels of 140.1 ng/ml and troponin I levels of 2.59 ng/ml,with no other significant abnormalities.The initial diagnosis was acute extensive anterior wall myocardial infarction.Emergency coronary angiography revealed a myocardial bridge in the mid-segment of the left anterior descending artery(LAD).Emergency CABG using the left internal mammary artery to the LAD was performed,leading to symptomatic improvement,and the patient was discharged in stable condition.However,the patient experienced a recurrent myocardial infarction seven years post-surgery and received secondary preventive medical therapy.The patient is currently under ongoing follow-up care.CABG is an effective treatment for myocardial bridge.However,based on the case reported in this study,we recommend careful evaluation of whether a patient may benefit from CABG.更多还原