CARDIOVASCULAR JOURNAL OF AFRICA • Vol 23, No 1, February 2012
AFRICA
e17
15 minutes, the patient recovered. Decreased arterial blood pres-
sure accompanying the chest pain with the dopamine infusion
suggested a dynamic LVOT obstruction. In the case of extensive
anterior ischaemia, even if mechanical reperfusion is performed,
a Doppler echocardiogram should be obtained for the outflow
tract velocity if the clinical status is not improving or is dete-
riorating.
As with dynamic LVOT obstruction, a myocardial bridge
may cause hypotension and tachycardia. Furthermore, dopa-
mine administration may augment the hypotension and further
titration may result in a vicious circle. Moreover, dopamine
administration may cause ischaemic symptoms in patients with a
myocardial bridge and these symptoms may be misinterpreted as
stent thrombosis, especially if the stent is implanted in the same
artery that already has a myocardial bridge.
Conclusion
It must be kept in mind that a myocardial bridge can mimic a
dynamic LVOT obstruction and stent thrombosis when the stent
is implanted in the same artery.
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