Clinical & Experimental Cardiology
Open Access

Abstract

Mini-Review: Nitroglycerin-Induced Coronary Collapse in Myocardial Bridging - Pathophysiology and Clinical Implications

Rose Ramsarran*, Sarah Hughes

Myocardial Bridging (MB) is a congenital anomaly in which an epicardial coronary artery, commonly the mid-Left Anterior Descending (LAD), tunnels through the myocardium rather than coursing along its surface. While typically benign, dynamic systolic compression of the bridged segment can precipitate ischemia, arrhythmias, or even infarction. Nitroglycerin, a classic anti-anginal agent, paradoxically aggravates MB-related obstruction by increasing vessel wall compliance and amplifying systolic narrowing. This mini-review summarizes current understanding of MB pathophysiology, diagnostic imaging modalities, and management strategies, highlighting the paradoxical pharmacologic effect of nitrates observed in a recent case of nitroglycerin-induced coronary collapse.

Published Date: 2025-12-15; Received Date: 2025-11-13