Abstract

We present an autopsy case of a 66-year-old man who died during walking. Besides a history of hypertension for 5 years, mild chest oppression appeared to occur shortly before death. A full autopsy and the police examination concluded that the cause of death was sudden cardiac death. The coronary artery showed a myocardial bridge in the left descending coronary artery and two bridges in the right coronary artery. Concentric hypertrophy of the left ventricle and moderate atherosclerotic narrowing of the coronary artery other than muscular bridges were found. Histological examination of the left ventricle showed minimal, but obvious, acute necrotic foci in addition to multiple small myocardial scars and advanced interstitial fibrosis. Multiple myocardial bridging may be a potential factor for sudden cardiac death in association with other factors, especially with left ventricular hypertrophy. Careful multilateral examination of the heart may be essential for evaluating the clinical significance of a muscular bridge when pathologists encounter sudden cardiac death with this relatively frequent anomaly.

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