Prominent myocardial bridging as a first clue to recognize haemorrhagic shock during percutaneous coronary intervention: a case report

Abstract Background Haemorrhage at the puncture site is a serious complication of percutaneous coronary intervention (PCI). Case summary A 73-year-old man underwent transfemoral intervention because of stable angina pectoris. After a rotational atherectomy, an everolimus-eluting stent was implanted from the left main trunk to the proximal site of the left anterior descending (LAD) artery. We also recognized that myocardial bridging was significantly induced at the middle portion of the LAD, which was not evident before the PCI. We suspected puncture-related haemorrhage and immediately performed lower limb arteriography. As a result, contrast media extravasation was observed at the branch of the right inferior epigastric artery. Finally, we performed coil embolization into the left common femoral artery, and the extravasation successfully disappeared. Four months later, he underwent coronary angiography. There were no findings of myocardial bridging. Discussion Myocardial bridging during a PCI procedure may indicate hypercontraction because of haemorrhage.