A 40-year-old man was admitted with the complaint of rest anginal episodes since few hours prior to admission. His BP was 120/80 mm Hg. ECG revealed no evidence of acute ischaemia. Coronary angiography revealed 80% luminal narrowing by systolic compression in the mid segment of the left anterior descending coronary artery best seen in the left anterior oblique cranial view. He improved symptomatically with beta-blockers, antiplatelets, statins and nitrates and the case was diagnosed as unstable angina due to coronary artery muscle bridge.
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