Abstract
Severe bronchospasm resulting in acute respiratory failure may precipitate cardiovascular complications due to myocardial oxygen supply-demand mismatch. A myocardial bridge is a typically benign congenital coronary anomaly that may become clinically significant during periods of tachycardia and increased contractility. We report a case of acute hypoxic hypercapnic respiratory failure due to severe bronchospasm temporally associated with ceftriaxone administration, complicated by myocardial injury attributed to an incidentally identified myocardial bridge. This case highlights the diagnostic complexity of acute dyspnea and underscores the importance of recognizing myocardial bridge during physiologic stress, a phenomenon that has rarely been reported in prior case reports.