[Myocardial bridge: description, significance, treatment]

Area of Science:

• Cardiology
• Vascular Anatomy
• Clinical Medicine

Context:

• Myocardial bridges are congenital anomalies where a segment of a coronary artery runs through the heart muscle.
• The clinical significance of myocardial bridges ranges from asymptomatic to severe ischemic events.
• Historically, management has been conservative, with surgical intervention reserved for refractory cases.

Purpose:

• To review the current understanding of myocardial bridges and their clinical implications.
• To discuss the diagnostic signs and symptoms associated with symptomatic myocardial bridges.
• To evaluate the evolving treatment strategies for myocardial bridges, including medical, surgical, and interventional approaches.

Summary:

• Myocardial bridges represent an abnormal course of coronary arteries, potentially leading to myocardial ischemia, infarction, or sudden death.
• Symptomatic myocardial bridges manifest with electrocardiographic, scintigraphic, or metabolic evidence of ischemia.
• While medical management is common, angioplasty and stenting have emerged as effective alternatives for patients unresponsive to conservative therapy.

Impact:

• This review highlights the potential severity of myocardial bridges, emphasizing the need for accurate diagnosis and timely intervention.
• It underscores the growing role of percutaneous coronary interventions like angioplasty and stenting in managing complex myocardial bridge cases.
• The findings provide valuable insights for clinicians managing patients with coronary artery anomalies and ischemic heart disease.