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[Influence of the myocardial bridging phenomenon on the myocardial structure and the coronary arteries wall structure
Jelena Tomanović-Koković1, Gordana Teofilovski-Parapid, Mirjana Oklobdzija
1Medicinski fakultet, Institut za ginekologiju i akuserstvo, Beograd. vlajko@eunet.yu
Insights
Myocardial bridges, where heart muscle covers coronary arteries, were found in 4.70% of autopsy cases. These bridges may cause coronary artery disease and heart dysfunction.
Area of Science:
- Cardiovascular Pathology
- Anatomical Variations
Context:
- Myocardial bridging is a congenital anomaly where a segment of cardiac muscle overlays a coronary artery.
- This anatomical variation can lead to dynamic obstruction of coronary blood flow.
Purpose:
- To investigate the structural changes in myocardial and coronary artery walls associated with myocardial bridging.
- To evaluate the potential role of myocardial bridging in causing heart malfunctions.
Summary:
- Autopsy analysis of 575 cases identified myocardial bridges in 4.70% (27 cases).
- Myocardial bridges were associated with significant arteriosclerotic changes (88.89%), myocardial fibrosis (88.89%), and lipomatosis (66.67%).
- The study suggests myocardial bridging compromises coronary perfusion, potentially initiating arteriosclerotic processes and leading to heart dysfunction.
Impact:
- Highlights myocardial bridging as a significant pathological finding with potential lethal consequences.
- Underscores the need for increased clinical attention and evaluation of myocardial bridging.
- Provides insights into the pathogenesis of coronary artery disease and associated cardiac pathologies.
Background/Aim:
Our research was performed to evaluate the influences of the myocardial bridgings of coronary arteries on the myocardial and coronary arteries wall structure chages, that could be a reason for multiple heart malfunctions.
Methods:
We analyzed the autopsy material, collected during a five-years period, and especially the group of 575 cases with the major aim to diagnose mors naturalis. In all cases with the presence of myocardial bridge over the arterial coronary wall revealed at autopsy, samples were taken for microscopic verification and examination.
Results:
We found myocardial bridges over the coronary arteries or their major branches in 27 of the cases (4.70%). We believe that myocardial bridges compromise coronary perfusion by cyclic compression of the overbridged vessels, and that it could be the initial factor in the pathogenesis of arteriosclerotic degeneration processes on the coronary artery wall. We found different grades of arteriosclerotic changes in 88.89% of the cases, as well as fibrosis of myocardium in 88.89% and lipomatosis in 66.67% of the cases with the present myocardial bridges.
Conclusion:
Our results suggested that myocardial bridging of coronary arteries and/or their branches was the pathological and even lethal phenomenon that de serves more intensive clinical evaluation.
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