Coronary myocardial bridge: an innocent bystander?

Area of Science:

• Cardiology
• Congenital Heart Abnormalities

Background:

• Myocardial bridge (MB) is a congenital anomaly where a segment of a coronary artery tunnels through heart muscle.
• It causes systolic compression and diastolic diameter reduction, with an incidence of 0.5%-5.5%.

Observation:

• The left anterior descending artery is most commonly affected, followed by diagonal branches, right coronary artery, and left circumflex.
• While generally benign, factors like high heart rate can precipitate symptoms such as angina.

Findings:

• Two cases of symptomatic myocardial bridge successfully treated with negative inotropic drugs and coronary stenting are presented.
• This highlights effective medical and interventional strategies for managing MB.

Implications:

• Myocardial bridge should be considered in differential diagnoses for typical angina symptoms without significant coronary artery disease.
• Correct diagnosis and management, including medical therapy and stenting, are crucial for symptomatic patients.