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Myocardial bridging: contemporary understanding of pathophysiology with implications for diagnostic and therapeutic

Michel T Corban1, Olivia Y Hung1, Parham Eshtehardi1

  • 1Andreas Gruentzig Cardiovascular Center, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA.

Journal of the American College of Cardiology
|March 4, 2014
PubMed

Insights

Myocardial bridging, a heart anomaly, can cause serious symptoms like angina or sudden cardiac death. This review covers its causes, diagnosis, and treatments for better patient outcomes.

Area of Science:

  • Cardiology
  • Cardiovascular Medicine
  • Congenital Heart Anomalies

Background:

  • Myocardial bridging is a congenital anomaly where a segment of a coronary artery travels through the heart muscle.
  • While often asymptomatic, it can lead to significant cardiovascular events.

Purpose of the Study:

  • To review the current understanding of myocardial bridging pathophysiology.
  • To outline diagnostic methods for identifying myocardial bridging.
  • To discuss therapeutic strategies for managing patients with myocardial bridging.

Main Methods:

  • Literature review of existing studies on myocardial bridging.
  • Analysis of diagnostic imaging techniques (e.g., angiography, CT, MRI).
  • Synthesis of clinical data on patient outcomes and treatment efficacy.

Main Results:

  • Myocardial bridging can cause myocardial ischemia due to dynamic compression of the artery during systole.
  • Diagnostic accuracy varies among imaging modalities, with invasive angiography often considered the gold standard.
  • Treatment strategies range from conservative medical management to surgical interventions.

Conclusions:

  • Myocardial bridging is a complex condition requiring a thorough understanding of its pathophysiology.
  • Accurate diagnosis is crucial for appropriate patient management.
  • Tailored therapeutic approaches are essential to mitigate the risk of adverse cardiovascular events.

Keywords:
coronary wall shear stressintracoronary Doppler velocity and pressureintravascular imagingmyocardial bridgemyotomypercutaneous coronary intervention

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