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Myocardial bridge
1Department of Anatomy, Faculty of Medicine, Near East University, Nicosia, Cyprus. mehtap.tiryakioglu@neu.edu.tr.
Insights
Myocardial bridging (MB) is a coronary artery anomaly where the artery tunnels through heart muscle. This case highlights MB in the posterior interventricular artery and right coronary artery, detected via CCTA.
Area of Science:
- Cardiology
- Anatomy
- Radiology
Background:
- Myocardial bridging (MB) is an anatomical variant where a coronary artery segment runs beneath myocardial tissue.
- The left anterior descending artery is most frequently affected, but other branches can also be involved.
- Advances in imaging, particularly coronary computed tomographic angiography (CCTA), have improved MB diagnosis.
Observation:
- A 60-year-old male patient presented with arrhythmia during a routine CCTA.
- The CCTA revealed myocardial bridging in two segments of the posterior interventricular artery.
- A small segment of the right coronary artery also showed signs of myocardial bridging.
Findings:
- The case identified myocardial bridging in less commonly affected coronary artery segments.
- Coronary computed tomographic angiography (CCTA) proved effective in diagnosing this anatomical variant.
- The patient's arrhythmia was incidentally detected during the investigation for MB.
Implications:
- While often asymptomatic, myocardial bridging can be linked to serious cardiac events.
- Understanding MB pathophysiology is crucial for clinical management and risk assessment.
- Accurate diagnosis through advanced imaging like CCTA aids in identifying potential complications associated with MB.
Abstract:
Myocardial bridging (MB) is an anatomical variant in which an epicardial coronary artery passes under a bridge of myocardium. The most commonly affected vessel is the left anterior descending coronary artery, although other branches such as the marginal branches, diagonal branches and posterior descending right coronary artery may be occasionally involved. Technological advances in radiological techniques have enabled better diagnosis of myocardial bridges especially coronary angiography and coronary computed tomographic angiography (CCTA). During a routine angiography by means of CCTA in a 60-year-old male patient with arrhythmia, a case of MB was found in two segments of the posterior interventricular artery and a small segment of the right coronary artery. Although most cases of myocardial bridges are asymptomatic, knowledge of its pathophysiology is of great clinical importance as some cases of MBs have been associated with acute coronary syndromes, ischaemia, arrhythmias and even sudden death.
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