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Update review on myocardial bridging: New insights

Anthony Matta1, Jerome Roncalli2, Didier Carrié2

  • 1Department of cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France; Department of cardiology, Intercommunal Hospital Centre Castres-Mazamet, Castres, France; Faculty of medicine, Holy Spirit University of Kaslik, Jounieh, Lebanon.

Trends in Cardiovascular Medicine
|June 13, 2022
PubMed

Insights

Myocardial bridging (MB) is a common congenital heart issue. It can cause myocardial ischemia and is linked to myocardial infarction, with treatments ranging from medication to invasive procedures.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Vascular Biology

Background:

  • Myocardial bridging (MB) is a common congenital abnormality.
  • It often remains asymptomatic but can manifest clinically in the third and fourth decades.
  • MB can lead to myocardial ischemia through various mechanisms.

Purpose of the Study:

  • To review the pathophysiology, clinical manifestations, and treatment of myocardial bridging.
  • To discuss the controversial association between MB and atherosclerotic disease.
  • To highlight the current treatment strategies and the need for further research.

Main Methods:

  • Literature review of studies on myocardial bridging.
  • Analysis of mechanisms causing myocardial ischemia in MB.
  • Evaluation of medical and invasive treatment options.
  • Discussion of the link between MB and coronary artery disease.

Main Results:

  • MB is associated with myocardial infarction and non-obstructive coronary artery disease.
  • Medical treatments include beta-blockers, calcium channel blockers, and ivabradine.
  • Invasive options like PCI, CABG, and myotomy are for refractory cases.
  • Data is largely anecdotal, lacking randomized clinical trials.

Conclusions:

  • Myocardial bridging is a significant condition requiring careful management.
  • Further research, including randomized clinical trials, is essential.
  • Personalized treatment strategies are crucial for patients with symptomatic MB.

Keywords:
AtherosclerosisCoronary spasmHypertrophic cardiomyopathyMINOCAMyocardial bridging

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