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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
Summary
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.
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