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Prevalence of Myocardial Bridging in Angiography Study
Smriti Shakya1, Ratna Mani Gajurel1, Chandra Mani Poudel1
1Department of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Center (MCVTC), Institute of Medicine, TUTH, Kathmandu, Nepal.
Insights
Myocardial bridging, a coronary artery anomaly, was found in 5.04% of patients undergoing invasive coronary angiography. This condition is a common finding in middle-aged individuals presenting with angina symptoms.
Area of Science:
- Cardiology
- Congenital Heart Disease
Background:
- Myocardial bridging is a congenital anomaly where a coronary artery segment courses through the heart muscle.
- Systolic compression can lead to ischemia, arrhythmias, or sudden cardiac death.
- Prevalence varies significantly with diagnostic methods.
Purpose of the Study:
- To determine the prevalence of myocardial bridging using invasive coronary angiography.
- To analyze demographic and clinical characteristics of patients with myocardial bridging.
Main Methods:
- Retrospective analysis of 5096 invasive coronary angiographies.
- Study conducted at Manmohan Cardiothoracic Vascular and Transplant center, Kathmandu, Nepal (March 2018 - April 2021).
Main Results:
- Myocardial bridging identified in 257 (5.04%) patients.
- More common in males (68.9%); mean age 54.52 years.
- Left anterior descending artery most commonly affected (89.9%), predominantly in the mid-segment (74.9%).
- Associated conditions include hypertension (29.9%) and diabetes mellitus (12.8%).
- Stable angina was the most frequent presentation (29.2%).
Conclusions:
- Myocardial bridging is a frequent finding in middle-aged patients undergoing invasive coronary angiography for angina.
- Invasive coronary angiography is a valuable tool for diagnosing myocardial bridging.
Background:
Myocardial bridging is a congenital anomaly in which a segment of epicardial coronary artery takes an intramyocardial course, the systolic compression of which could be asymptomatic or may lead to major hemodynamic changes such as myocardial ischemia, arrhythmias or sudden cardiac death. The prevalence is highly variable depending upon different investigational modalities to diagnose it. Here we have aimed to study the prevalence through invasive coronary angiography.
Methods:
This retrospective study was carried out at Manmohan Cardiothoracic Vascular and Transplant center, Kathmandu, Nepal. The invasive coronary angiography of 5096 patients were studied from March 2018 to April 2021 done for various indications.
Results:
Among all the patients, the myocardial bridging was identified in 257 (5.04%) patients. About 177 (68.9%) were males and 80 (31.1%) were females. The mean age of the patients having myocardial bridging was 54.52 ± 10.31years. Diabetes mellitus was found in 33(12.8%) and hypertension was found in 77(29.9%) patients with myocardial bridging. Stable angina (29.2%) was the most common clinical presentation. Treadmill test was positive in about 70 (27.2%) patients. Majority of patients had myocardial bridge in left anterior descending artery alone (89.9%) and located mostly in mid-part (74.9%).
Conclusions:
The myocardial bridging is not an uncommon finding on invasive coronary angiography in middle aged people who present with typical angina.
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