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Unveiling the Masquerading of Myocardial Bridging in Cardiovascular Diseases

Song Wu1, Danni Wu1, Xianlun Li1,2

  • 1China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, 100029 Beijing, China.

Reviews in Cardiovascular Medicine
|August 8, 2025
PubMed

Insights

Myocardial bridging (MB), once thought benign, is now linked to cardiovascular diseases. Understanding its mechanisms and tailored treatments is crucial for managing associated conditions like hypertrophic cardiomyopathy.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Vascular Biology

Background:

  • Myocardial bridging (MB) is a congenital coronary artery anomaly.
  • Initially considered benign, MB is increasingly associated with cardiovascular diseases.
  • Pathological mechanisms include ischemia, vasospasm, and atherosclerosis due to dynamic compression.

Purpose of the Study:

  • To review the relationship between MB and cardiovascular diseases.
  • To explore underlying mechanisms, diagnostic assessments, and treatment strategies.
  • To highlight the importance of evaluating MB in patients with other cardiovascular conditions.

Main Methods:

  • Review of existing literature on Myocardial Bridging.
  • Analysis of anatomical and hemodynamic features using advanced imaging.
  • Examination of associations with hypertrophic cardiomyopathy, atherosclerosis, and INOCA/MINOCA.

Main Results:

  • MB can lead to myocardial ischemia, coronary vasospasm, and proximal atherosclerosis.
  • Advanced imaging improves understanding of MB's features.
  • Symptom-driven treatment is primary, but evaluation of asymptomatic patients with concomitant diseases is recommended.

Conclusions:

  • MB is associated with various cardiovascular conditions requiring careful evaluation.
  • Pharmacological therapy and management of underlying conditions are first-line treatments.
  • Further large-scale randomized controlled trials are needed to validate findings and guide treatment.

Keywords:
INOCAMINOCAatherosclerosishypertrophic cardiomyopathymyocardial bridging

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