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Exertional Syncope Caused by Hemodynamically Significant Myocardial Bridging With Coronary Vasospasm

Takumi Toya1, Yoshichika Miyazaki2, Otoya Sekine2

  • 1Department of Cardiology, NHO Tokyo Medical Center, Tokyo, Japan; Nishikoyama Toya Medical Clinic-Diabetes and Cardiovascular Care, Tokyo, Japan.

JACC. Case Reports
|July 22, 2026
PubMed

Insights

Myocardial bridging (MB) can cause exertional syncope by impairing blood flow during diastole, especially with tachycardia and coronary vasospasm. Invasive assessment is key to diagnosing significant MB and associated coronary vasospasm.

Area of Science:

  • Cardiology
  • Cardiovascular Physiology

Background:

  • Myocardial bridging (MB) is a congenital anomaly where a segment of a coronary artery travels through the heart muscle.
  • MB can lead to myocardial ischemia due to impaired diastolic coronary perfusion and coronary vasomotor dysfunction.
  • Symptoms may include exertional presyncope or syncope.
Abstract

Keywords:
coronary vasospasmexertional syncopemyocardial bridging

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