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Myocardial Bridging

A segment of a coronary artery that travels through the myocardium and is compressed during systole.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

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What is Myocardial Bridging?

Myocardial bridging is a congenital anatomic variant in which a coronary artery that normally runs on the surface of the heart (epicardium) dips through the heart muscle. The left anterior descending (LAD) artery is most commonly affected.

During systolic contraction the bridged segment is compressed and the lumen is narrowed. Most cases are clinically silent, but deep or long bridges can cause angina, ischemia, arrhythmia and rarely myocardial infarction.

Diagnosis is usually made when systolic compression is seen on coronary angiography. Cardiac CT angiography is also useful for anatomic evaluation.

Beta-blockers are first-line therapy in symptomatic patients; surgical myotomy or bypass may be considered in severe refractory cases.

Symptoms

Typical anginal chest pain on exertion
Palpitations and rhythm irregularity
Exertional dyspnea
Syncope or presyncope (rare)
Positive stress test
Asymptomatic in most patients

Risk Factors

Congenital anatomic variation
Association with hypertrophic cardiomyopathy
Intense physical activity (in athletes)
Tachycardia (worsens bridge compression)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Exertion-induced chest pain, especially in young people
  • Unexplained syncope or arrhythmia
  • Asymptomatic patients with a positive stress test

Treatment Methods

01
Beta-blocker therapy (slows heart rate and increases diastolic filling)
02
Non-dihydropyridine calcium channel blockers
03
Avoidance of nitrates (reflex tachycardia can worsen the situation)
04
Surgical myotomy (transection of the muscle bridge) in severe refractory cases
05
Coronary bypass grafting as an alternative

Which Department to Visit?

You can visit our Kardiyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.