Myocardial bridging: literature review

Abstract

The myocardial bridging is a congenital anomaly of the coronary arteries in which bundles of myocardial involve a segment of the epicardial coronary artery, leading to compression of a segment in the ventricular systole, reversing itself during diastole. It’s one of the main differential diagnosis of coronary artery disease and may manifest as chest pain, myocardial infarction or sudden death, but in most cases are asymptomatic. Its pathophysiology is still controversial. His clinical diagnosis should be considered in patients with chest pain and no risk factors for cardiovascular disease. In laboratory exams, the most common finding in coronary angiography is the compression of a coronary segment during systole, reversed during diastole. The first treatment of symptomatic myocardial bridging is medications to reduce symptoms of ischemia and minimize the risk of future cardiac events. In the persistence of clinical symptomatology, percutaneous intervention using stents or surgical treatment are types of threatment. The long-term prognosis is usually good. Although an anatomical finding is usually asymptomatic, in rare cases can cause major complications, including sudden death. Therefore, the myocardial bridge should be considered in young patients at low risk for cardiovascular disease and no evidence of myocardial ischemia, but with no chest pain or symptoms consistent with the severity of coronary artery disease.