Myocardial bridging of the coronary arteries
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Myocardial bridging (MB) is a common congenital anomaly of the coronary arteries1.
Epidemiology
- it is found approximately in 20-30% of adult population on autopsy studies.
- incidence of in coronary angiograms is upto 2-15%
Pathology
Normally major coronary arteries course epicardially through out its length, in some cases segment of coronary arteries courses intramurally in the myocardium ( tunneled(tunneled artery).
Myocardial bridging may be described as superficial or deep.
Location
This is typically described for left anterior descending artery (LAD) - with, with the mid LAD considered the most common location 5, however other major coronary arteries can also be involved 2.
Clinical significance
- myocardial bridging does not produce any symptoms in majority of patients
. - it may cause symptoms like angina or ischemia in some patients
.
Radiographic features
CT and angiography
- angiographic diangosis is by demonstrating indirect sign called milking effect
. - MDCT can show a portion of segment which is involved in myocardial bridging
. - the bridged segment often appears to be free of atherosclerosis 5
.
Treatment and prognosis
There are some reports suggesting efficacy with calcium channel blockers for symptomatic patients 3.
-<p><strong>Myocardial bridging (MB)</strong> is a common <a href="/articles/congenital-anomaly-of-the-coronary-arteries">congenital anomaly of the coronary arteries</a><sup>1</sup>. </p><h4>Epidemiology</h4><ul>- +<p><strong>Myocardial bridging (MB)</strong> is a common <a href="/articles/congenital-anomaly-of-the-coronary-arteries">congenital anomaly of the coronary arteries</a> <sup>1</sup>. </p><h4>Epidemiology</h4><ul>
-</ul><h4>Pathology</h4><p>Normally major coronary arteries course epicardially through out its length, in some cases segment of coronary arteries courses intramurally in the myocardium ( tunneled artery). </p><p>Myocardial bridging may be described as superficial or deep.</p><h5>Location</h5><p>This is typically described for left anterior descending artery (LAD) - with the mid LAD considered the most common location <sup>5</sup>, however other major coronary arteries can also be involved <sup>2</sup>.</p><h4>Clinical significance</h4><ul>-<li>myocardial bridging does not produce any symptoms in majority of patients.</li>-<li>it may cause symptoms like angina or ischemia in some patients.</li>- +</ul><h4>Pathology</h4><p>Normally major coronary arteries course epicardially through out its length, in some cases segment of coronary arteries courses intramurally in the myocardium (tunneled artery). </p><p>Myocardial bridging may be described as superficial or deep.</p><h5>Location</h5><p>This is typically described for left anterior descending artery (LAD), with the mid LAD considered the most common location <sup>5</sup>, however other major coronary arteries can also be involved <sup>2</sup>.</p><h4>Clinical significance</h4><ul>
- +<li>myocardial bridging does not produce any symptoms in majority of patients</li>
- +<li>it may cause symptoms like angina or ischemia in some patients</li>
-<li>angiographic diangosis is by demonstrating indirect sign called <a title="Milking effect" href="/articles/milking-effect">milking effect</a>.</li>-<li>MDCT can show a portion of segment which is involved in myocardial bridging.</li>-<li>the bridged segment often appears to be free of atherosclerosis <sup>5</sup>.</li>- +<li>angiographic diangosis is by demonstrating indirect sign called <a href="/articles/milking-effect">milking effect</a>
- +</li>
- +<li>MDCT can show a portion of segment which is involved in myocardial bridging</li>
- +<li>the bridged segment often appears to be free of atherosclerosis <sup>5</sup>
- +</li>
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