Introduction
Myocardial bridging (MB) is a harmless congenital coronary anomaly where
one or more of the coronary arteries pass through the heart muscle
rather than lying on its surface. Exact prevalence of MB is uncertain;
however, MB is expected to present in about one-third of adults to some
extent. (1)
The amount of myocardial fibers traversing above the artery enables
differentiation between superficial (1-2mm of myocardial) and deep
(>2mm of myocardium) bridge; this differentiation is
significant as the depth correlates with the amount of compression
exerted in systole (1). MB has been linked with angina, arrhythmia,
depressed left ventricular function, myocardial stunning, and early
death after cardiac transplantation, and sudden death. (2)
Most people don’t have myocardial bridge symptoms and generally it is a
benign condition but might have symptoms like chest pain during physical
activity or emotional stress. Other angina like symptoms may include
shortness of breath, palpitation and dizziness. (3, 4)
MB induces myocardial ischemia via various mechanisms, such as
supply-demand mismatch, endothelial dysfunction, coronary micro vascular
dysfunction and external mechanical compression. (5)