Author + information
- Marinos Charalambous1,
- John Makaryus1,
- Elpidoforos Soteriades2,
- Savvas Constantinides2 and
- Christos Christou2
Myocardial bridging (MB) is an anatomical variant of the coronary arteries in which a portion of the coronary artery takes an intramuscular course and becomes covered by a “bridge” of myocardium. While usually asymptomatic, MB may be responsible for chest pain, acute coronary syndromes, left ventricular dysfunction and arrhythmias. The prevalence of MB reported on autopsy studies and on coronary computed tomography (CCT) varies but the mean prevalence is approximately 25%. There are very few studies reporting the prevalence of MB based on coronary angiography (CA). Our aim is to identify the epidemiological and morphological characteristics of MB based on our CA registry.
Data from 6779 angiograms performed between January 2006 and December 2015 were analyzed. All patients reported to have MB on CA were identified. Baseline characteristics, indications for CA and all procedural information were collected through a computerized database.
Among 6779 CA performed, only 22 cases of MB were reported (prevalence 0.3%). Mean age was 58.8 years (range 38-75 years). Only 2/22 (9%) were females. The indications for CA were: chest pain [9/22 (41%)], abnormal stress test [9/22 (41%)], abnormal CCT [(2/22 (9%)], acute Ml [2/22 (9%)]. 18 out of 22 patients (82%) had MB in mid-LAD. 4 out of 22 patients (18%) had MB in distal LAD. 5 out of 22 patients (23%) had obstructive CAD in addition to MB. 12 out of 22 (55%) patients had no CAD and 5 out of 22 (23%) had non-obstructive CAD.
Based on our study, Myocardial Bridging is significantly underdiagnosed (reported prevalence 0.3%) during coronary angiography compared to the rates reported on CCT or autopsy studies (mean prevalence 25%). MB can have great clinical significance, especially in symptomatic patients and every effort should be made to report such lesions during coronary angiography.