Myocardial bridges: morphological and functional aspects.
TL;DR: The superficial type of myocardial bridge does not seem to constrict the artery during systole but the deep muscle bridges, by virtue of their relation with the left anterior descending coronary artery, could twist the vessel and thus compromise its diastolic flow and thus result in ischaemia.
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Abstract: OBJECTIVE--To assess the arrangement of myocardial bridges. DESIGN--A necropsy study of 90 consecutive hearts (56 male, 34 female). RESULTS--Myocardial bridges, either single or multiple, were seen in 50 (55.6%) of the 90 hearts. The left anterior descending artery was the most commonly affected artery. Thirty five of the 50 hearts which contained in total 41 muscle bridges were dissected further with a magnifying glass. Two different types of muscle bridges could be identified. Thirty one of these 41 myocardial bridges were superficial, crossing the artery transversely towards the apex of the heart at an acute angle or perpendicularly. The remaining 10 myocardial bridges crossed the left anterior descending coronary artery and surrounded it by a muscle bundle that arose from the right ventricular apical trabeculae and crossed the artery transversely, obliquely, or helically before terminating in the interventricular septum. CONCLUSIONS--The superficial type of myocardial bridge does not seem to constrict the artery during systole but the deep muscle bridges, by virtue of their relation with the left anterior descending coronary artery, could twist the vessel and thus compromise its diastolic flow. This may result in ischaemia.
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Prevalence of myocardial bridging and correlation with coronary atherosclerosis studied with 64-slice CT coronary angiography
Ludovico La Grutta,Giuseppe Runza,G. Lo Re,Massimo Galia,Valerio Alaimo,Emanuele Grassedonio,Tommaso Vincenzo Bartolotta,Roberto Malago,Carlo Tedeschi,Filippo Cademartiri,M. De Maria,Adelfio Elio Cardinale,Roberto Lagalla,Massimo Midiri +13 more
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Myocardial Bridge as a Cause of Thrombus Formation and Myocardial Infarction in a Young Athlete
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Myocardial bridging in a young patient with sudden death
TL;DR: There is much controversy about the incidence and clinical significance of a segmental intramyocardial course of the left anterior descending coromy artery, also known as myocardial bridging, but the prevalence of this condition is highly variable in necropsy series and the angiographic prevalence is much lower.
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References
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Relation of myocardial bridges and loops on the coronary arteries to coronary occlusions
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