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(Circulation. 2002;106:2616.)
© 2002 American Heart Association, Inc.

Mini-Review: Current Perspective

Update on Myocardial Bridging

Stefan Möhlenkamp, MD; Waldemar Hort, MD; Junbo Ge, MD; Raimund Erbel, MD

From the Clinic of Cardiology (S.M., R.E.), University Clinic Essen, Germany; Institute of Pathology (W.H.), Heinrich Heine University Düsseldorf, Germany; and Department of Cardiology (J.G.), Zhongshan Hospital, Fudan University, China.

Correspondence to Professor Raimund Erbel, MD, FACC, FESC, Clinic of Cardiology, University Clinic Essen, Hufelandstrasse 55, 45122 Essen, Germany. E-mail erbel@med.uni-essen.de

Key Words: myocardial bridging • anatomy • tunneled artery • arteries

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Muscle overlying the intramyocardial segment of an epicardial coronary artery, first mentioned by Reyman¹ in 1737, is termed a myocardial bridge, and the artery coursing within the myocardium is called a tunneled artery (Figure 1). It is characterized by systolic compression of the tunneled segment, which remains clinically silent in the vast majority of cases. An in-depth analysis of autopsy samples was first presented by Geiringer et al² in 1951, but clinical interest and systematic research was triggered by an observed association of myocardial bridging with myocardial ischemia.^2–5

View larger version (68K): [in this window] [in a new window]   Figure 1. Typical systolic compression (arrows) of the mid LAD at two sites in series. Diastolic lumen dimensions are normal. The coronary tree shows no angiographic signs of coronary atherosclerosis.

New imaging techniques have led to improved identification and functional quantitation of myocardial bridging in vivo, which is crucial for establishing a link between systolic compression and the clinical presentation, and hence for commencing appropriate therapy. In the present article, we summarize clinically relevant aspects of myocardial bridging with an emphasis on morphological and hemodynamic alterations and their representation in imaging techniques.

Prevalence

The prevalence varies substantially among studies with a much higher rate at autopsy versus angiography (Table).^2,4–28 Variation at autopsy may in part be attributable to the care taken at preparation and the selection of hearts. Poláek, who included myocardial loops, reports the highest rate with bridges or loops in 86% of cases.²⁹ On average, myocardial bridges are present in about one third of adults.

View this table: [in this window] [in a new window]   Prevalence . . . [Full Text of this Article]

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