Original article: Myocardial bridge - a not so rare finding in patients undergoing coronary angiography for chest pain

Background: Muscle fibers overlying the intramyocardial segment of an epicardial coronary artery are termed myocardial bridge. The aim of this study was to determine the frequency, angiographic characteristics, anatomical aspects, clinical manifestations and possible associations of myocardial bridges in a large urban Indian population of adults undergoing coronary angiography in our centre (Sawai Man Singh Medical College, Jaipur, Rajasthan, India). Methods: The angiographic data of 3275 adult patients undergoing coronary angiography were retrospectively analysed for the diagnosis of myocardial bridge. Quantitative coronary angiography was used for analysis. Results: Myocardial bridge was present in 42 (1.28%) of the 3275 coronary angiographies. The location of the bridge was in the left anterior descending coronary artery in 40 cases (95.23%), and the left circumflex coronary artery in 2 cases (4.76%). Of the 42 patients with myocardial bridges 31 ( 73.8%) had associated significant coronary artery disease. Remaining 11 (26.19%) patients presented with isolated bridges. Of the 11 patients of isolated myocardial bridges, 3 (27.27%) patients presented with acute myocardial infarction. The mean length of bridge was 19.07±8.86 mm and mean percentage of systolic obliteration by the bridge was 54.40±19.67%. Conclusion: Chest pain was the common reason for angiography in patients with myocardial bridge. The incidence of myocardial bridge may vary according to population. Myocardial bridge is more frequently found in the middle segment of the left anterior descending coronary artery. Myocardial bridging can accelerate atherosclerosis and precipitate acute myocardial infarction.