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Br Heart J. 1991 November; 66(5): 364–367.
PMCID: PMC1024775

Myocardial bridges: morphological and functional aspects.

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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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • GEIRINGER E. The mural coronary. Am Heart J. 1951 Mar;41(3):359–368. [PubMed]
  • BURNSIDES C, EDWARDS JC, LANSING AI, SWARM RL. Arteriosclerosis in the intramural and extramural portions of coronary arteries in the human heart. Circulation. 1956 Feb;13(2):235–241. [PubMed]
  • Vasan RS, Bahl VK, Rajani M. Myocardial infarction associated with a myocardial bridge. Int J Cardiol. 1989 Nov;25(2):240–241. [PubMed]
  • Bestetti RB, Costa RS, Zucolotto S, Oliveira JS. Fatal outcome associated with autopsy proven myocardial bridging of the left anterior descending coronary artery. Eur Heart J. 1989 Jun;10(6):573–576. [PubMed]
  • POLACEK P, KRALOVE H. Relation of myocardial bridges and loops on the coronary arteries to coronary occulsions. Am Heart J. 1961 Jan;61:44–52. [PubMed]
  • Visscher DW, Miles BL, Waller BF. Tunneled ("bridged") left anterior descending coronary artery in a newborn without clinical or morphologic evidence of myocardial ischemia. Cathet Cardiovasc Diagn. 1983;9(5):493–496. [PubMed]
  • Hansen BF. Myocardial covering on epicardial coronary arteries. Prevalence, localization and significance. Scand J Thorac Cardiovasc Surg. 1982;16(2):151–155. [PubMed]
  • Ishii T, Hosoda Y, Osaka T, Imai T, Shimada H, Takami A, Yamada H. The significance of myocardial bridge upon atherosclerosis in the left anterior descending coronary artery. J Pathol. 1986 Apr;148(4):279–291. [PubMed]
  • Bezerra AJ, Prates JC, DiDio LJ. Incidence and clinical significance of bridges of myocardium over the coronary arteries and their branches. Surg Radiol Anat. 1987;9(4):273–280. [PubMed]
  • Reig J, Loncan MP, Martin S, Binia M, Petit M, Domenech JM. Ponts myocardiques. Incidence et relation avec certaines variables coronariennes. Arch Anat Histol Embryol. 1986;69:101–110. [PubMed]
  • Marshall ME, Headley RN. Intramural coronary artery as a cause of unstable angina pectoris. South Med J. 1978 Oct;71(10):1304–1306. [PubMed]
  • Hill RC, Chitwood WR, Jr, Bashore TM, Sink JD, Cox JL, Wechsler AS. Coronary flow and regional function before and after supraarterial myotomy for myocardial bridging. Ann Thorac Surg. 1981 Feb;31(2):176–181. [PubMed]
  • Loures JB, Sousa JE, Pimentel WA, Freire RJ, Büchler JR, Gizzi JC, Fontes VF, Jatene AD. Estudo hemodinâmico e metabólico de pacientes com ponte miocárdica na artéria descendente anterior. Arq Bras Cardiol. 1978 Jun;31(3):159–165. [PubMed]
  • PORSTMANN W, IWIG J. [Intramural coronary vessels in the angiogram]. Fortschr Geb Rontgenstr Nuklearmed. 1960 Feb;92:129–133. [PubMed]
  • Amplatz K, Anderson R. Angiographic appearance of myocardial bridging of the coronary artery. Invest Radiol. 1968 May-Jun;3(3):213–215. [PubMed]
  • Angelini P, Trivellato M, Donis J, Leachman RD. Myocardial bridges: a review. Prog Cardiovasc Dis. 1983 Jul-Aug;26(1):75–88. [PubMed]
  • Ishimori T, Raizner AE, Chahine RA, Awdeh M, Luchi RJ. Myocardial bridges in man: clinical correlations and angiographic accentuation with nitroglycerin. Cathet Cardiovasc Diagn. 1977;3(1):59–65. [PubMed]
  • Pichard AD, Casanegra P, Marchant E, Rodriguez JA. Abnormal regional myocardial flow in myocardial bridging of the left anterior descending coronary artery. Am J Cardiol. 1981 Apr;47(4):978–982. [PubMed]
  • Carvalho VB, Macruz R, Décourt LV, Arie S, Manrique R, Mello SC, Godoy M, Galiano N, da Luz PL, Pileggi F. Hemodynamic determinants of coronary constriction in human myocardial bridges. Am Heart J. 1984 Jul;108(1):73–80. [PubMed]

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