Diagnosis, prognosis and treatment of "myocardial bridging": state of the art and unresolved issues

• Published in: Recenti progressi in medicina Vol. 104; no. 9; p. 493
• Main Authors: Vernuccio, Federica, Fazio, Giovanni, Lo Re, Giuseppe, Grutta, Giuseppe, Insalaco, Antonella, Galfano, Maria Cristina, Rabita, Fabrizio, La Grutta, Ludovico
• Format: Journal Article
• Language: Italian
• Published: Italy 01.09.2013
• Subjects: Adrenergic beta-Antagonists - therapeutic use; Calcium Channel Blockers - therapeutic use; Coronary Angiography; Drug Therapy, Combination; Humans; Myocardial Bridging - diagnosis; Myocardial Bridging - diagnostic imaging; Myocardial Bridging - drug therapy; Prognosis; Tomography, X-Ray Computed; Ultrasonography; Vasodilator Agents - therapeutic use
• ISSN: 0034-1193
• DOI: 10.1701/1331.14738

The current gold standard for the diagnosis of myocardial bridging is conventional coronary angiography; however, it shows only indirect signs of the disease, due to the systolic compression of the artery caused by the myocardial bridge with narrowing of the lumen and diastolic relaxation. On the other hand, computed tomography coronary angiography, even though exposing to radiation, clearly demonstrates the intramural course, the overlying muscular bands and the surrounding tissues also in asymptomatic patients and in absence of systolic compression. The prognosis of patients with myocardial bridge is usually good, but further studies are needed to evaluate the long-term prognosis of these patients, the adequate diagnostic and preventive approach and to better discern which patients should be candidate to medical, percutaneous or surgical treatment.