MYOCARDIAL BRIDGES: FROM DIAGNOSIS TO TREATMENT

Bochkarev Alexey Borisovich, Novikov Maxim Sergeevich, Sheverdin Nikolay Nikolaevich, Toropov (Grigoryan) Ksenia Arsenova, Kurskova Anastasia Igorevna

Myocardial bridging (MM) is a common anomaly of the coronary tree; very often it is not clinically manifested. Typically the artery involved is the left anterior descending artery at its proximal and/or midportion. MM can cause ischemia through various mechanisms directly proportional to the degree of compression of the intramyocardial tract, which impairs coronary blood flow. MM, when symptomatic, often begins with exertional angina, with some patients experiencing more severe conditions such as unstable angina or myocardial infarction. Diagnostic testing includes non-invasive and invasive testing methods. In symptomatic cases, drug therapy with beta blockers, calcium receptor antagonists, and ivabradine is sufficient to treat angina. If this method is ineffective, PCI, CABG, or myomectomy are performed. Objective: To review the literature on the pathogenesis, diagnosis, treatment and monitoring of patients with myocardial bridges. Materials and methods: open sources from PubMed, Cochrane Library databases, Elibrary.

Keywords:myocardial bridge, intravascular ultrasound, optical coherence tomography, tunnelized coronary artery