title: The chance finding at multislice computed tomography coronary angiography of myocardial bridging.
abstract: Myocardial bridging is present when a segment of a major epicardial coronary artery, the 'tunnelled artery', runs intramurally through the myocardium. With each systole, the coronary artery is compressed. The pathophysiology of myocardial bridging is incompletely understood. With each systole, the coronary artery is compressed. Moreover, intravascular ultrasound analysis revealed a delayed relaxation after systolic compression, which may extend significantly into diastole. This explains both the impaired coronary flow reserve and ischemia. Evidence indicates that the intima beneath the bridge is protected from atherosclerosis, and the proximal segment is more susceptible to the development of atherosclerotic lesions because of haemodynamic disturbances. Myocardial bridging is sometimes associated with overt pathology, as well as it can just be an incidental finding without any significance. Myocardial bridging may cause angina pectoris, myocardial infarction, life threatening arrhythmias and even sudden cardiac death but most of them are harmless. Furthermore depressed left ventricular function, myocardial stunning, early death after cardiac transplantation has been also reported. Although the exact management is not well known, beta blockers seem to be the first choice. Stenting is controversial and one must think "twice" before stenting the bridged coronary artery. We report a case of chance finding at multislice computed tomography coronary angiography of two myocardial bridging. Also this case focuses attention on myocardial bridging and it confirms that multislice computed tomography coronary angiography technology represents a useful, noninvasive imaging method of its assessment.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Dattilo
authors.forename: Scipione
authors.initials: S
authors.lastname: Carerj
authors.forename: Annalisa
authors.initials: A
authors.lastname: Lamari
authors.forename: Francesco
authors.initials: F
authors.lastname: Messina
authors.forename: Egidio
authors.initials: E
authors.lastname: Imbalzano
authors.forename: Gianluca
authors.initials: G
authors.lastname: Di Bella
authors.forename: Filippo
authors.initials: F
authors.lastname: Marte
authors.forename: Salvatore
authors.initials: S
authors.lastname: Patanè
mesh_terms: D017023:Coronary Angiography / Q000379:methods*; D004452:Echocardiography; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D054084:Myocardial Bridging / Q000000981:diagnostic imaging*