title: Myocardial bridging on coronary CTA: an innocent bystander or a culprit in myocardial infarction?
abstract: Myocardial bridging describes the clinical entity whereby a segment of coronary artery is either partially or completely covered by surrounding myocardium. It represents the most frequent congenital coronary anomaly and has an estimated prevalence of ≤13% on angiographic series. With the emergence of cardiac computed tomography and its ability to simultaneously image the coronary arteries and also the myocardium, there has been an apparent increase in the detection rates of myocardial bridges (prevalence as high as 44%). It has now become important to evaluate their clinical significance. Myocardial bridging is generally considered a benign entity with survival rates of 97% at 5 years; however, there is now emerging evidence that certain myocardial bridge characteristics may be associated with cardiovascular morbidity. The length and depth of myocardial bridges have been associated with increased atherosclerosis, whereas the degree of systolic compression has been associated with ischemia on myocardial perfusion single-photon emission tomography. On the basis of current evidence, it appears that limiting further testing for ischemia to symptomatic patients with long and/or deep myocardial brides would be appropriate.
authors.affiliation: Department of Imaging and Medicine, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 90048, USA.
authors.forename: Rine
authors.initials: R
authors.lastname: Nakanishi
authors.forename: Ronak
authors.initials: R
authors.lastname: Rajani
authors.forename: Yukio
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Ishii
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Berman
mesh_terms: D015984:Causality; D015897:Comorbidity; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D006801:Humans; D054084:Myocardial Bridging / Q000000981:diagnostic imaging* / Q000401:mortality*; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000401:mortality*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*