title: Myocardial bridges, neither rare nor isolated-Autopsy study.
abstract: OBJECTIVE
  Myocardial bridge is a congenital anomaly with a markedly variable reported incidence on autopsy (4.7%-86%), likely related to geographical regions. Our previous retrospective study showed a prevalence of 0.8%, which we doubted to be the true one in the examined sample of the Serbian population. To assess the importance of the phenomenon we conducted a 2-year prospective study at the same institution.
  
  
  METHODS
  Ninety-six cadaver hearts from adult individuals of both genders (51 men, 45 women) who died from natural causes underwent special dissection. Tunneled coronary arteries and myocardium were examined using light microscopy.
  
  
  RESULTS
  A total of 14 myocardial bridges were found in 13 (13.54%) hearts. This anomaly was insignificantly more common in men (13.72% vs. 13.33%, p>0.05). In one heart we noted two myocardial bridges (the left anterior interventricular artery and left marginal artery were overbridged). None of the myocardial bridges had been diagnosed during life. The most common causes of death were cardiac related. Myocardial bridges were located in the following areas: left anterior interventricular (50%), left circumflex artery (28.6%), left marginal artery (14.3%), and right coronary artery (7.1%). In 92.3% of cases, the right coronary artery was dominant. The only heart with a balanced-type had two bridges. Most of the myocardial bridges were long and deep. All tunneled coronary arteries, and although surrounded by "coronary cushion," were not protected from atherosclerosis. In 30.8% of hearts with myocardial bridges, we found additional coronary artery anomalies.
  
  
  CONCLUSIONS
  Myocardial bridges were not rare in the examined sample of the Serbian population and were often associated with other coronary artery anomalies, rendering the carriers at higher risk.
authors: Institute of Anatomy "Niko Miljanic", Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors: G
authors: G
authors: Teofilovski-Parapid
authors: Institute of Pathology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors: R
authors: R
authors: Jankovic
authors: Serbian Academy of Sciences and Arts, Belgrade, Serbia; Division of Cardiology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors: V
authors: V
authors: Kanjuh
authors: Cardiovascular Pathology Inc., Gaithersburg, MD, USA.
authors: R
authors: R
authors: Virmani
authors: Département de Cardiologie, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Faculté de Médecine, Université Paris-Descartes, Paris, France.
authors: N
authors: N
authors: Danchin
authors: Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil.
authors: N
authors: N
authors: Prates
authors: Division of Cardiology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors: D V
authors: DV
authors: Simic
authors: Division of Cardiology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia. Electronic address: biljana_parapid@yahoo.com.
authors: B
authors: B
authors: Parapid
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000453:epidemiology / Q000473:pathology; D001344:Autopsy; D002102:Cadaver; D002423:Cause of Death; D003331:Coronary Vessels / Q000473:pathology; D004210:Dissection; D005260:Female; D006330:Heart Defects, Congenital / Q000453:epidemiology* / Q000473:pathology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors; D055771:Serbia / Q000453:epidemiology
keywords: Anterior interventricular artery; Autopsy; Coronary artery anomalies; Light microscopy; Morphology; Morphometry; Myocardial bridges