Myocardial bridging ‘a double-edged sword’: Analysis and significance

Abstract Introduction Myocardial bridging (MB) in coronary artery exhibits a role of a double-edged sword in coronary artery disease (CAD). The objectives under study were to validate the prevalence and segments of coronaries with myocardial bridging, length and diameter of bridging segments and cardiac dominance patterns among a west coastal population of Kerala and Karnataka, India from coronary angiogram reports. The co-relation of bridged segments and cardiac dominance patterns in diseased and non-diseased coronary arteries were assessed to find out the significance of both in CAD. Materials and Methods The angiograms were obtained from K.S Hegde Medical Academy and Hospital, Karnataka after procuring the ethical clearance. 1000 cases with clinical symptoms, ECG abnormalities were studied prospectively. Recanalized normal looking coronary arteries were excluded. Results Myocardial bridging were seen in 50 cases with majority involvement of mid-segment of the left anterior descending artery (LAD). Mean ± S.D for the length of bridged segments can be expressed as 17.96 ± 9.79 mm for upper limit (U.L) and 14.51 ± 7.56 mm for lower limit (L.L) respectively. Cardiac dominance was seen as right in 863 cases, left in 77 cases, co-dominant in 60 cases. 629 patients had diseased coronaries among the study group. Out of the 50 bridged coronaries, eleven cases had stenosis among bridged segments Discussion and conclusion Significant association (p