Is myocardial bridge dangerous? How to treat it?

Hello! Coronary artery (coronary artery) and its branches generally run in epicardial adipose tissue. Myocardial bridge refers to a certain segment of coronary artery or a certain segment of its branches running in myocardial fibers and covered by bridging myocardial fibers. This kind of myocardial fiber bundle is called myocardial bridge. Because it runs in the heart fibers, the heart will inevitably compress the coronary artery when it contracts, so sometimes there will be myocardial ischemia similar to angina pectoris. However, the recent study of angiography combined with intravascular ultrasound has the ability to prove that the vascular compression of myocardial bridge is not completely in systolic phase, but lasts until diastolic phase, which can reduce the coronary blood flow reserve [5], so myocardial bridge can cause myocardial ischemia, especially in patients with severe hemodynamic disorder. The risk of myocardial bridge is mainly related to the compression position and stenosis degree of coronary artery during myocardial contraction. The more the main branch with large blood supply area is compressed, the more obvious the stenosis after compression. Then the more obvious the symptoms, the higher the risk. Myocardial bridge is most common in the left anterior descending branch, and there are also reports about clinical cardiovascular events caused by myocardial bridge. If there are no symptoms, you can observe and follow up without considering drug treatment. If the symptoms are obvious, we can consider: 1 drug therapy: β -blocker can reduce the pressure in circulation and coronary artery, reduce vascular compression, and its negative conduction can prolong diastolic period and improve coronary artery perfusion; 2. Myocardial bridge resection or coronary artery dissolution: Most people think that surgical treatment is effective for those patients who still have ischemic symptoms after receiving drug treatment. However, some people think that the operation is quite dangerous, mainly because the course of coronary myocardial bridge is unpredictable, and sometimes it is necessary to deeply cut the ventricular wall, which may lead to the subsequent occurrence of left ventricular aneurysm. Coronary stent implantation: Recent studies show that coronary stent implantation can relieve the symptoms of angina pectoris in patients with symptomatic myocardial bridge, and can be used as an important treatment for patients with persistent severe angina pectoris and poor efficacy of beta blockers.