ABSTRACT
Coronary arteries supply blood to the heart. They run through the epicardial adipose tissue during their course. Occasionally a band of myocardial tissue overlies a segment of the coronary arteries. This band of myocardium overlying the coronary artery is named as Myocardial Bridge (MB). There have been numerous instances of sudden and unexpected cardiac death where the presentation of myocardial bridging was the main clinically pertinent finding post-mortem. We wanted to study the distinct morphological aspects of MBs along with the structural composition of the coronary vessel present beneath, in front of and past the myocardial bridge. METHODSMicroscopy and morphometry were utilized to detail the distinct morphological characteristics of myocardial bridges as well as to take a closer look at the structural composition of the coronary vessel present beneath, in front of and past the myocardial bridge being evaluated. Three segments of the left anterior descending artery (LAD) were utilized to glean testable samples. These samples are as follows: (A) located proximally to the bridge at a distance of 8 mm, (B) alongside the bridge and (C) located distally from the bridge at a distance of 8 mm. RESULTSPrevalence of MB was found to be 40 %. Male to female ratio was 7:1. 87.5 % of the hearts have single MB, 10 % have double MB, 2.5 % have triple MB. Most common vessel affected is LAD. The MBs ranged in length from 4.4 mm to 45 mm with a length of 12.67 mm being the quantifiable mean. Thickness of MB ranged from 0.4 to 1.9 mm with mean thickness of 1.11 mm. The component of the coronary artery that was bridged often showed a diminished tunica intima compared to similar segments taken from proximal and distal sites. It should be noted that the proximal segment is predisposed to atherosclerotic presentation on account of myocardial bridging. CONCLUSIONSA myocardial bridge leads to detrimental changes in the vessel which in turn leads to early presentation of atherosclerosis, arrhythmias, myocardial infarctions and in severe cases, sudden death. Myocardial bridging is frequently localized in the LAD. It can have significant effects on the overall health.