Clinical Analysis Of Myocardial Bridge In Coronary Arteriography

Objective: In order to investigate the incidence, clinical characteristics, therapeuticsand prognosis of coronary myocardial bridge in patients who undergone coronary arteriography (CAG). Approach to characteristics of anatomic structure and mechanism of pathophysiology.Methods: We accumulate the clinical informations of 381 cases with CAG duringJuly 2008 to March 2009. The clinical data of 13 patients who were diagnosed as coronary myocardial bridge were analyzed retrospectively. We observe the symptoms,analysis the results of auxiliary examinations, like EKG and coronary arteriography. Collect the treatments of these patients. Try to find out the clinical feature of this disease. Each patient receive a 1 month follow up to check whether the symptom got better.Results: Among 381 cases,13 cases were diagnosed as myocardial bridge. Thedetection rate is 3.41%. The left anterior descending artery was affected by myocardial bridge in most of cases. ST-T segment changes which indicate ischemia can be found in 6 cases, while 2 of them get a positive result in treadmill test. There were 4 cases with atherosclerosis which all located in the proximal artery of myocardial bridge. 1 of the 4 cases with coronary stenosis greater than 75%,and got a stent implantation .The stenosis of other 3 cases was equal to 20%～30%. Short of breath was the main complaint in all 13 patients. Only 4 patients revealed the typical symptom of angina pectoris with blood flow restriction in systolic greater than 50%.All the symptoms were improved by beta-blockers and calcium channel blockers in the follow up.Conclusion: Coronary myocardial bridge can lead to angina pectoris and changes inEKG. The severey of the symptoms depends on the stenosis. Coronary myocardial bridges are usually found in the distant part of the left anterior descending(LAD).It can lead to a high risk to atherosclerosis in the proximal part of myocardial bridge. Medication is effective for myocardial bridge with symptoms. Only a few cases need PCI or surgical procedure.