Bonvini Robert F, Alibegovic Jasmina, Perret Xavier, Keller Pierre-Frédéric, Camenzind Edoardo, Verin Vitali, Sigwart Ulrich
Cardiology Center, University Hospital of Geneva, 24 Rue Micheli du Crest, 1211 Geneva, Switzerland.
Heart Vessels. 2008 Jan;23(1):67-70. doi: 10.1007/s00380-007-1011-z. Epub 2008 Feb 14.
Myocardial bridge (MB) or tunneled coronary artery is an inborn abnormality, which implicates a systolic vessel compression with a persistent mid-late diastolic diameter reduction. Myocardial bridges are often observed during coronary angiography with an incidence of 0.5%-5.5%. The most involved coronary artery is the left anterior descending artery followed by the diagonal branches, the right coronary artery, and the left circumflex. The overall long-term prognosis is generally benign. However, several risk or precipitating factors (e.g., high heart rate, left ventricular hypertrophy, decreased peripheral vascular resistance) may trigger symptoms (most frequently angina). Herein, we describe two cases of symptomatic myocardial bridge, where medical treatment (i.e., inotropic negative drug) and coronary stenting were successfully utilized to treat this pathology. We also focus on the clinical presentation, and the diagnostic and therapeutic modalities to correctly manage this frequently observed congenital coronary abnormality, underlining the fact that in cases of typical angina symptoms without any significant coronary artery disease, MB should be considered as a possible differential diagnosis.
心肌桥（MB）或冠状动脉走行于心肌内是一种先天性异常，其意味着收缩期血管受压且舒张中后期管径持续减小。心肌桥常在冠状动脉造影时被观察到，发生率为0.5% - 5.5%。最常受累的冠状动脉是左前降支，其次是对角支、右冠状动脉和左旋支。总体长期预后通常良好。然而，一些危险因素或诱发因素（如高心率、左心室肥厚、外周血管阻力降低）可能引发症状（最常见的是心绞痛）。在此，我们描述两例有症状的心肌桥病例，其中药物治疗（即使用负性肌力药物）和冠状动脉支架置入术成功用于治疗该病症。我们还着重介绍了临床表现以及正确处理这种常见先天性冠状动脉异常的诊断和治疗方式，强调在出现典型心绞痛症状且无任何显著冠状动脉疾病的情况下，应将心肌桥视为一种可能的鉴别诊断。
