Department of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Center (MCVTC), Institute of Medicine, TUTH, Kathmandu, Nepal.
J Nepal Health Res Counc. 2023 Mar 10;20(3):774-778. doi: 10.33314/jnhrc.v20i3.4268.
Myocardial bridging is a congenital anomaly in which a segment of epicardial coronary artery takes an intramyocardial course, the systolic compression of which could be asymptomatic or may lead to major hemodynamic changes such as myocardial ischemia, arrhythmias or sudden cardiac death. The prevalence is highly variable depending upon different investigational modalities to diagnose it. Here we have aimed to study the prevalence through invasive coronary angiography.
This retrospective study was carried out at Manmohan Cardiothoracic Vascular and Transplant center, Kathmandu, Nepal. The invasive coronary angiography of 5096 patients were studied from March 2018 to April 2021 done for various indications.
Among all the patients, the myocardial bridging was identified in 257 (5.04%) patients. About 177 (68.9%) were males and 80 (31.1%) were females. The mean age of the patients having myocardial bridging was 54.52 ± 10.31years. Diabetes mellitus was found in 33(12.8%) and hypertension was found in 77(29.9%) patients with myocardial bridging. Stable angina (29.2%) was the most common clinical presentation. Treadmill test was positive in about 70 (27.2%) patients. Majority of patients had myocardial bridge in left anterior descending artery alone (89.9%) and located mostly in mid-part (74.9%).
The myocardial bridging is not an uncommon finding on invasive coronary angiography in middle aged people who present with typical angina.
心肌桥是一种先天性异常，其中一段心外膜冠状动脉走行于心肌内，其收缩期压迫可能无症状，也可能导致严重的血流动力学变化，如心肌缺血、心律失常或心源性猝死。其患病率因不同的诊断方法而有很大差异。在这里，我们旨在通过有创冠状动脉造影来研究其患病率。
本回顾性研究在尼泊尔加德满都的 Manmohan 心胸血管和移植中心进行。研究了 2018 年 3 月至 2021 年 4 月期间因各种原因进行的 5096 例有创冠状动脉造影患者。
在所有患者中，257 例（5.04%）患者被诊断为心肌桥。其中 177 例（68.9%）为男性，80 例（31.1%）为女性。有心肌桥的患者平均年龄为 54.52 ± 10.31 岁。有心肌桥的患者中，33 例（12.8%）患有糖尿病，77 例（29.9%）患有高血压。稳定型心绞痛（29.2%）是最常见的临床表现。约 70 例（27.2%）患者的跑步机测试呈阳性。大多数患者的左前降支只有心肌桥（89.9%），并且主要位于中段（74.9%）。
在中年人群中，有典型心绞痛症状的患者，有创冠状动脉造影中发现心肌桥并不罕见。
