Prevalence of Symptomatic Myocardial “Bridges” in Patients Hospitalized for Acute Coronary Syndrome

Topicality: Nowadays myocardial bridges (MB) are among the leading congenital malformations of coronary arteries (CA). The presence of MB is known to be associated with the signs of ischemia, malignant arrhythmias and sudden death.
Objective: To establish the prevalence of MB among the patients hospitalized for acute coronary syndrome (ACS). Materials and methods. 378 patients hospitalized for ACS in the first 2–6.5 hours of the onset of pain syndrome were retrospectively analyzed. All patients underwent emergency coronary angiography.
Results: Coronary angiography found MB in 25 persons (6.7%), average age 57.3 ± 3.4 years. There were 4 females (16%), average age62.0±2.1 years, and 21 males (84%), average age 56.4±3.1years. MB were detected in the left anterior descending artery (LAD) in the middle third – in 17 patients (68%), the distal third – in 5 (20%), the proximal part – in 1 (4%). One patient (4%) had MB in proximal and middle third and one patient (4%)–in proximal third and diagonal branch. A side from MB the following pathologic states were diagnosed: CA stenosis – in 13 patients (52%), single-vessel lesion – in 6 (46.2%), two-vessel lesion - in 2 (8%), CA trunk stenosis – in one (4%), three-vessel lesion – in4 (30.8%). 7 patients (28%) underwent coronary stenting for stenosis, one patient (4%) – myocardial bridge stenting, one patient (4%) –coronary artery bypass graft surgery.
Conclusions: Among hospitalized for ACS patients 25 (6.7%) had MB detected by coronary angiography, more often males than females (p=0.05). MB were found in the patients with and without hemodynamically significant stenosis.