Myocardial bridges and ischemic heart disease

The clinical, electrocardiographs and angiocardiographic data are reported of 37 patients with myocardial bridges, in the absence of coronary atherosclerosis. An intramyocardial course of the left anterior descending coronary artery was present in all cases: myocardial bridges on the posterior descending and first diagonal branch were associated in one patient. The clinical presentation was that of ischemic heart disease in all cases, with stable angina in nine, unstable angina in 19, the intermediate syndrome in five, and a history or evidence of previous myocardial infarction in four. In 20 cases, left ventricular wall motion appeared to be abnormal on the antero-lateral or apical profile. One patient died suddenly the day following hospital discharge; of 27 patients followed over a 3–36 month interval, only four (15%) were free of symptoms on medical treatment. The frequent association of myocardial bridges with a clinical picture of ischemic heart disease which is sometimes severe, is emphasized together with the disappointing results of medical treatment.