Coronary angiography myocardial bridge: Difference between revisions
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==Overview== | ==Overview== | ||
A myocardial bridge or MB is defined as a segment of a major [[coronary artery|coronary]] [[epicardial]] [[artery]] that "tunnels" or passes intramurally through the [[myocardium]] beneath the muscle bridge during [[systole]].<ref name="pmid15764618">{{cite journal |author=Alegria JR, Herrmann J, Holmes DR, Lerman A, Rihal CS |title=Myocardial bridging |journal=[[European Heart Journal]] |volume=26 |issue=12 |pages=1159–68 |year=2005 |month=June |pmid=15764618 |doi=10.1093/eurheartj/ehi203 |url=http://eurheartj.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=15764618 |accessdate=2012-07-01}}</ref><ref name="pmid12427660">{{cite journal |author=Möhlenkamp S, Hort W, Ge J, Erbel R |title=Update on myocardial bridging |journal=[[Circulation]] |volume=106 |issue=20 |pages=2616–22 |year=2002 |month=November |pmid=12427660 |doi= |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=12427660 |accessdate=2012-07-01}}</ref> Myocardial bridges are generally located in the distribution of the [[left anterior descending artery]] ([[LAD]]) and its [[diagonal branch]]es. | A myocardial bridge or MB is defined as a segment of a major [[coronary artery|coronary]] [[epicardial]] [[artery]] that "tunnels" or passes intramurally through the [[myocardium]] beneath the muscle bridge during [[systole]].<ref name="pmid15764618">{{cite journal |author=Alegria JR, Herrmann J, Holmes DR, Lerman A, Rihal CS |title=Myocardial bridging |journal=[[European Heart Journal]] |volume=26 |issue=12 |pages=1159–68 |year=2005 |month=June |pmid=15764618 |doi=10.1093/eurheartj/ehi203 |url=http://eurheartj.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=15764618 |accessdate=2012-07-01}}</ref><ref name="pmid12427660">{{cite journal |author=Möhlenkamp S, Hort W, Ge J, Erbel R |title=Update on myocardial bridging |journal=[[Circulation]] |volume=106 |issue=20 |pages=2616–22 |year=2002 |month=November |pmid=12427660 |doi= |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=12427660 |accessdate=2012-07-01}}</ref> Myocardial bridges are generally located in the distribution of the [[left anterior descending artery]] ([[LAD]]) and its [[diagonal branch]]es. [[Systolic]] narrowing of the [[epicardial]] [[artery]] shows complete reversal during [[diasole]].<ref name="pmid15764618">{{cite journal |author=Alegria JR, Herrmann J, Holmes DR, Lerman A, Rihal CS |title=Myocardial bridging |journal=[[European Heart Journal]] |volume=26 |issue=12 |pages=1159–68 |year=2005 |month=June |pmid=15764618 |doi=10.1093/eurheartj/ehi203 |url=http://eurheartj.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=15764618 |accessdate=2012-07-01}}</ref>. The [[angiographic]] manifestation depends on:<ref name="pmid15764618">{{cite journal |author=Alegria JR, Herrmann J, Holmes DR, Lerman A, Rihal CS |title=Myocardial bridging |journal=[[European Heart Journal]] |volume=26 |issue=12 |pages=1159–68 |year=2005 |month=June |pmid=15764618 |doi=10.1093/eurheartj/ehi203 |url=http://eurheartj.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=15764618 |accessdate=2012-07-01}}</ref> the thickness and length of [[myocardial]] bridge, the reciprocal orientation of the [[coronary artery]] and [[myocardial]] fibers, the presence of loose [[connective tissue]] or [[adipose tissue]] around the bridged segment, the presence of an [[left ventricular outflow tract obstruction|aortic outflow tract obstruction]], the intrinsic tone of the wall of the [[coronary artery]], the presence of a [[proximal]] [[coronary artery|coronary]] fixed obstruction and the state of [[myocardial]] [[contractility]]. | ||
==Example== | ==Example== | ||
Revision as of 22:37, 3 September 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]
Overview
A myocardial bridge or MB is defined as a segment of a major coronary epicardial artery that "tunnels" or passes intramurally through the myocardium beneath the muscle bridge during systole.[1][2] Myocardial bridges are generally located in the distribution of the left anterior descending artery (LAD) and its diagonal branches. Systolic narrowing of the epicardial artery shows complete reversal during diasole.[1]. The angiographic manifestation depends on:[1] the thickness and length of myocardial bridge, the reciprocal orientation of the coronary artery and myocardial fibers, the presence of loose connective tissue or adipose tissue around the bridged segment, the presence of an aortic outflow tract obstruction, the intrinsic tone of the wall of the coronary artery, the presence of a proximal coronary fixed obstruction and the state of myocardial contractility.
Example
Shown below is an animated image depicting myocardial bridge.
Shown below are two static images of the same case depicting myocardial bridge. Outlined with yellow in the image on the left is the part of the coronary artery during diastole. This same part of the coronary artery is outlined in yellow in the image on the right during systole; note that this outlined part is narrowed compared to its shape during diastole.
References
- ↑ 1.0 1.1 1.2 Alegria JR, Herrmann J, Holmes DR, Lerman A, Rihal CS (2005). "Myocardial bridging". European Heart Journal. 26 (12): 1159–68. doi:10.1093/eurheartj/ehi203. PMID 15764618. Retrieved 2012-07-01. Unknown parameter
|month=ignored (help) - ↑ Möhlenkamp S, Hort W, Ge J, Erbel R (2002). "Update on myocardial bridging". Circulation. 106 (20): 2616–22. PMID 12427660. Retrieved 2012-07-01. Unknown parameter
|month=ignored (help)