Introduction
The heart is the most important organ in the human body that pumps blood to different body parts. It also carries the blood to the lungs for purification before circulating throughout the body. Any damage to the heart can cause serious complications. Rarely the heart may be defective at birth which causes discomfort like chest pain. Myocardial bridging is a condition that affects heart health although it is mostly asymptomatic. Proper diagnosis and treatment can restore heart health and improve the lifespan of an individual.
What Is a Heart?
A hollow muscular organ that is situated between the lungs is called a heart. It is the most important organ that has four chambers. The four chambers of the heart are two atriums and two ventricles. The right side of the heart receives deoxygenated blood from the body and transfers it to the lungs for purification. The left side of the heart sends the purified blood from the lungs to other parts of the body for purification. A membrane called the pericardium surrounds the heart. The heart receives blood supply from the coronary arteries. The pericardium helps restrict excessive heart movements and helps with the contraction of different heart muscles. Any damage to the heart or its supporting tissues can have a significant impact on the overall health of an individual.
What Is Myocardial Bridging?
In myocardial bridging, the coronary arteries get twisted within the heart muscle instead of lying on its surface. It is a harmless condition that usually is asymptomatic. Very rarely people with myocardial bridging may experience heart conditions like angina or chest pain.
What Are the Symptoms of Myocardial Bridging?
Some of the common symptoms experienced by individuals with myocardial bridging are listed below. Though these symptoms are quite rare.
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Angina or chest pain.
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Back or neck pain.
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Shortness of breath.
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Irregular heart rhythm.
What Are the Causes of Myocardial Bridging?
Usually, myocardial bridging occurs at birth, however, most people are less aware of the condition. The individuals experiencing chest pain are usually younger and healthy when compared to other patients with heart problems. These individuals do not have typical risk factors like excess weight, smoking, or cholesterol. The condition may occur in both men and women.
Can Myocardial Bridging Cause Heart Attack?
It is usually a benign condition and an incidental finding during cardiac tests. Although the bridging may not cause heart attack, it may lead to arrhythmia and acute coronary syndromes like ischemia and infarction which may result in unexpected death.
How Many People Have Myocardial Bridge?
Myocardial bridging is an extremely rare anomaly and is characterized by an intramyocardial segment of one or more arteries. The frequency of occurrence varies between 1.5 to 16 percent.
How to Test for Myocardial Bridges?
The diagnosis of myocardial bridging involves various imaging techniques that help exactly locate the position of bridging. The following tests are conducted to identify myocardial bridging.
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Echocardiogram - It is an imaging technique that uses ultrasound and sound waves to create an image of the heart. It gives information about the heart's size and shape when the heart is stressed through exercise or medications.
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Computerized Tomography(CT) Scan - It utilizes radiation, which allows the doctors to view the blood vessels of the heart. It is a highly accurate test, and correct interpretation aids in the success of the treatment.
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Cardiac Catheterization - A minimally invasive procedure, in which a catheter, a thin and flexible tube is inserted into the large blood vessel leading to the heart. It helps examine the blood vessels of the heart and detects any blockage.
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Intravascular Ultrasound - A small device is inserted into the artery which helps determine the myocardial bridge with the help of ultrasound.
What Is the Use of Blunt Dissection Technique for Surgical Unroofing in Myocardial Bridging?
A bunt dissection technique helps to carefully separate the heart tissues along the planes using a blunt instrument. Blunt dissections are extremely time-consuming but cause minimal damage to the surrounding structures. It is done with the help of a circular knife that opens the myocardium near the coronary artery with the help of fine tweezers.
What Are the Other Treatment Modalities for Myocardial Bridges?
The doctors examine the patient thoroughly before deciding the treatment for an individual. Some individuals may have chest pain but no physical blockage of arteries. So the treatment options may range from medications to surgical procedures.
The following drugs are helpful in cardiac bridging.
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Aspirin - It prevents blood clots or artery blockages, which enables easy blood flow throughout the body. However, any individual undergoing a procedure should priorly inform their doctors regarding the medication, as there may be a heavy loss of blood.
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Statins - These drugs reduce the cholesterol levels in the blood, thereby preventing the build-up of plaque and other fatty deposits which block the blood flow.
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Calcium-Channel Blockers - These drugs help widen blood vessels and relax muscles.
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Beta- Blockers - These drugs slow the heart rate by controlling the amount of blood squeezed by the heart during each heartbeat.
If the patient experiences intolerable pain in spite of medications, the doctor may suggest surgical unroofing. So the surgeon may eliminate the myocardial bridge and free the underlying artery. The precise location of the bridging is viewed by cardiac catheterization. The surgeon makes a vertical incision to reach the heart and opens the chest wall.
After the surgery, the doctor may recommend a few lifestyle modifications for the benefit of the heart. It includes the following.
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Exercising.
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Tailored nutrition plans.
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Stress reduction techniques.
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Emotional support through cognitive behavioral therapy.
Conclusion
Myocardial bridging occurs when an artery gets trapped within the heart muscle instead of lying on the surface. The affected individuals may experience mild cardiac symptoms like chest pain and irregular heart rhythm. Various diagnosing techniques like echocardiograms and ultrasounds help to precisely locate the bridging. With those diagnostic aids, the surgeon performs surgery to free the artery which minimizes the symptoms. However, the individual is kept on observation and recommended lifestyle modifications for the success of the treatment.
