Evaluation and treatment of myocardial bridging by clinical phenotype

Authors

• Barry F. Uretsky, Division of Cardiology, Central Arkansas Veterans Health System, Little Rock, Arkansas.
• Srdjan B. Aleksandric, Cardiology Clinic, University Clinical Center of Serbia, Belgrade, Serbia.
• Srikanth Vallurupalli, Division of Cardiology, Central Arkansas Veterans Health System, Little Rock, Arkansas.
• Adib Chaus, Advocate Health - MidwestFollow
• Abdul Hakeem, Division of Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan.
• James C. Blankenship, Division of Cardiology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
• Yochai Birnbaum, Division of Cardiology, Baylor College of Medicine, Houston, Texas.
• Morton J. Kern, Division of Cardiology, Long Beach Veteran's Administration Medical Center, Long Beach, California.

Recommended Citation

Uretsky BF, Aleksandric SB, Vallurupalli S, et al. Evaluation and Treatment of Myocardial Bridging by Clinical Phenotype. J Soc Cardiovasc Angiogr Interv. 2026;5(8):105402. Published 2026 Jun 23. doi:10.1016/j.jscai.2026.105402

Affiliations

Advocate Lutheran General Hospital

Abstract

Myocardial bridging (MB), most commonly involving the left anterior descending artery, is an intramyocardial segment of a coronary artery traditionally regarded as a benign anatomical variant. However, in a subset of patients, MB has been implicated in anginal syndromes, myocardial infarction, and even sudden cardiac death. Most cases are asymptomatic and identified incidentally on coronary computed tomography or invasive angiography. Controversy surrounds best practices for management of this entity. This review summarizes current evidence in adult patients with isolated MB on the mechanisms producing ischemia and adverse cardiac outcomes, the value of testing modalities to diagnose ischemia, and treatment strategies based on the patient's symptoms and clinical presentation (phenotype).

Type

Article

PubMed ID

42626043