Sudden death in young adults: Are myocardial bridges dangerous?

Myocardial bridges (MB), a congenital abnormality of the coronary arteries, refers to a segment of a main epicardial artery that crosses the myocardium beneath a bridge of myocardial tissue (tunnelled artery). Once thought a benign anatomical variant because often found at autopsy in normal patients, MB have been associated with angina, acute myocardial infarction, ventricular tachycardia, syncope, atrioventricular block, and sudden death. Systolic flow is interrupted during systolic ventricular compression of the coronary branch created by a MB. Studies indicate that the tunica Intima beneath a MB could protect against atherosclerosis, whereas the proximal segment could be more subject to the onset and development of atherosclerotic plaque. This article discusses the most recent knowledge on the anatomy, pathophysiology, clinical manifestations and treatment of MB.