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Question:

If a myocardial bridge is a congenital anomaly, why would it suddenly become a problem?  

Hi there.  My father has recently been diagnosed with a myocardial bridge after waking with chest pain and having an angio performed in Vietnam. He was discharged with a course of medication for one week and no further intervention. My question is if his bridge has been a congenital anomaly, then why all of a sudden does it become a problem in his mid 50's? 

submitted by Kealy from Perth, Western Australia on 5/22/2013

Answer:

Michael J. Mihalick, MDby Texas Heart Institute cardiologist, Michael J. Mihalick, MD  

Dear Kealy, In my experience, muscle bridges are usually an angiographic phenomenon rather than a  cause of chest pain due to myocardial ischemia (lack of blood flow to the heart muscle). As far as your father's symptoms are concerned, there is no harm beginning a trial of medication (as is being done). If your father has had only one episode of chest pain, I would think it unlikely that the myocardial bridge is the cause. If his chest pain is recurrent, a functional study such as a nuclear stress test may be helpful. If this test is negative, the bridge can be eliminated as a cause. Other possible causes for the chest discomfort should be considered if the symptoms are recurrent. If the symptoms subside and the evaluation is negative, I would not pursue any further testing or treatment and consider the finding of a myocardial bridge a coincidence. Sincerely. 

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Updated June 2013
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Texas Heart Institute Heart Information Center
Through this community outreach program, staff members of the Texas Heart Institute (THI) provide educational information related to the prevention, diagnosis, and treatment of cardiovascular disease. It is not the intention of THI to provide specific medical advice, but rather to provide users with information to better understand their health and their diagnosed disorders. Specific medical advice will not be provided and THI urges you to visit a qualified physician for diagnosis and for answers to your questions.
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