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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


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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