Question:

Why did my symptoms re: myocardial bridge show up now?

I am a 60 yr old male in good health and fit. I had chest pain on exertion, had a stress echo and heart cath. Coronary arteries very clear & diagnosed with a Myocardial Bridge across the LAD. Currently being treated with Calcium channel blockers.

I have 3 questions: Why did symptoms show up at age 60? I’ve been extremely active my entire life. I am very fond of high intensity aerobic exercise and plan on riding a bicycle across the USA next year. How hard can I safely push the chest pain? Does the surgical option require splitting the sternum or is there a less aggressive option?

Submitted by Jeff from Medford, Oregon on 04/01/2014

Answer:
by Denton A. Cooley, MD

Myocardial bridges are a subject of controversy and many cardiologists doubt their importance. Strain on the myocardium (heart muscle) may lead to compression of the underlying coronary artery. Perhaps you could reconsider your proposed strenuous, long distance cycling trip. Unfortunately, there is no certain way to know how ‘safely you may push your chest pain’. Regarding surgical repair, a smaller incision in the chest wall may be possible. Alternatives should be discussed with your surgeon.