I have an LAD muscle bridge.  Why would surgical repair not be offered?

Hello, I am a 34 y/o man that has had a pacemaker for 5 years due to block, and afib in past treated with cardioversion. I have been having increased chest pain and shortness of breath. I had a CT angio today and they found a significant LAD myocardial bridge. Being a health professional I began to research and found some articles that show both paroxysmal afib and AV block can be contributed to the bridge. I also found several studies that show the LAD bridge can increase your chances of sudden cardiac death. I am a very active 34 year old, slightly overweight, and the angio showed no calcium deposits or blockages. The cardiologist did not want to do anything regarding the findings as I am already on metoprolol and ASA. But I’m finding my quality of life being depleted by chest pain. Why would surgical repair not be mentioned? Would it not help my symptoms and prevent the increase of possible sudden cardiac arrest and death? Thanks for your time.

Submitted by Chris from Saskatchewan, Canada on 07/29/2014

by Denton A. Cooley, MD

Myocardial bridges may or may not interfere with ventricular function. This is controversial. In selected cases, surgical de-bridging may relieve angina and improve normal coronary flow. Balloon angioplasty may be an alternative.