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Insuficiencia cardíaca

On-line version ISSN 1852-3862


CARDINALI RE¹, Braian A. et al. Puente miocárdico sintomático: ¿El paciente debe resignarse a los síntomas?. Insuf. card. [online]. 2019, vol.14, n.2, pp.64-69. ISSN 1852-3862.

Myocardial bridging (MB) is a congenital anomaly in which a segment of a coronary artery takes a tunneled intramuscular course under a bridge of overlying myocardium, and it can have different lengths, ranging from 4 mm to 80 mm. MB can occur in any coronary artery, but 67-98% of cases occur in the anterior descending coronary artery. Usually, the MB is an angiographic finding or it can be found in autopsies. However, some patients may present myocardial ischemia, symptomatic or silent, induced by exercise; as well as presenting an acute coronary syndrome, myocardial stunning, ventricular dysfunction, Tako-tsubo syndrome, ventricular arrhythmia or even debut with sudden death. The vast majority of patients with a MB are asymptomatic, and in many cases the diagnosis is made incidentally when performing a coronary angiography requested for other reasons. Currently, we have different complementary methods, invasive and non-invasive to make the diagnosis. With regard to treatment, medical treatment is the choice, but if it is not useful, we have the option of endovascular or surgical resolution. This pathology is a forgotten entity with few controlled clinical trials that prove the efficacy of the proposed treatments, which leads to our patients being resigned to the symptoms.

Keywords : Myocardial bridge; Symptoms; Medical treatment; Myotomy; Endovascular resolution.

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