Myocardial bridging (MB) is a congenital coronary anomaly characterized by an epicardial coronary artery taking an intramuscular course, causing systolic compression of the tunneled segment. In comparison to coronary artery disease (CAD), myocardial bridges have been uncommonly associated with acute coronary syndromes and sudden cardiac death.Evidence of accelerated atherosclerotic plaque formation proximal to the bridged segment may increase the risk for future adverse cardiac events in these patients.

This Single–Center Retrospective Study included 323 adult in-patients who underwent coronary angiography for suspected myocardial ischemia in 2022. Clinical information and in-hospital outcomes were obtained by review of medical records.

Myocardial bridging was observed in 31 out of 323 patients (9.60%), with the majority in the mid-left anterior descending artery (87.10%). MB was more prevalent in females (56.62%), and these patients were younger than patients with obstructive CAD (56.9 versus 63.6 years). Chronic Coronary Syndrome was more prevalent in the MB group (82.62%). The coronary segment proximal to the area with MB showed the concurrent presence of obstructive CAD in 16.12% and non-obstructive CAD in 29.03% of cases. In-hospital mortality occurred in 4.44% of the studied population. However, there were no mortalities in the MB group.

Among patients admitted for suspected myocardial ischemia, 9.6% had MB. These patients were younger and, more often, female. Obstructive and non-obstructive CAD were noted in bridged vessels. Although patients with obstructive CAD have a higher risk of experiencing in-hospital death and cardiac complications, evidence of increased atherosclerotic plaque formation in bridged vessels has important implications for future adverse cardiac events and repeat hospitalizations in the MB population. Aggressive risk factor modification, emphasis on long-term follow-up, and the establishment of clinical practice guidelines are therefore necessary for patients with MB.