Retrospective analysis of coronary angiograms showing myocardial bridging and its clinical manifestations in a specialized center in the Midwest of Brazil

Purpose Myocardial bridging is a coronary anatomical variation in which a tunneled pathway of the coronary artery is covered by overlapping myocardial muscle fibers. The objective was to relate the angiographic findings of systolic constriction in myocardial bridging pathways with the various clinical presentations of angina in patients at this institution. Methods A retrospective review was performed on a database of diagnostic coronary angiography exams performed from May 2016 to May 2024, which included 15,108 exams. A total of 1,476 patients had myocardial bridging (9.77%), and 178 were selected for our sample. These patients had exclusively myocardial bridging and were free of coronary atherosclerotic obstructions. Results The sample groups were classified according to the degree of systolic compression as mild (< 50%), moderate (50% to 75%), or severe (> 75%). The sample had a mean age of 57.01 years, with 55.50% women, 61.23% hypertensive, 6.75% diabetic, and 14.60% smokers. Patients in the moderate and severe groups had significantly more episodes of angina pectoris than did those in the mild constriction group. A greater extent of the tunneled segment of the myocardial bridge was associated with anginal symptoms. Conclusion There was an association between anginal symptoms and the degree of systolic constriction and extension in the coronary segments affected by myocardial bridging in the coronary angiography exams analyzed in this study.