Anomalous Anatomy

Myocardial Bridging
Myocardial bridging is a congenital anomaly describes as an epicardial segment of a coronary artery that courses through the myocardium. Most commonly, the LAD midsegment is involved in bridging. Myocardial bridging is defined as a deep segment of artery deep to the myocardium with 2.3 mm or more of myocardial coverage. Although bridging is usually asymptomatic, it can result in symptoms beginning in the third decade and reports include myocardial infarction, angina, arrhythmias or even death.

Myocardial bridge of the left anterior descending coronary artery.

Volume rendered image shows mid-left anterior descending coronary artery shows the vessel tracking along the anterior interventricular sulcus and diving into the myocardium. Curved planar reconstruction shows LAD tracking and diving into the myocardium and exiting as it tracts inferiorly towards the apex of the heart.

Curved planar reconstruction shows LAD tracking and diving into the myocardium and exiting as it tracts inferiorly towards the apex of the heart.

Curved planar reconstruction shows LAD tracking and diving into the myocardium and exiting as it tracts inferiorly towards the apex of the heart.Curved planar reconstruction shows LAD deep to the myocardium.

Curved planar reconstruction shows LAD deep to the myocardium.