PERCENTAGE INCIDENCE, MORPHOLOGY AND MORPHOMETRY OF MYOCARDIAL BRIDGES: A CADAVERIC STUDY

Abstract

Address for Correspondence: Ms. Sujatha Manupati, Ph.D. Scholar, Department of Anatomy, Sri Venkateswara Medical College, Tirupati, Andhra Pradesh. India. Mobile No.: +919246943011 E-Mail: manupatisujatha@gmail.com *1 Ph.D. Scholar, Department of Anatomy, S.V. Medical College, Tirupati, Andhra Pradesh, India. 2 Professor & Head, Department of Anatomy, S.V. Medical College,Tirupati, Andhra Pradesh, India. 3 Associate professor, Department of Forensic Medicine, RIMS Medical College, Kadapa, Andhra Pradesh, India. 4 Professor & Head, Dept of Anatomy, SVIMS, Sri Padmavathi Medical College for women, Tirupati, Andhra Pradesh India. Introduction: Myocardial bridging is the term used when a segment of major epicardial coronary artery runs intramuscularly under the tunnel formed by fibers of myocardium that bridges instead of it’s normal or routine epicardial path. In the literature there are varying reports on clinical implications of myocardial bridges from protection against atherosclerosis to myocardial ischemia, as well as leading to infarction and sudden cardiac death. Materials and Methods: 150 adult formalin fixed human hearts which were available in the department of Anatomy and Forensic Medicine, S.V.Medical College, Tirupati, Andhra Pradesh, India. These hearts were dissected and observed for the presence, location, type, number and direction of myocardial bridges and their association with coronary dominance. With the help of digital calipers morphometric parameters (length, width& thickness) of myocardial bridges and length of blood vessel underneath the myocardial bridge were measured, noted and photographs were taken. Results: The overall incidence of myocardial bridges was 20.6%( 31/150). Among these 18.6% (28/31) were on left anterior descending (LAD) artery and 2% (03/31) were on posterior interventricular (PIV) artery. The direction of muscle fibers in the bridges were oblique to the direction of the coronary vessels in majority of cases. Length, width and thickness of myocardial bridges were in the range of 12-69.7mm, 3.74-8.6mm and 1.3-3.87mm respectively. Conclusions: Myocardial bridges may be associated with wide range of clinical problems. Contraction of myocardial bridge may results in vascular compression and myocardial ischemia. Knowledge on morphology and morphometric details of myocardial bridges facilitates cardiologists in diagnosis, planning therapeutic strategies and prognostic predictions.