Location of atherosclerotic plaques in relation to a myocardial bridge:
a) 20 – 30 mm proximal to the myocardial bridge
b) within the myocardial bridge
c) Distal to the myocardial bridge
d) Non of the above
Correct answer: a) 20 – 30 mm proximal to the myocardial bridge
Reversal of systolic flow from the bridge segment has been noted on Doppler tracing. In the coronary segment proximal to the bridge, the retrograde flow collides with the antegrade flow, causing high systolic wall shear stress. This is thought to be the reason for coronary plaques about 20 – 30 mm upstream of the myocardial bridge .
1. Tarantini G et al. Left Anterior Descending Artery Myocardial Bridging: A Clinical Approach. J Am Coll Cardiol. 2016 Dec 27;68(25):2887-2899.