Myocardial bridging of the left anterior descending coronary artery and anomalous origin of circumflex coronary artery: preoperative assessment with MDCT.

Myocardial bridging is anatomically defined as the muscle overlying the intramural segment of a major epicardial coronary artery—mainly the midportion of the left anterior descending (LAD) coronary artery. This congenital variation has been associated with myocardial ischemia, conduction disturbances, myocardial infarction, and sudden death. The pathophysiology of myocardial bridges is characterized by external phasic systolic vessel compression with a persistent mid to late diastolic diameter reduction. Percutaneous transluminal coronary angioplasty with stent placement, traditional coronary artery bypass grafting, and longitudinal myotomy of the overlying myocardial tissue band have all been used to treat symptomatic patients refractory to medical management. We report the case of a patient with symptomatic myocardial bridging of the LAD coronary artery evaluated using MDCT for preoperative assessment.