Anatomical and functional evaluation of myocardial bridging on the left anterior descending artery by cardiovascular magnetic resonance imaging.

A myocardial muscle bridge spans a segment of a major epicardial coronary artery that is located in the myocardium. This anatomic configuration can be responsible for angina pectoris, arrhythmias or even death. The current reference standard for diagnosis is conventional x-ray coronary angiography showing systolic compression of an epicardial vessel and the typical angiographic "milking effect." We report the case of a patient with myocardial bridging on the left anterior descending artery, in whom a combination of noninvasive high resolution display of the coronary artery lumen, visualization of the myocardium and functional assessment of blood flow during dobutamine stimulation by cardiovascular magnetic resonance imaging was performed.