SPECT perfusion imaging and myocardial bridges: bridging the gap of diagnostic uncertainty.

摘要

Myocardial bridging constitutes an intramyocardial segment of epicardial coronary artery with variable length (4 to 40 mm) and depth (1 to 10 mm). Although bridging was first described as early as 1737 it remains a difficult contemporary clinical conundrum. Its reported incidence varies from 0.5% to 40% when identified clinically and from 15% to 85% when found at autopsy.1'2'4 Bridging can be asymptomatic; however, when symptoms are present they can range from exer-tional fatigue, shortness of breath, angina, and syncope to sudden cardiac death. The prognosis of patients with myocardial bridging ranges from benign to extremely malignant, and there are no guidelines on appropriate medical or revascularization strategies. All these factors lead to uncertainty in the management of patients with this entity which is mostly not evidence based.