Symptoms
How We Can Help You
A myocardial bridge is a usually harmless condition in which one or more of the coronary arteries goes through the heart muscle instead of lying on its surface. Most bridges don’t seem to cause symptoms. However, some people with myocardial bridges can experience angina, or chest pain.
At Stanford, we actively look for and diagnose hard-to-detect forms of non-obstructive coronary artery disease, like myocardial bridging. In fact, our doctors helped to establish the link between myocardial bridges and chest pain. We use specific tests to diagnose this condition and give people an explanation for their pain. Our cardiologists provide experienced-based treatment approaches to ease symptoms and prevent complications.
What We Offer You for Myocardial Bridging
- Nationally recognized expertise in nonobstructive coronary artery diseases, like myocardial bridging, with the most active programs in the United States.
- Precise diagnostic tests such as diastolic fractional flow reserve (dFFR) to measure blood flow and pressure in sections of the coronary arteries.
- Robust treatment options from heart surgeons who perform more unroofing procedures to remove the myocardial bridge than any other program in the country.
- Team-based approach that brings together cardiologists, psychologists, surgeons, and other specialists to create a care plan tailored to your needs.
- Comprehensive support services including mindfulness classes and nutrition counseling to help people with myocardial bridging live healthfully.
- Active research program by Stanford doctors who have studied more people with myocardial bridging than any other program in the world.
Treatment for Myocardial Bridging
At Stanford, our cardiologists frequently see people who have chest pain but no physical blockages of the arteries. We conduct thorough diagnostic tests to determine whether a myocardial bridge is present and if it is causing the chest pain.
Our approach includes making you an active partner in your treatment plan. We discuss all the options with you to find the method that suits your lifestyle and needs the best. Throughout treatment, we support you every step of the way, meeting with you regularly to monitor your progress and help you feel your best.
Our treatment options include:
Medication
If our providers prescribe medication, they will find the right dosage for you and help manage any possible side effects. The drugs we prescribe for myocardial bridging may include:
- Beta blockers: Drugs that slow the heart rate and help ease the amount of force with which the heart squeezes
- Calcium channel blockers: Medications that help to relax and widen blood vessels
- Statins: These reduce cholesterol levels in the blood, which helps to prevent plaque build-up.
- Aspirin: Aspirin may help prevent blood clots or artery blockages.
Our surgeons are experts at surgical unroofing for myocardial bridging because they perform the most such procedures nationwide.
Surgical unroofing
Some people with myocardial bridging may still experience intolerable chest pain and other symptoms, despite taking medication. In those cases, your doctor will discuss the option of surgical unroofing with you.
During this procedure, the surgeon removes the myocardial bridge and frees the constricted artery underneath. The surgeon uses a detailed map, created during a cardiac catheterization, that shows the precise location of the bridge. To access the heart, the surgeon performs a sternotomy (vertical incision down the chest, to open the chest wall). In some cases, the surgeon can also perform a lateral thoracotomy (smaller incision in the side of the chest).
Stanford is currently developing less invasive ways to perform this procedure. Our surgeons have performed the most unroofing surgeries in the country. This high volume gives us the experience and expertise to better care for you.
Lifestyle modification and support
After heart surgery, the cardiologists, behavioral psychologists, and dietitians from our Cardiac Behavioral Medicine Program help you make any necessary lifestyle changes to keep your heart healthy and get you back to living a full, active life.
Our support services include:
- Tailored nutrition plans
- Mindfulness-based stress reduction techniques
- Exercise training
- Smoking cessation programs
- Emotional support through cognitive behavioral therapy
Treatment for related conditions
Some people with myocardial bridging also have endothelial dysfunction, another form of nonobstructive coronary artery disease, in which the heart arteries narrow when they should dilate (open). Our specialists also treat this condition, if you have it.
Clinical Trials
Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. As a Stanford Health Care patient, you may have access to the latest, advanced clinical trials.
Our doctors routinely use the dFFR test to measure blood flow and pressure through the myocardial bridge. We regularly participate in clinical trials to find new methods to interpret and apply the results of that test.
Open trials refer to studies currently recruiting participants or that may recruit participants in the near future. Closed trials are not currently enrolling, but similar studies may open in the future.