Sometimes in our lives, the unthinkable happens, right? Especially when it comes to our physical health, there are some medical conditions that we may not have even heard of. But it is very important to be aware of them. Today we are going to talk about a heart condition that is a little strange, but can affect some people. This is called (Myocardial Bridge). You may not have heard of this name, but we will talk about it simply, in a way that you can understand.
What is this myocardial bridge?
Simply put, your heart has blood vessels that supply blood, which we call the coronary arteries. These arteries are usually located above the heart muscle. That is, they go over the surface of the heart. However, in this condition called (Myocardial Bridge), what happens is that instead of going over the heart muscle, part of this coronary artery in your heart goes under the muscle. It's like a little tunnel, or like going under a bridge. That's what doctors call the piece of heart muscle that sits above that blood vessel (Myocardial Bridge).
Now imagine, sometimes, when the heart beats, that is, when the heart muscle contracts, the muscle bridge above can press on the blood vessel below. It's like when someone steps on a water pipe, the water flow slows down. What happens if you press on it like that? That pressure can obstruct the blood flow. Then the heart muscle may not get the oxygen-rich blood it needs.
You know, the coronary arteries are channels that perform a very important function. Our heart muscles, like every other part of our body, need oxygen. This oxygen is brought to us by those coronary arteries. So if this blood flow is obstructed, problems can arise.
Most often, this condition (Myocardial Bridge) is seen in the left side of the heart, the main artery that goes down (Left Anterior Descending Artery) , or as doctors call it (LAD) . This is a major vein that supplies blood to the front wall of the heart and other important parts. However, this condition can occur in any artery that brings blood to the heart, to a greater or lesser extent.
Is this condition called (Myocardial Bridge) dangerous? How common is it?
In most cases, having a myocardial bridge does not cause much harm. Most people live normal lives without even knowing they have it and without any symptoms. That's the truth.
However, sometimes, as mentioned earlier, if the heart muscle is deprived of oxygen, you may experience chest pain called angina . This usually occurs when your heart starts to beat faster, such as during exercise.
When asked how common this condition is, researchers say that myocardial bridge is a more common but underdiagnosed condition than you might think. This is because the percentage varies depending on the method used to detect it. According to some studies, between 16% and 30% of people who are diagnosed with this condition through tests such as angiograms, say that this condition may be present in a significant number of people. This means that a significant number of people may have it than you might think.
What are the symptoms of this?
Many people with a myocardial bridge do not show any symptoms. However, as they age or develop other medical conditions (such as high blood pressure or diabetes), some people may develop symptoms. Sometimes it can take years for symptoms to appear.
The main symptom is chest pain ((Angina)) . This is usually felt:
- When exercising, running, or climbing stairs
- When you feel a lot of pressure, anxiety, or sadness
- Sometimes it can also come after a big meal.
The way this pain is described varies from person to person. Some may feel like it's being squeezed, squeezed, or weighed down.
Other symptoms can sometimes be similar to those of a heart attack, so you should also be aware of these:
- Shortness of breath : Feeling like you have difficulty breathing even with a little exertion.
- Heart palpitations : The chest may feel like it is pounding or pounding.
- Dizziness : You may feel dizzy, possibly even fainting.
Important: If you have symptoms that suggest you are having a heart attack (severe chest pain, pain radiating down your arm, sweating, vomiting), you should go to an emergency room immediately. Don't put it off.
Why does this (Myocardial Bridge) occur?
This is a question with a very simple answer. Myocardial Bridge is a congenital condition . That means it's something you're born with . When the heart develops in the embryo, that blood vessel is formed in a way that goes into the muscle. There's no specific reason for it, it just happens.
What complications can this cause?
In fact, major complications from a myocardial bridge are very rare. However, sometimes, especially when combined with other medical conditions, these things can happen. You should not be afraid of these, but be aware of them:
- Myocardial Ischemia: As mentioned earlier, when a blood vessel becomes blocked, the heart muscle may not receive enough oxygen. This is when things like chest pain occur.
- Coronary Vasospasm: Sometimes these arteries can suddenly and severely constrict, which can also interfere with blood flow.
- Atherosclerosis plaque buildup near the myocardial bridge: It has been found that plaque builds up on the walls of the blood vessel near the bridge, making the vessel more likely to narrow. This may be because the way blood flows through the bridge changes.
- Acute Coronary Syndrome: This can be a heart attack or unstable angina.
- Ventricular Arrhythmias: Irregular heartbeats can occur that start in the lower chambers of the heart.
- Broken Heart Syndrome: This is a temporary heart weakness that can occur after severe stress.
- Heart Attack: Although rare, a heart attack can occur if blood flow is completely blocked.
- Sudden Cardiac Death: This is very rare, but it is possible.
Remember that these complications are very rare .
How do doctors detect the presence of this (Myocardial Bridge)?
It may be discovered by chance when you see a doctor because you have symptoms, or during tests for another reason. If a doctor suspects that you have a myocardial bridge, they may do the following tests:
- Coronary angiogram: This is the most important test. In this test, a small tube is inserted through a vein in your arm or leg and guided to the coronary arteries of your heart. A special dye is then injected into it and X-ray pictures are taken. This allows the narrowing of the artery to be clearly seen.
- Intravascular Ultrasound (IVUS): In this, at the same time as the angiogram, a small ultrasound device is passed into the artery to see how tightly the artery's inner walls and the bridge are being squeezed.
- Optical Coherence Tomography (OCT): Similar to IVUS, this is another advanced method that uses light to see inside the artery.
- Coronary Computed Tomography Angiogram (CT Angiogram): This is a CT scan. This also uses dye to create three-dimensional images of the arteries in the heart. This can help determine if there is a myocardial bridge and how long and deep it is.
So is there a treatment for this? How do you do it?
Yes, there are treatments for those who have symptoms. Not everyone needs surgery. Your doctor will decide which treatment is best for you. Let's take a look at what these treatments are:
- Medications: Often, the first treatment is medication. These include medications called beta-blockers or calcium channel blockers . These medications work by slowing the heart rate, increasing the time the arteries remain relaxed between heartbeats, and reducing the pressure on the blood vessels. For some people, a medication called ivabradine is also given as an alternative.
- Surgery: For those with severe symptoms that cannot be controlled with medication, or if the bridge is very deep and long, surgery may be recommended.
- One method is called (Surgical Myotomy) . That is, surgically cutting and removing the muscle bridge over the blood vessel (unroofing). But this is only done if the bridge is a little short and shallow.
- The other method is called Coronary Artery Bypass Surgery (CABG) . This involves bypassing the blocked area and using a piece of blood vessel taken from another part of the body (usually from the leg or the inside of the chest) to create an alternative route for blood flow. This is usually done if the bridge is long and deep.
- Stent placement: Another option is to place a stent. A stent is a small metal tube that looks like a mesh. It is placed inside the blocked blood vessel and inflated from the inside. Then, even if the muscle is blocked, the stent keeps the vessel open, allowing blood to flow more easily. However, there are different opinions about placing a stent in this case. Sometimes, the stent can break or become blocked again, so doctors make these decisions very carefully.
What should I expect if I have a myocardial bridge?
Like many people, you may have a myocardial bridge and not have any symptoms. Such people do not need any special treatment. If there are symptoms, they can often be controlled with medication.
If the symptoms do not improve with medication, surgery (myotomy or bypass) or stent placement should be considered. If a myocardial bridge is being surgically removed, it is wise to choose a hospital with experienced surgeons who frequently perform such surgeries.
This (Myocardial Bridge) is not something that will heal on its own without surgical removal. But most people do not need surgery.
How are people living with this condition coping?
Many people with Myocardial Bridge live longer and have better long-term health.
Survival rates depend on whether you have other medical conditions. In one study, about 90% of people with myocardial infarction were still alive 10 years after diagnosis. However, if they also had other heart conditions, such as coronary artery disease (CAD), survival rates were slightly lower.
How should I take care of my health?
Because having a myocardial bridge has been found to slightly increase the risk of fatty deposits in the arteries (atherosclerosis), your doctor will likely advise you to control other risk factors that may contribute to it. This is important whether you have symptoms or not.
- Avoid Smoking: The most important thing to prevent atherosclerosis is to stay away from tobacco products completely. If you are a smoker, ask your doctor for help in quitting.
- Control other risk factors: If you have high blood pressure, diabetes, or high cholesterol levels, control them well.
- Healthy diet: Eat a diet low in oil, sugar, and salt, and high in fruits and vegetables.
- Regular exercise: Talk to your doctor to find out what exercises are right for you, and do them regularly.
- Take your prescribed medications correctly: If you already have coronary artery disease (CAD), it is essential to take your antiplatelet drugs (blood thinners) and cholesterol-lowering medications (cholesterol-lowering medicines) exactly and on time as prescribed by your doctor.
When should I see the doctor?
It is very important to keep your follow-up appointments with your doctor. Your doctor will need to see you regularly to make sure you are taking the right amount of medication and how your symptoms are. It is also important to go for follow-up appointments after surgery or a stent is placed.
As mentioned earlier, if you have symptoms of a heart attack (such as severe chest pain, difficulty breathing, sweating), call 911 immediately or go to the nearest emergency room.
What questions should I ask my doctor?
When you find out you have a myocardial bridge, it's normal to have a lot of questions on your mind. You can ask your doctor questions like these:
- How often do I need to come for follow-up?
- Do I need medicine or do I need surgery?
- Why are you recommending this treatment option to me? What are the benefits for me? Are there any disadvantages?
- What changes do I need to make in my diet and lifestyle?
- Can I exercise? What kind of exercise is good?
It's normal to feel a little scared and worried when you hear that something is wrong with your heart. But remember, for most people, a myocardial bridge is not something to worry about. If you have symptoms, talk to your doctor to determine the best treatment for you.
Finally, what to remember (Take-Home Message)
Okay, so now you have a better understanding of what we talked about (Myocardial Bridge). In summary:
- Myocardial bridge is a congenital condition in which a coronary artery in the heart passes through a muscle.
- For many people, this causes no symptoms and no harm.
- Some people may experience symptoms such as chest pain (angina), especially when they are tired.
- Symptoms can often be controlled with medication. Rarely, surgery or stenting may be necessary.
- Lifestyle changes (smoking cessation, healthy diet, exercise) are important to reduce the risk of atherosclerosis.
- If you experience severe chest pain or symptoms of a heart attack, seek medical advice immediately.
It's important to take care of your heart. Being aware of these conditions will help you seek treatment early if needed and help you live a healthy life.
` Myocardial bridge, heart disease, angina, coronary artery, heart surgery, stent, heart health
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