Myocardial Bridge (मायोकार्डियल ब्रिज) एक rare congenital cardiac anomaly है जिसमें coronary artery (सप्लाई करने वाली हृदय धमनियाँ) हृदय की मांसपेशियों (myocardium) के नीचे से गुजरती हैं।
- आमतौर पर left anterior descending artery (LAD) प्रभावित होती है।
- यह anatomical variation अक्सर benign होता है, लेकिन कुछ मामलों में chest pain, arrhythmia और myocardial ischemia का कारण बन सकता है।
- Diagnosis के लिए coronary angiography या CT angiography उपयोग किया जाता है।
Myocardial Bridge क्या है (What is Myocardial Bridge)
- Normal coronary artery heart muscle के ऊपर होती है, लेकिन bridge में artery heart muscle के नीचे tunnel बनाती है।
- Heart contraction (systole) के दौरान artery compress हो सकती है।
- Rarely, ischemia और arrhythmia के कारण symptoms उत्पन्न होते हैं।
Myocardial Bridge कारण (Causes of Myocardial Bridge)
1. Congenital Cause
- Present from birth (genetic / developmental anomaly)
2. Anatomical Variation
- Usually LAD artery involvement
- Can be single or multiple segments
3. Risk Factors for Symptoms
- Tachycardia (fast heart rate)
- Hypertension
- Atherosclerosis in compressed segment
Mostly asymptomatic, discovered incidentally during angiography।
Myocardial Bridge लक्षण (Symptoms of Myocardial Bridge)
Most cases asymptomatic, लेकिन symptomatic cases में शामिल हैं:
- Chest pain or angina, especially during exertion
- Palpitations or arrhythmia
- Shortness of breath (dyspnea)
- Rarely, myocardial infarction (heart attack)
- Syncope (fainting) in severe cases
Symptoms usually appear if arterial compression severe हो या atherosclerosis coexist करे।
Myocardial Bridge कैसे पहचाने (Diagnosis of Myocardial Bridge)
- Coronary Angiography – gold standard, “milking effect” दिखता है
- CT Coronary Angiography – non-invasive detection
- Stress Test / ECG – ischemic changes during exertion
- Echocardiography – sometimes help detect wall motion abnormalities
- Differential Diagnosis – typical angina, atherosclerotic CAD
Accurate diagnosis prevents misdiagnosis and unnecessary interventions।
Myocardial Bridge इलाज (Treatment of Myocardial Bridge)
1. Medical Management (First-line)
- Beta-blockers – reduce heart rate, systolic compression
- Calcium channel blockers – improve blood flow, reduce symptoms
- Avoid vasodilators like nitrates (can worsen compression)
2. Interventional / Surgical Options (Rare cases)
- Surgical myotomy – cut bridge muscle over artery
- Coronary artery bypass graft (CABG) – if severe ischemia
- Stenting – rarely, high restenosis risk
3. Lifestyle Measures
- Avoid strenuous exertion if symptomatic
- Control hypertension and heart rate
- Regular cardiac follow-up
रोकथाम (Prevention)
- Cannot prevent congenital anomaly
- Prevent complications by controlling heart rate, blood pressure, cholesterol
- Avoid stimulant drugs (caffeine, decongestants) that increase heart rate
- Regular check-ups for patients with chest pain
सावधानियाँ (Precautions)
- Do not ignore exertional chest pain
- Adhere to prescribed beta-blockers / calcium channel blockers
- Avoid sudden strenuous activity without medical advice
- Monitor for palpitations or fainting
FAQs (अक्सर पूछे जाने वाले प्रश्न)
Q1. Myocardial bridge dangerous है?
Most cases benign हैं, लेकिन severe compression में angina, arrhythmia या heart attack हो सकता है।
Q2. क्या यह treatable है?
हाँ, medications और rare surgical procedures से symptoms control किए जा सकते हैं।
Q3. क्या exercise allowed है?
Light to moderate exercise usually safe; strenuous exercise only under doctor supervision।
Q4. Myocardial bridge heart attack cause कर सकता है?
Rarely, especially if severe compression या coexisting coronary artery disease हो।
निष्कर्ष (Conclusion)
Myocardial Bridge (मायोकार्डियल ब्रिज) एक congenital anatomical variant है।
Mostly benign, लेकिन symptomatic patients में chest pain, arrhythmia और ischemia हो सकता है।
Early detection, medical therapy, heart rate control और regular follow-up से complications prevent किए जा सकते हैं।
यदि कोई exertional chest pain या palpitations महसूस करे, तो तुरंत cardiologist से consultation करें।