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Mild Myocardial Bridge??
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Mild Myocardial Bridge??

WOW. I'm just shocked! I had a cardiac cath done.. in Jan, after about 2 years of some sinus tach.. upperback and chest wall discomfort. I've had indepth testing by many other resources to rule out a medical condition as a cuase of this sinus tach. So, I'm told by my cardio doc.. cath normal... I did not need a follow up. Not feeling to great about this. I went to my local hospital to obtian a copy of my cath report to see for myself. All looke normal unitl I saw that it was noted that I have a mild myocradial bridge in the MID LAD of my heart. This was never disclosed to me.. and apparently from what I have read, it's a condition that is present from birth. The cardio's notes read that he does not think the myocardial bridge is causing my symptoms. Well, to me I'm not going to settle for this and have scheduled a second op here. I need to know what the % of a bridge I have and how to handel this. Am I doing the right thing? does anyone have any infor on this defect?? Thanks. I have CAD in my family, and the only risk factors that I have whcih are prtty big IMO.. is smoking (trying VERY hard to quit) and low HDL.. nothing else at this point.
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Avatar_n_tn
I'm not familiar with myocardial bridge and this piqued my interest, so I did some reading. Internet search brings lots of info., some of which is confusing and conflicting. It sounds like there has been more research and interest in myocardial bridge over the last 5 years and many questions remain. The Texas Heart Institute has some good information--
http://www.texasheart.com/HIC/Topics/Cond/MyocardialBridge.cfm and also
at... /HIC/HeartDoctor/answer_114.cfm  

From what I understand, it's the most common congenital heart abnormality, usually harmless with excellent long-term survival. Sounds like it may be more of a problem if a person has other heart conditions along with it.

Did I understand correctly that the doctor didn't tell you about having a myocardial bridge, that you first found out when you went and read the report? If that's the case, well, I think he/she should have told you from the get-go.  

How old are you and how long have you been having symptoms? How are you feeling now?

Have you tried posting your question to the expert/MD forum? It would be interesting to see what they have to say. Also what other people's experiences have been on this forum with this condition.

Good of you that you are working on quitting smoking.

I guess I'd get a second opinion, especially if you're not feeling that great or having trouble doing the stuff you want to do. I'd be inclined to go somewhere that does a lot of work with patients with myocardial bridges. I would also want to find out if the 2nd opinion folks also say it is mild and if there are no other conditions of importance, just how often you should be rechecked and what they recommend as far as testing (what tests and how often)? Please keep us posted...  
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Avatar_f_tn
Right. The cardio who did my cath did not make me aware of this conditon. I am VERY mad about this. Infact, I was still having pain after my cath, and I was told by his nurse it's not your heart speak to your primary care. My symptoms started almost 2 years ago.. and have been on and off sinus tach, chest wall discomfort and upperback pain.. that NO other medical test can identify a cause for any of this. Now.. I find there is a potential cause for alarm.. with a defect in my heart.. and IMO, I have the right to find out if this is going to kill me. So, I called my EP cardio's office they are the ones who have had me on many monitors for the sinus tach and I will see them today.. to ask some questions and understand this better. I'm very upset and worried right now. I think it's very unethical of a cardio doc not to disclose this type on info to a patient.
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Avatar_f_tn
Well, I got back from the appointment from another cardio, and he told me my cath reoprt was normal and they find these mild myocardal bridges often at angio. told me it was common and nothing to worry over. Should I accept that?
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367994_tn?1304957193
Literally a bridging of heart muscle over one of the major arteries to the heart (usually the left anterior descending artery). The heart has formed in this abnormal design from birth, whereby the artery is actually 'tunneled' through a part of the heart muscle.

It shouldn't  present any specific medical problems, but if it did, the problem might be due to the tissue covering the artery prevents the normal dilation of the vessel of interest. The constriction could impair blood flow and cause chest pain, etc.  If minor as the doctor describes there shouldn't be any concerns and if the angio is normal that indicates there is normal blood flow through the bridge.
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Avatar_f_tn
Thanks kenkeith. The cath report does indicate there are no blood flow limitaions trhough the bridge... and everything else looked great. I guess it's just a little unsettleing to find out when your 41 that you've had a small defect from birth that you never new exisited. I still have chest wall pain and upperback pain.. that no one can seem to find a cause for. I was starting to think it's due to the bridge after googling bridges..  but the cardio is saying no. Not sure why I have this pain.. and the on and off sinus tach.. but the sinus tach and pain never coexist together. Perhaps anxeity?
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Avatar_n_tn
I'd be feeling unsettled, too.

Anxiety can cause palpitations. What happens when you exercise as far as pain and/or palpitations? Did you wear a 24-hour or 48-hour Holter monitor to see what's happening rhythm-wise with your heart?

I guess the other things to consider, if they haven't already ruled them out with tests, etc. include possible gallbladder problems or digestive/gastroesophageal reflux (GERD).

Have they put you on beta blockers to see if that helps the pain?
  
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Avatar_f_tn
Yvette, Yes. I've had about 15 montiors.. and all they have revealed are some occasional pacs and pvcs.. and just sinus tach. I have even seen an EP specialist he's the cardio that deals with the electrical system of the heart.. and he had me on a montior that watched my heart for 6 weeks straight for 24. hours per day. Same findings occasional pvcs and pacs.. and some sinus tach.. nothing else like SVT.. afib.. none of that. As for a beta blocker.. my BP is on the low side to being with.. so I'd probably bottom out and hit the floor.. LOL. no need for that. I dunno?? My cardio said this mild bridge would have nothing to do with my symptoms.. not sure if I should take his word?? I am having a thoractic MRI.. to see if something is off in my spine because the back burning has been so bad. I have tested negative with an upper GI for GERD.. a hernia.. and ulcer.. gallbladder also checked and is fine. All odd!! As for pain on excertion, I can't say I have that. It's more when i'm sitting at the computer.. or lying in bed at night.
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Avatar_n_tn
Wow. You've sure been through a lot of testing. A thoracic MRI sounds like a good idea.
What's weird is that some of the info. I read on this condition talks about cardiac spasms and the myocardial bridge. So if you were having a spasm when you were on a monitor, that would show up but I wonder if that could be happening when you're not being monitored?

I'm getting so leery, as lately I've been reading more articles about and hearing more women in their 30s and 40s speaking about having congenital heart conditions that they just found out they had. They started feeling lousy and basically kept persisting in getting tests (even though some of their doctors kind of blew off their symptoms.) In fact, when I see my cardiologist, I am going to talk with him about myocardial bridge and ask him if it's possible I may have that!

Long story short, but I had a "heart murmur" from birth that they decided was bad enough that it needed to be investigated with heart catherization when I was turning 15 (I'm 52 now--and cardiac caths are way different now than they were back then and that was before they even used tests like echocardiograms!) They said I had pulmonary valve stenosis. Later re-diagnosed with mitral valve prolapse a few years later, as well as mild mitral insufficiency. Then a few years later, they say MVP is gone, but I have mild mitral insufficiency, mild pulmonary insufficiency, mild tricuspid insufficiency, and a nodule on my anterior mitral valve leaflet of unknown origin. Most recently, my echo showed slightly enlarged left atrium and some hyperdynamic blood flow. Well, I know sometimes reading the Internet leads a person to draw false conclusions, but I did see that in some cases of bridging, there's a hyperdynamic flow and also abnormality of ST depression in the same leads that my last nuclear stress test showed. Sometimes I get weird chest heaviness and holter monitors can't explain why.

My maternal grandmother died suddenly of a heart attack at age 51 and my father, they believe, has had cardiac spasms in the past which they think might explain the wide variability in some of his cardiac test results.

I am scheduled to see my cardio next month and he is doing another echo (last one was 2 or 3 years ago). I am going to talk with him about this bridging possibility. Maybe they need to do an TEE.

Thanks for sharing your experiences; much appreciated and good luck.  
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Avatar_f_tn
Gosh yvette you have been through the ringer yourself... I'm sorry for all your heart troubles. Yeah.. knowing and reading about what these bridges can cause really scares the daylights out of me.. since I get this sinus tach.. that they can't pin point the reason for.I don't know where to draw the line? Do I find yet a third cardio some where else.. and explain to him my symptoms and the finding of this bridge?? or do I just let it go and hope to god it does not suddenly kill me? I too would think if I was having angina or spasms all of the testing I've been through would have showed something.. but then again I don't know.? I am young with 3 kids and am so afraid this bridge thing could kill me well before my time. I'm worried, I'm aslo beign looked at for pheo. A urine and blood test both came back sort of messed up..so that is still on the table as a cause for my troubles. a pheo is a rare adrenal tumor... could explain the tachy episodes and chest wall pain.
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976897_tn?1379171202
It's one of those things in life where if you didn't know about it, you'd never have guessed it was there. It's harmless in your case because your blood flow is unaffected, but in some people this is not the case. In some people, particularly during exercise, the artery is pinched by the bridge with each heart beat, upsetting normal flow. It depends I believe on the thickness of the bridge and in most cases it is very thin. I would put this to the back of your mind because an angiogram would 'definitely' have picked up a pinching.
With regards to your sinus tachy, I'm not sure where to begin with suggestions because so many influences can cause this. You are correct with anxiety being one of them.
Check to see if your level of Catecholamine has been looked at, it's produced by the adrenal gland and is used to control the 'fight or run' level of the heart. Here are some common causes of sinus tachy....

stress, anxiety, fear, anemia, dehydration, caffeine, nicotine, cocaine, amphetamines, thyroid gland issues,

There are many others but these are the most common. Not pregnant are you? this can be another cause.
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Avatar_f_tn
Hi Ed. Thanks for your reply. I guess now that I know it's there.. it's bugging me. My mom had a very mild MI at age 60.. and she did not even have this MB thing. So, I have a history of CAD.. and I've been a smoker.. but I'm trying VERY hard to quit right away. I'ts funny you mention Catecholamine's because right now I'm under investigation for a rare adrenal tumor called a pheo. My norephinfrine (sp) is way high. I know my thyorid is fine.. and anxeity, well I have that now becuase of all of this. LOL. I am not on a beta blocker.. because they did not feel it was needed at this point. They beign my cardio. I'm just worried is all. And I hope I don't get CAD..and then have complications due to the bridge. I also don't like the fact that I've seen the words sudden death asscociated with this condition.. that makes me real nervous.
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Avatar_f_tn
If anyone else can relate or has any further information with regards to this sort of thing.. please.. I ask you to help me out here. I'm very freaked out about this. Thanks.
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Avatar_n_tn
Hi.  I too just found out that I have a mild myocardial bridge in my distal LAD.  Also I have symptoms just like you but am being told it is not from the bridge.  Along with the pains, I also get anxiety feelings.  Have you gone anywhere else yet for opinions?  I noticed that it has been some time since you posted.  I am trying to find answers too.
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Avatar_n_tn
hi found out i have a bridge also i am 58 years old about 5 years ago started having a little shortness of breath and some stange digizziness spells  also mt blood prssure started to be high pulse rate fast  went thru heart   mri  and lung test everything okay  started getting a little huccup in my breath was told by dr. this was normal symptoms started esclated started seeing new neuro cardio doct cardio dr was concerned about my heart action on the left ekg adnormal stess test blood pressure went way down so then did angiogram have a bridge     i did not realize that little by little i was having tightness in my chest and that normal hiccup is not normal and this strange feeling of the bottom falling out  high blood pressure is not normal  and too  early remember it took me 2 nuclear stess test the first one 5 years before did not pick up i   just started medicines  but it feels strange no tightness in chest and i can walk to my office and not be out of breath my pulse rate went down from steady 90 to70 i did not realize that even my pilse rate was high
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