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Myocardial bridge in type 3 LAD

I (38, Male, non-smoking, 5'9" 69 k.g.) was diagnosed with a myocardial bridge late last year. As part of health check up for insurance, I underwent a treadmill test, and was told that it was "positive for ischemic heart disease". I had no symptoms whatsoever.

I went for CT coronary angiography, and the following was reported:
1. calcium score zero
2. RCA, AM normal. no stenosis.occlusion
3. PDA, PLVB, normal. Filling from RCA. no stenosis.
4. Left main: normal in course and caliber-no stenosis. Divides into LAD, LCX and Ramus Intermedius.
5. LAD: Type III. short segment myocardial bridging seen in mid segment.LAD normal in course and caliber. No evidence of stenosis.
6. Diagonal, LCX, Ramus, OM1, OM2 all normal and no stenosis.

Doctor suggested no interventions. I wanted a second opinion as I have two young kids. Recently, I went to another cardiologist recommended by a relative, and he said the definitive evidence could be got by a real time test where in they injected some dye through a catheter, and checked the blockage in the LAD. He said it was fine, but prescribed beta or calcium blockers.

My questions are:
1. Should I take medicines? I know long term usage may have repercussions.
2. Is my heart suffering from ischemia? Is the myocardial bridge damaging my heart muscles? I don't want to drop dead suddenly.
3. I have no shortage of breath, but since 3-4 days I seem to have slight twinges(not pain) in the chest area when brushing my teeth. There is quite a bit of stress at work these days- I am changing my job, and things will get better in 1-2 months. Could these twinges be because of any heart problems?
4. Is it OK to exercise- yoga, cricket, cardio, etc.

Many thanks in advance,

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Thanks Ed34!

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976897 tn?1379167602
You could be experiencing ischemia in the LAD area due to the bridge, but not infarction. The heart muscle is not in a state where it will not recover if ischemia is present. A catheterization (angiogram) will show the artery in real time and they can measure blood flow/pressure either side of the bridge to see the amount of pressure the bridge is exerting. You are not going to drop down dead from this, you have been like it for nearly 4 decades. It can just get a bit worse as you age. Most blood is supplied to the heart muscle when it is relaxed, not when it is squeezing. It's when the heart squeezes that your artery is being squashed anything from 5-99%. The medication is to keep your heart a bit more relaxed, so I would take them until the angiogram results are known. If it turns out that you have substantial compression of the artery, then medication is the first line of defence. Surgery is an option, but only usually if you suffer lots of symptoms which medication In some cases, where the bridge is thin and short, stents are used to hold the artery open. The options will be evaluated by the cardiologist who does the angiogram.
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