Myocardial bridges in man: clinical correlations and angiographic accentuation with nitroglycerin

Cathet Cardiovasc Diagn. 1977;3(1):59-65. doi: 10.1002/ccd.1810030107.


Little is known of the clinical significance of myocardial bridges, which may be recognized angiographically as systolic coronary artery narrowing (SCAN). A retrospective review of a 1 year's experience (313 consecutive coronary arteriograms) revealed 5 patients with SCAN, an incidence of 1.6%. SCAN involved the proximal and/or middle segments of the left anterior descending coronary artery in all patients. It is of particular note that the administration of nitroglycerin noticeably accentuated the SCAN phenomenon in each of 3 patients to whom it was administered. Four of the 5 patients had left ventricular hypertrophy due to hypertrophic cardiomyopathy (2), aortic stenosis (1), and hypertension (1). All 5 patients with the SCAN phenomenon had anginal chest pains, and critical obstructive coronary atherosclerosis was observed in only 2 cases. The other 3 patients showed, otherwise normal coronary arteriograms. Thus, myocardial bridges appear to be angiographically manifest predominantly in patients with cardiac hypertrophy. Nitroglycerin, which accentuates SCAN, might be useful as a provocative test to enhance the angiographic recognition of this phenomenon. The possible role of myocardial bridges in the production of myocardial ischemia warrants further investigation.

MeSH terms

  • Adult
  • Coronary Angiography*
  • Female
  • Heart Defects, Congenital / diagnostic imaging*
  • Humans
  • Male
  • Middle Aged
  • Nitroglycerin*
  • Radiographic Image Enhancement


  • Nitroglycerin