How To Manage Angina Caused By Myocardial Bridging

Myocardial bridging is a condition where a segment of a coronary artery passes through the heart muscle instead of lying on the surface. This can lead to angina due to the compression of the artery during heart contractions. For patients experiencing angina from this condition, treatment options typically include medications that reduce myocardial contractility and relieve chest discomfort. Among the most commonly recommended are beta-blockers and calcium channel blockers.

Recommended Medications

Beta-blockers such as Propranolol and Metoprolol are often prescribed to slow heart rate and decrease the force of heart contractions. This helps reduce the pressure on the coronary arteries and alleviates angina symptoms. Similarly, calcium channel blockers like Diltiazem and Verapamil help relax the heart muscle and improve blood flow, further reducing the likelihood of angina episodes.

Additional Therapies

It's also important to note that myocardial bridging can cause abnormal blood flow patterns, including retrograde flow during systole. This may damage the inner lining of the coronary artery and increase the risk of atherosclerosis in that area. To mitigate these risks, doctors may recommend additional therapies such as antiplatelet agents and cholesterol-lowering medications. Aspirin (e.g., Bayer Aspirin) and Clopidogrel are commonly used to prevent clot formation, while statins may be added to combat plaque buildup.

Medications To Avoid

Patients diagnosed with myocardial bridging should avoid certain medications that can worsen angina symptoms. Nitrates, for example, can increase the degree of arterial compression and exacerbate chest pain. Likewise, positive inotropic agents such as dopamine, which increase the strength of heart contractions, should be avoided as they can further compress the affected artery and lead to more frequent or severe angina episodes.

Conclusion

While myocardial bridging is often a benign condition, it can cause significant symptoms in some individuals. Proper medication management is key to controlling angina and preventing complications. Always consult with a cardiologist to determine the most appropriate treatment plan based on your specific condition and overall health status.