Posterior interventricular artery (PIA) present in the posterior interventricular groove over the inferior surface of the heart. Human hearts consist of either Right coronary predominance or Left coronary predominance. Left coronary predominant people are more prone to get ischemic heart diseases. In left coronary predominance entire left ventricle except a part of the right ventricle adjoining anterior interventricular groove supplied by the left main coronary artery. Left coronary dominance has a poor prognosis in acute coronary syndrome when compared with the right coronary predominance. Myocardial bridging may be benign or malignant. So myocardial bridging with left coronary dominance may be a risk factor to the ischemic heart disease. The aim of the present study is to find out the coronary dominance pattern in myocardial bridged hearts in cadavers. Ninety cadaveric hearts were procured from the Department of Anatomy, IMS & SUM Hospital Bhubaneswar. After a simple dissecting procedure, myocardial bridges and coronary dominance patterns were observed. Myocardial bridging was present over the left anterior interventricular artery in 51(56.7%) hearts. Out of 51 myocardial bridged hearts, right coronary predominance is present in 45 (88.24%) hearts and left coronary predominance present in 6(11.76%) hearts. Along with the left dominance, if myocardial bridge present over the left epicardial coronary artery, there may be an increased frequency of myocardial ischemia.
Myocardial bridge(MB) is an anatomical variant. Sometimes MB can cause compression over the coronary arteries and causes ischemic heart diseases.MB associated with bends of coronary arteries double the risk of coronary artery disease. So the present study aimed to find out the incidence of bends of the coronary artery along with the myocardial bridging. 100 heart specimens were obtained from routine dissection conducted for undergraduate students in the department of Anatomy IMS & SUM Hospital Bhubaneswar. After the simple dissecting procedure, epicardial coronary arteries, their branches and myocardial bridges and hairpin bends of coronary arteries were observed. Myocardial bridges present 41 (41%) over Left anterior descending artery(LAD) only.Among 41 hearts single myocardial bridge present in 37((90.25%) hearts, double myocardial bridge were present in 3((7.31%) hearts and triple myocardial bridges present in only one heart(2.44%). Hairpin bends of the coronary artery were present in double and triple myocardial bridged hearts only. No hairpin bends of the coronary artery was observed in the single myocardial bridge. Hair pin bends of the coronary arteries are the unique features of the myocardial bridges in multiple myocardial bridges, i.e. double and triple myocardial bridges. However, hairpin bends of coronary arteries were absent in single myocardial bridged hearts.
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