Gross anatomical study on the human myocardial bridges with special reference to the spatial relationship among coronary arteries, cardiac veins, and autonomic nerves

Abstract

Coronary arteries are frequently covered by cardiac muscles. This arrangement is termed a myocardial bridge. Previous studies have shown that myocardial bridges can cause myocardial ischemic diseases or cardiac arrhythmia, but the relevant pathogenic mechanisms remain unknown. We examined 60 hearts from Japanese cadavers macroscopically to clarify the spatial relationships among coronary arteries, cardiac veins and autonomic nerves. We found 86 myocardial bridges in 47 hearts from the 60 cadavers examined (78.3%). Next, we dissected out nine hearts with myocardial bridges in detail under the operating microscope. We found no additional branches of coronary arteries on the myocardial bridge surfaces. However, the cardiac veins, which usually accompany the coronary arteries, ran independently on the myocardial bridge surfaces in the same region. Cardiac autonomic nerves comprised two rami: one was associated with the coronary artery under the myocardial bridge and the other ran on the surface of the bridge. Such spatial relationships among the coronary arteries, cardiac veins and cardiac autonomic nerves at the myocardial bridges are quite similar to those in mouse embryo hearts.

Myocardial Bridging: A Meta‐Analysis of Prevalence

“…The most likely cause of this heterogeneity was a failure to identify all the bridges, either because of a low detection sensitivity of the methods used for assessing MB or due to a superficial analysis of the cases. From our personal experience, MB can be identified during the autopsy, when looking carefully for it, in more than 75% of cases, a level that was reached by some necropsy reports included in the meta‐analysis . However, in most cases, the bridges are either superficial, having a thickness of less than 1–2 mm, or are located at the level of the coronary segments that are usually not appropriately dissected (especially marginal and diagonal arteries).…”

“…In forensic autopsies, it is sometimes considered a cause of sudden death and is often reported as such in scientific articles, especially in association with other congenital cardiac or coronary anomalies . It is considered an inborn anomaly, being found in studies on human fetuses , and it appears to reflect particular developmental processes within the heart . The description of the morphological characteristics of MBs is extremely heterogeneous in the scientific literature.…”

Vascular supply of the anterior interventricular epicardial nerves and ventricular Purkinje fibers in the porcine hearts

“…As is well known from previous work on the hearts of various species, including the human and pig (Arora, Waldmann, Hopkins, & Armour, 2003;Batulevicius et al, 2008;Pauza et al, 2000;Pauziene et al, 2000;Pauziene et al, 2017;Saburkina et al, 2010;Watanabe et al, 2016), the anterior interventricular region and adjacent anterior surfaces of the ventricles is one of the most suitable areas for performing studies oriented on the morphology of the epicardial nerves.…”

Jaw pain and myocardial ischemia: A review of potential neuroanatomical pathways

“…The pathways for referred cardiac pain are complex, proving difficult to map out a single route (Loukas et al ; Muresian ; Norman and Riley ; Watanabe et al ). Moreover, patients experience variant sensations and locations during episodes of myocardial ischemia due to the convergence of visceral and somatic inputs in various brain/brain stem regions.…”