Srpski arhiv za celokupno lekarstvo 2015 Volume 143, Issue 3-4, Pages: 153-157
https://doi.org/10.2298/SARH1504153M
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Myocardial bridges: A prospective forensic autopsy study
Micić-Labudović Jelena (School of Medicine, Institute of Forensic Medicine, Belgrade)
Atanasijević Tatjana (School of Medicine, Institute of Forensic Medicine, Belgrade)
Popović Vesna (School of Medicine, Institute of Forensic Medicine, Belgrade)
Mihailović Zoran (School of Medicine, Institute of Forensic Medicine, Belgrade)
Nikolić Slobodan (School of Medicine, Institute of Forensic Medicine, Belgrade)
Puzović Dragana (School of Dental Medicine, Institute of Forensic Dentistry, Belgrade)
Introduction. When the coronary artery, located subepicardially, submerges
into the myocardium and appears again subepicardially after a short
intramural course, it represents an embedded coronary artery, while the part
of the myocardium above is a myocardial bridge. Objective. We investigated
the frequency of the embedded left coronary artery (LAD) in the autopsy
material considering the descending branch of the LAD to be the most
important one in the nourishment of the myocardium and myocardial bridges to
be the most frequent in its area, as well as clinically important. Methods.
A prospective autopsy study of 975 cases was performed, including both,
natural (21.33%) and violent (78.67%) deaths. The sample consisted of 74.56%
males and 25.44% females. In order to discover myocardyal bridges and their
characteristics, the hearts were examined by both transverse cuts and
longitudinal openings of the LAD. Results. Myocardial bridge was found in 78
cases (8.00%), more commonly in males (9.35%) than females (4.03%). The
average length of the myocardial bridge was 21.85±16.10mm and thickness
3.744±1.48 mm. The common localization of the myocardial bridge was the
proximal half of the LAD (89.74%). The upper part of the artery, proximal to
the bridge, was a common site of atherosclerotic changes. Myocardial bridge
was found in 12.50% of natural deaths, but in 13.38% out of all cases of
sudden cardiac deaths. Conclusion. Therefore, the presence of the myocardial
bridge by itself is not predominant, but it is certainly a contributing
factor to a sudden cardiac death.
Keywords: myocardial bridge, forensic autopsy study, manner of death
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