Table 1.
Proposed classification scheme and therapeutic strategy for myocardial bridging (adapted from Schwartz et al).66
| Clinical Symptoms | Signs of Ischemia | Initial Treatment Strategy | Secondary Treatment if No Improvement | |
|---|---|---|---|---|
| Type A | Yes | No | Reassurance | – |
| Type B | Yes | Yes, by non-invasive stress testing | Beta-blockersb | Intracoronary hemodynamic evaluationa → surgery or stenting if abnormal |
| Type C | Yes | Yes, by altered intracoronary hemodynamicsa | Beta-blockersb | Surgery or stenting |
a
By quantitative coronary arteriography, fractional flow reserve, or intracoronary Doppler.
b
If beta-blockers are contraindicated, non-dihydropyridine calcium-channel blockers can be used.