{"id":"9c3487e7fc6a","type":"article","url":"https://hartvaat.nl/2026/03/24/myocardiale-brug-praktische-gids-voor-diagnose-en-behandeling-in-het-ccta-tijdpe/","title":"Myocardiale brug: praktische gids voor diagnose en behandeling in het CCTA-tijdperk","title_en":"","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"European heart journal","doi":"10.1093/eurheartj/ehaf1038","source_url":"https://doi.org/10.1093/eurheartj/ehaf1038","authors":["Beatriz Castillo Rodriguez","Renzo Laborante","Affan Rizwan","Muzamil Khawaja","Stefano Elia","Noah Newman","Rehma Siddiqui","Daniel Berman","Giuseppe Patti","Hartzell V Schaff","Domenico D'Amario","Chayakrit Krittanawong"],"significance":6,"published":"2026-04-21","source_date":"2026-03-24","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/spontane-coronaire-arterie-dissectie/","https://hartvaat.nl/kennis/coronairlijden/coronaire-ct-angiografie/"],"congress":"","summary_en":"Myocardial bridging is the most common congenital coronary anomaly, usually benign but increasingly detected by coronary CT angiography and implicated in ischaemia with non-obstructive coronary arteries (INOCA). This EHJ review provides an evidence-based guide to diagnosis (CCTA, invasive angiography with IVUS/OCT) and management, addressing unresolved controversies around symptomatic treatment. A practical reference as imaging-led incidental findings rise.","created":"2026-07-03T10:32:46Z","updated":"2026-07-03T13:31:42Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Myocardiale bridging is de meest voorkomende aangeboren coronaire anomalie, in de meeste gevallen benigne. Door de toename van coronaire CT-angiografie wordt het echter vaker herkend en komt het soms zichtbaar terug bij INOCA-patiënten. Deze EHJ-review geeft een evidence-based leidraad voor diagnostiek (CCTA, invasieve angiografie met IVUS/OCT) en management, en bespreekt open controversen rond symptomatische behandeling. Relevant nu beeldvorming de incidenteel-bevindingen doet toenemen.","abstract_original":"Myocardial bridging is the most common congenital coronary anomaly, characterized by an intramyocardial course of a segment of an epicardial coronary artery, with considerable variability in its depth and length. In most cases, MB is a benign anatomical variant without clinical significance, often asymptomatic and not requiring treatment. However, with the increasing use of coronary computed tomography angiography for coronary assessment, myocardial bridging is now more frequently identified during non-invasive imaging. It can also be diagnosed via invasive coronary angiography, where it appears as a dynamic systolic compression of the tunnelled artery segment, and further anatomical characterization can be enhanced by intravascular ultrasound or optical coherence tomography. Growing recognition of myocardial bridging's role in ischaemia with non-obstructive coronary arteries has heightened clinical interest in its prevalence, diagnostic strategies, and management approaches. As such, this narrative review provides clinicians with an updated, evidence-based guide to the diagnosis and therapeutic management of myocardial bridging, while also addressing ongoing controversies and areas of uncertainty."}