What is a wall coronary artery?

Coronary artery mural, also known as myocardial bridge, is an anatomical variation of the coronary arteries. In normal individuals, the coronary arteries typically run along the surface of the myocardium and are connected to the heart via connective tissue. In some cases, a segment of the coronary artery may pass through the myocardium; the overlying myocardial fibers are called the myocardial bridge, while the coronary artery running beneath the myocardial bridge is referred to as the mural coronary artery.

The prevalence of mural coronary artery in the population is quite high, possibly ranging from 15% to 85%. In most cases, patients with mural coronary arteries do not experience obvious symptoms and therefore do not require specific treatment. A minority of patients may develop angina-like symptoms such as chest tightness, shortness of breath, palpitations, and even arrhythmias. These symptoms may occur due to compression of the mural coronary artery during cardiac contraction, leading to myocardial ischemia.

Treatment options for mural coronary artery include pharmacological therapy, interventional therapy, and surgical treatment. Pharmacological therapy usually involves the use of beta-blockers or calcium channel antagonists to reduce myocardial contractility and alleviate compression of the coronary artery. Interventional procedures, such as balloon angioplasty, can restore blood flow to the affected coronary artery. Surgical treatment may be considered for patients with severe or high-risk symptoms.