How to deal with myocardial bridge and angina

Coronary microvascular dysfunction is a highly prevalent cause of angina in the ‘ischemia with nonobstructed coronary artery’ (INOCA) patients. The presence of myocardial bridge could represent the direct cause of angina in this patient subset. In this case, full physiological assessment allowed complete evaluation of an INOCA patient with myocardial bridge, unmasking its un-obstructive physiology, the presence of microvascular dysfunction, and the presence of epicardial spasm. Full physiological evaluation will be of paramount importance in the future in INOCA patients in order to establish tailored medical treatment.