Isolated myocardial bridging: A potential cause of sudden cardiac death in thailand

Abstract

© 2020 Romanian Society of Legal Medicine. Introduction. The clinical significance of myocardial bridging (MB) as a potential cause of death has been debated. There is inconsistency in prevalence reports of MB as a cause of death in sudden cardiac death (SCD). We aimed to identify the prevalence of MB as a potential cause of SCD in non-ischemic heart disease (non-IHD) in Asian population. Methods. The SCD autopsy reports from Bangkok, Thailand between January 2012 and June 2014 were included. External causes, drug toxicity, and inconclusive autopsies were excluded. Conventional risk factors were recorded and compared between MB and non-MB. Results. Among 1,152 autopsy reports, 138 cases (85.5% male) were considered as SCD. 111 cases (80.4%) were caused by ischemic heart disease (IHD) whereas 27 cases (19.6%) were not (non-IHD). In IHD, the causes of death were coronary atherosclerosis, acute myocardial infarction, and old myocardial infarction (41.4, 34.2, and 24.3%). In non-IHD, MB was the most common pathological finding of SCD, followed by isolated left ventricular hypertrophy, hypertrophic cardiomyopathy, and myocarditis (29.6%, 25.9%, 22.2% and 14.8%). There were more males in both groups (MB [87.5%], non-MB [85.4%]). Mean (SD) heart weight of MB was lower than non-MB, [345.0(49.6) vs. 444.0(108.6) g, p=0.012]. There was no difference in mean age and body mass index. Conclusions. Our study suggested that MB might be a potential cause of SCD in non-IHD Asian population and highlights the mortality in asymptomatic MB patients.