Common symptoms include:[6][7] Myocardial bridges can cause numerous complications – which are often as misunderstood in the medical community as the condition itself.

There are three key tests currently used to diagnose myocardial bridges by Stanford University: CT scan, cardiac catheterization, and stress ultrasound.

Stanford's center for myocardial bridges has offered second opinion services from a distance for some ten years, including to numerous international patients.

According to a 2007 study:[8] Clinical suspicion of a myocardial bridge would be warranted in all cases of typical or atypical chest pain in subjects who have a low probability of atherosclerosis because they are free from the traditional cardiovascular risk factors, particularly in the young.A 2017 article in Stanford Medical Center's official blog Scope explains the hardships people with MB face, including the dismissal of their symptoms and obstacles in their lives as a result of the lack of MB education amongst cardiologists:[15] Many of these patients have these heartbreaking stories to tell.

Full open heart surgery is usually reserved for very large myocardial bridges and/or specific situations that make thoracotomy difficult.

In 2019, University of Chicago surgeon Dr. Husam Balkhy emerged as a provider of robotic-assisted unroofing surgery, with some patients being possible candidates for this route.

Some residual symptoms caused by complications from a lifetime of living with a myocardial bridge may continue after unroofing surgery such as endothelial dysfunction, vasospasm, plaque, narrowed artery.

[citation needed] A few cases have occurred in various hospitals in which patients have not been completely unroofed, leaving segments of the MB, resulting in lingering symptoms.

[citation needed] Hospitals that have performed unroofing surgery include: In many other countries, including a number of highly developed countries such as the UK, Australia, New Zealand, Ireland and Sweden, unroofing surgery for myocardial bridges remains unavailable, and in some, the condition remains unrecognized as a medical problem.

As a result of these studies and others, an estimated prevalence of approximately 25% is generally accepted.According to Stanford University Medical Center, MBs are often misunderstood by doctors, who may have been taught that the condition is always benign.

[However] angiographic and intravascular ultrasonographic studies demonstrated that vessel compression during systole is followed by the delay in the increase in luminal diameter during diastole, thus affecting the predominant phase of coronary perfusion, especially during episodes of tachycardia.

These data suggest that angina, acute coronary syndromes, and arrhythmias in patients with myocardial bridging may be explained by the reduced ischemic threshold.”[21] In other words, while the myocardial bridge itself only compresses the artery while the heart squeezes (systolic period), which is only 15% of the time in the heartbeat cycle, in fact, the artery stays compressed long after the heart relaxes.

This is because arteries are sturdy and pliable, so after being compressed they are very slow to reopen, remaining in some level of semi-compression for most if not all of the diastolic period i.e. the other 85% of the heartbeat cycle (hence the critical need for dFFR testing in diagnosing myocardial bridges).

[citation needed] Thus the coronary artery is fully open to allow normal blood flow for only a small percentage of each heartbeat cycle.