Myocardial bridging and ecstasy: a fatal combination involving a 22 year-old male

A band of cardiac muscle overlying an intramural segment of a coronary artery is defined as myocardial bridging (MB), which is a congenital coronary anomaly. Normally, the coronary arteries run over the surface of the epicardium but can enter the myocardium in various extents. This intramural segment is called a “tunnelled” artery, which reappears later on the heart's surface. The coronary artery most often involved is the left anterior descending (LAD) one. Occasionally, the diagonal branches, the posterior descending right coronary artery or marginal branches of the circumflex artery may be overbridged