Literally a bridging of heart muscle over one of the major arteries to the heart (usually the left anterior descending artery). The heart has formed in this abnormal design from birth, whereby the artery is actually ‘tunneled’ through a part of the heart muscle. The major coronary arteries are located in the sub-epicardial region. Localization of a coronary arterial segment in the myocardial tissue is termed myocardial bridging. In these patients, there is a temporary systolic coronary arterial luminal narrowing. Symptomatic patients are most often middle-aged men with typical or atypical chest pain, either related or unrelated to exercise. Myocardial bridging usually has a benign prognosis, but some cases associated with myocardial ischemia, infarction, and sudden death have been reported.