During emotional excitement or exercise, some middle-aged people may experience manifestations similar to myocardial ischemia of coronary heart disease, such as chest tightness and angina, and some may also have manifestations of cardiac arrhythmia, such as atrioventricular block, or in more serious cases, even myocardial infarction and sudden death. Many people think they are suffering from coronary heart disease. In fact, some of these people have a disease called coronary artery myocardial bridge. According to the recently published Chinese Medical Journal (CMJ) in English, this disease is a congenital condition that can be present at birth, and its incidence is inconsistent and varies widely among research institutions. The majority of people who develop this disease are asymptomatic, with only 18% showing signs of myocardial ischemia, most of which do not manifest until middle age. The detection rate of the disease by coronary angiography is only 0.5% to 16%. As we know, the coronary arteries and their branches are usually located under the epicardium, but if a segment of the coronary artery is submerged under the myocardium, the surface of the myocardium is covered by a coronary artery myocardial bridge. Myocardial bridges have a compressive effect on the coronary arteries during the systolic phase of the heart, causing a certain degree of stenosis. Since the coronary perfusion flow during the systolic phase only accounts for 5% to 30% of the full cycle, most of the blood flow is perfused during the diastolic phase. Therefore, the traditional concept is that myocardial bridges do not have a significant effect on the overall coronary blood flow and do not necessarily cause myocardial ischemia. In contrast, modern clinical studies have found that myocardial bridges not only narrow the systolic coronary arteries, but also delay their recovery in early diastole and cause some narrowing of the coronary arteries in diastole, thus causing myocardial ischemia. Especially during tachycardia or exercise, because the heart rate is accelerated, the contraction force of myocardial bridge is increased, the oxygen consumption of myocardium is increased, and the degree of pressure on blood vessels is increased, which leads to the aggravation of myocardial ischemic symptoms and even infarction. Therefore, the clinical significance and treatment of this disease are gradually being paid attention to. In addition, the majority of myocardial bridges occur in the anterior descending branch of the left coronary artery, which mainly supplies blood to the left ventricle, and the consequences are serious once the degree of stenosis increases. At present, coronary angiography is still the gold standard for confirming the diagnosis of this disease. The treatment of coronary artery myocardial bridges includes pharmacological, interventional and surgical treatment, which is the most effective method to choose. If the patient is asymptomatic or has mild symptoms, no treatment is needed. Those with symptoms should avoid vigorous exercise to prevent tachycardia, and pharmacological treatment should be the first choice. Stent intervention is still controversial, mainly because of the risk of thrombosis and restenosis, the long-term efficacy of stent intervention is uncertain, and sometimes the stent may also form restenosis due to the compression of the myocardial bridge. Surgical treatment includes myocardial bridge release and coronary artery bypass grafting. The surgical approach should be chosen according to the patient’s condition and the extent of lesions in the important branches. Myocardial bridge release is the surgical treatment of choice, with complete myocardial bridge release and regular follow-up.