Concept: The phenomenon of coronary arteries passing through the myocardium (so-called myocardial bridges). Patients may present with clinical manifestations such as myocardial ischemia, acute coronary syndrome, myocardial spasm, exercise-induced supraventricular tachycardia, ventricular tachycardia or atrioventricular block, myocardial stenosis, transient ventricular insufficiency, syncope or even sudden death. Functional myocardial bridges are less common on coronary angiography, accounting for only 0.5%-16% of cases and ranging from 4 mm to 80 mm in length. Although myocardial bridges can be formed on the surface of any epicardial artery, most occur in the left anterior descending branch, accounting for 67%-98% of cases. Myocardial bridges range in depth from 0.3 mm to 28 mm. Anatomically, myocardial bridges consist of superficial myocardial fibers that span the left anterior descending branch or deep fibers that surround the left anterior descending branch, and myocardial bridges >5 mm in depth are less likely to be suitable for surgical myotomy. The hemodynamic impact of myocardial bridges depends on the thickness and length of the myocardial bridge, and the direction of its course is related to the myocardial fibers. Diagnosis: There are many methods to diagnose myocardial bridges, but due to the lack of a diagnostic gold standard, the accuracy of the diagnosis reported by various tests varies. Myocardial bridges can be classified into three types according to Schwarz’s typing: A, B, and C (see table below.) Patients with type A do not require treatment, whereas in patients with types B and C, 5-year follow-up studies have shown that β-blockers or calcium antagonists significantly improve symptoms in both types. Reconstructive therapy may be considered in patients with type C who fail to respond to pharmacologic therapy. Cardiac surgery: This includes supracoronary myocardiotomy and coronary artery bypass grafting (CABG). Myocardiotomy is intended to correct the underlying pathologic mechanism and is an option for patients with symptomatic myocardial bridges who have failed pharmacologic therapy, have systolic coronary stenosis ≥75% on coronary angiography, or have evidence of myocardial ischemia and infarction. CABG is an option for patients with myocardial bridges >25 mm in length or >5 mm in depth or in which the coronary segments within the myocardial bridge fail to fully relax in diastole. the left internal mammary artery is more prone to occlusion as a bypass artery compared with the saphenous vein, and therefore, CABG for myocardial bridges is preferred to the saphenous vein.