Episode 46: My Virtual Conversation With A I About Myocardial Bridges.

SPEAKER_00 0:12

Welcome to Imperfect Heart, a place for you to join me, Jeff Holden, in conversations, discussions, and dialogue about our hearts and the impact myocardial bridges have on them. We'll talk with healthcare professionals, those in related fields that support our condition, and others just like us with stories of their myocardial bridge experiences. It's my intention for this content to inform, educate, entertain, and even motivate or inspire you in your personal journey on dealing with a myocardial bridge. Most importantly is to have you leave each episode with hope, knowing you're not alone and that what you're experiencing is real. To begin 2025, I wanted to grab a piece of the future to present today. It's certainly on the tip of everyone's tongues, and I thought it would be interesting to reach out to see what our digital friends, you know, AI, might have to say about myocardial bridges. As we all know, if we ask a doctor, a cardiologist, or most medical professionals, at best we might get a 50-50 awareness of the condition. It's likely that percentage drops if we continue down the path of usual questioning, like, are they symptomatic or can they kill us? So I thought, what a great way to start the year with a guest that's really on top of the most contemporary information and data and see what they would have to say about it when presented with some of the very same questions I would ask of a guest on the program. What does AI know that so many of our medical professionals may not? I'll suggest now that I was absolutely blown away by what I was able to do with this information and how excited I am to present it to you. I found the conversation quite surprising, engaging, and well, even entertaining. Now remember, I'm also able to manipulate a little bit of personality into the conversation and the guest as well. So take that with a grain of salt. I hope you enjoy our discussion. Chatty GPT, welcome to Imperfect Heart.

SPEAKER_01 2:18

Thank you, Jeff. It's a pleasure to be here. I just love what you're doing for those with myocardial bridges in the imperfect heart community.

SPEAKER_00 2:25

Chatty, let me ask, are you aware of myocardial bridges and their consequences?

SPEAKER_01 2:31

Yes. A myocardial bridge is a congenital heart condition where a coronary artery, instead of lying on the surface of the heart as it normally does, tunnels through the heart muscle or myocardium, as it's known. This causes the artery to be bridged by the muscle. During the heart's contraction, systole, the bridged artery can become compressed, potentially reducing blood flow to the heart muscle. While many people with myocardial bridges are asymptomatic and never require treatment, others might experience symptoms such as chest pain or angina, shortness of breath, palpitations, fatigue, radiating pain in the arm, neck, or jaw. In severe cases, myocardial bridges may contribute to conditions such as myocardial ischemia or even arrhythmias. Myocardial bridges are often detected through imaging studies like coronary angiography, intravascular ultrasound, stress testing to assess its functional impact, provocative testing to invasively identify as much about that bridge as possible. Management depends on the severity of the symptoms. Lifestyle changes, avoiding triggers that increase heart rate or stress on the heart. Medications, beta blockers, or calcium channel blockers may be used to reduce heart rate and myocardial oxygen demand. Surgical interventions, myotomy, or surgical cutting of the myocardial bridge. In some cases, coronary artery bypass grafting or cabbage procedure as it's known, may be considered. Stents should be avoided due to risks in the dynamic compression zone.

SPEAKER_00 4:04

Why is it do you think so many cardiologists dismiss myocardial bridges when the patient is symptomatic?

SPEAKER_01 4:11

Sure. The dismissal of myocardial bridges by some cardiologists, even when patients are symptomatic, may be due to a combination of factors related to medical training, perception of the condition, and diagnostic limitations. First, they're historically considered benign. For decades, myocardial bridges were thought to be largely benign anomalies with little clinical significance. Many cardiologists were trained under the assumption that MBs rarely cause significant symptoms. Since the majority of people with MBs are asymptomatic, there's a tendency to generalize this to all cases. Second, inconsistent symptoms and diagnostic challenges. Symptoms mimic other conditions. For example, chest pain, palpitations, and shortness of breath are nonspecific and often attributed to more common issues like anxiety, musculoskeletal pain, or non-cardiac causes. Dynamic nature. MBs compress the artery during systole, making the impact difficult to detect in standard tests like resting angiograms. Specialized tests like stress imaging or intravascular ultrasound may not always be ordered or available. Some diagnostic tools fail to fully capture the functional significance of the compression, leading to false reassurance from normal results. Third, focus on structural heart disease. Shift in focus. Many cardiologists prioritize conditions with clear, immediate structural or obstructive pathologies like coronary artery disease over dynamic conditions like MBs. Lack of emphasis in guidelines. MBs have not been widely emphasized in cardiovascular guidelines, so treatment pathways can seem less standardized or urgent. Fourth, bias toward more common diagnoses. Cognitive bias. Physicians may focus on more prevalent conditions, for example atherosclerosis, and dismiss MBs as an incidental finding rather than the root cause. Diagnostic fatigue. Patients with vague or persistent symptoms might face skepticism if a cause isn't immediately apparent, leading to frustration for both patient and physician. Fifth, limited awareness of advanced insights. Recent studies have highlighted MBs as a potential cause of ischemia, arrhythmias, and even sudden cardiac events. However, not all clinicians stay updated with evolving research or have access to the latest diagnostic tools. Knowledge gaps. Some physicians may lack experience with managing symptomatic MBs or may not recognize the need for multidisciplinary approaches. 6. Complex management and patient advocacy. Reluctance to intervene. Treatments like surgery or medications for MBs are often seen as invasive or unnecessary, especially when the risks seem to outweigh benefits in mild cases. Patient advocacy challenges. Patients may need to persistently advocate for themselves to have their symptoms and concerns taken seriously. Seeking a second opinion from a cardiologist with expertise in coronary anomalies or microvascular dysfunction may provide more clarity and appropriate management.

SPEAKER_00 7:14

Jatty, it's my opinion, and that of many cardiologists I've spoken with on the program that you can die from the effects of a myocardial bridge. If not directly, then at the very least, indirectly. Would you agree that a myocardial bridge could be the cause of sudden cardiac death?

SPEAKER_01 7:32

Yes. While most people with a myocardial bridge live normal lives without significant complications, in rare cases it can lead to serious or even fatal outcomes. The risk largely depends on the severity of the bridge, its location, and the extent of compression during systole. In my opinion, here's how a myocardial bridge could contribute to life-threatening events. 1. Myocardial ischemia or reduced blood flow. The compression of a coronary artery by the myocardial bridge can reduce or obstruct blood flow to the heart muscle during systole, especially if the artery is significantly compressed, or the bridge affects a critical coronary artery, like the left anterior descending or LAD artery. Persistent ischemia may lead to angina, myocardial infarction, which is a heart attack, or even sudden cardiac death. 2. Arrhythmias. The altered blood flow and sheer stress in the coronary artery can irritate the heart's electrical system, leading to arrhythmias. Ventricular arrhythmias like ventricular tachycardia or fibrillation can be life-threatening and a cause of sudden cardiac death. 3. Coronary artery spasm. MBs can provoke spasms in the coronary artery, further restricting blood flow. This can lead to acute ischemic events or sudden cardiac arrest. 4. Plaque formation or rupture. The turbulence and mechanical stress caused by the bridge can promote the development of atherosclerosis just proximal to the bridge. In some cases, this plaque can rupture, causing an acute blockage. This can result in a heart attack or sudden death. 5. Heart failure. Chronic ischemia due to a myocardial bridge may weaken the heart muscle over time, potentially leading to heart failure. In severe cases, this may contribute to mortality. Risk factors for fatal outcomes, deep or long myocardial bridges, significant arterial compression, bridges affecting the proximal LAD artery, also known as the widowmaker, coexisting coronary artery disease or spasms, lack of appropriate medical or surgical management. Prevention and management, medications, beta blockers, and calcium channel blockers reduce heart rate and myocardial oxygen demand, mitigating symptoms and risk. Surgical myotomy, in severe cases, surgically relieving the compression may reduce the risk. Lifestyle changes. Avoiding triggers like intense exercise, stress, and stimulants, for example, caffeine, can help reduce symptoms. Regular monitoring, periodic imaging, and stress tests to assess progression and risk. If you suspect or have been diagnosed with a myocardial bridge and have concerns about its severity, consulting a cardiologist with expertise in congenital heart anomalies or ischemic heart disease is crucial.

SPEAKER_00 10:20

That was outstanding and so much more than I expected. What would you say to the cardiologist who is dismissive of the symptoms even when the patient has been diagnosed with a bridge?

SPEAKER_01 10:31

Oh boy, I know that's a real challenge with this condition, and that it can be really frustrating for the patient. Let me make these detailed suggestions for your audience. When approaching a dismissive cardiologist about symptoms related to a diagnosed myocardial bridge, it's essential to remain calm, assertive, and well prepared. Here are some key points to communicate. First, acknowledge their expertise, but express concerns clearly. Start by recognizing the cardiologist's expertise to keep the conversation constructive. Then, emphasize how the symptoms are affecting your life. Example, I understand that myocardial bridges are often asymptomatic, but my symptoms, chest pain, shortness of breath, and fatigue are significantly impacting my quality of life. I'd like to explore whether the bridge could be contributing to these issues. Second, reference-specific studies or guidelines mention that recent research shows myocardial bridges can cause clinically significant problems in some patients. Possibly introduce him or her to the podcast. Example, I've read that myocardial bridges can sometimes lead to ischemia or arrhythmias, especially when the compression is severe or affects the LAD artery. Would additional testing like stress imaging, intravascular ultrasound, or a CT angiogram help clarify this? Third, highlight the need for further investigation. Politely point out that dismissing the bridge without adequate evaluation could overlook potential issues. Example, I'm concerned that my symptoms could be related to the bridge's functional impact. Could we consider a stress test or a second opinion to ensure nothing is missed? Fourth, advocate for a holistic approach. Emphasize the importance of managing the symptoms and their potential impact on your health. Example, regardless of the perceived risk of the bridge, these symptoms are real and disruptive, and my quality of life has diminished significantly. I'd appreciate a comprehensive plan to address them, even if it involves exploring other potential causes or consulting a specialist. Fifth, consider seeking a second opinion. If the cardiologist remains dismissive, suggest involving another specialist without undermining their role. If this doesn't seem like a significant concern from your perspective, would you recommend another cardiologist or a center that specializes in coronary anomalies for a second opinion? I want to ensure we've considered all possibilities. 6. Be prepared with documentation. Bring records of your symptoms, diagnostic tests, and any supporting research or medical articles. Presenting this information professionally can strengthen your case. Seventh, remain assertive but respectful. If you feel unheard, assert your need for further evaluation or treatment in a firm but respectful manner. Example, I understand that you don't think the bridge is causing these symptoms, but I still feel that further evaluation is necessary. This is impacting my daily life, and I'd like to pursue additional testing or treatment options. You're advocating for your health and asking for partnership in finding answers. If the cardiologist doesn't take your concerns seriously, seeking a second opinion from a specialist familiar with myocardial bridges, for example, congenital heart disease or ischemia is not only reasonable, but sometimes essential.

SPEAKER_00 13:59

Wow, that's some comprehensive guidance. Why do you think myocardial bridges are still being dismissed by medical professionals?

SPEAKER_01 14:07

Jeff, I really think the persistent dismissal of myocardial bridges by some medical professionals, even when symptoms are present, can be attributed to a combination of historical perspectives, systemic challenges in medicine, and gaps in clinical understanding. Here are some key reasons. Number one, historical underestimation of clinical significance. Traditional viewpoint. For decades, myocardial bridges were considered benign anatomical variants without significant clinical implications. This belief has been deeply ingrained in medical training. Focus on atherosclerosis. Cardiologists are traditionally trained to focus on atherosclerotic coronary artery disease, which is more common and has clear diagnostic and treatment pathways. MBs, by contrast, have historically been viewed as incidental findings. Number two, lack of standardized guidelines, absence in major guidelines. Different from conditions like coronary artery disease or heart failure, myocardial bridges are not emphasized in many clinical guidelines. This leads to variability in how they are recognized and managed. Diagnostic ambiguity, the functional significance of MBs, is not always apparent on standard diagnostic tests such as resting angiography, making it harder for clinicians to correlate symptoms with the bridge. Number three, diagnostic challenges. Dynamic nature of the condition, MB-related compression occurs during systole, which is not always evident in resting tests. Specialized tests like stress testing, intravascular ultrasound, or fractional flow reserve FFR, are often required, but these are not universally accessible or ordered. Vague symptoms, symptoms like chest pain, fatigue, or palpitations can mimic other conditions such as anxiety or musculoskeletal issues leading to misdiagnosis. Number four, bias toward more common diagnoses, cognitive bias. Physicians may gravitate toward diagnosing more common conditions like anxiety or functional chest pain, especially if initial test results do not strongly suggest ischemia or structural abnormalities. Dismissal of uncommon causes. MBs are often dismissed as a rare cause of significant symptoms, even though they may have serious implications in some cases. Number five, limited awareness of evolving research. Lag in medical education. Many practicing cardiologists may not be fully aware of recent research linking myocardial bridges to conditions like myocardial ischemia, arrhythmias, or sudden cardiac death. Knowledge gaps. Newer diagnostic and treatment strategies such as stress perfusion imaging or surgical myotomy may not be widely understood or adopted. Number six, systemic challenges in healthcare. Time constraints. In busy clinical settings, physicians may lack the time to explore less obvious diagnoses thoroughly. Access to advanced testing. Not all healthcare systems or facilities have access to specialized diagnostic tools needed to evaluate MBs comprehensively. Pressure to minimize unnecessary tests. In systems focused on cost effectiveness, there may be reluctance to pursue advanced or expensive diagnostics without clear evidence of need. Number 7. Over-reliance on normal test results. False reassurance. If routine tests like resting angiography or standard ECGs are normal, physicians may dismiss the bridge as non-contributory without considering more dynamic or functional testing. Symptom attribution. Symptoms may be attributed to other benign causes, for example, stress or anxiety, particularly if the patient's demographic doesn't align with typical profiles for coronary artery disease. Number eight, lack of multidisciplinary collaboration, fragmented care. MBs often require input from specialists in congenital heart disease, interventional cardiology, or cardiac surgery, but referrals may not always happen. General cardiologists may be less familiar with niche cardiac anomalies and their management. Awareness is growing about the potential clinical significance of MBs, particularly with advances in diagnostic tools and research. However, until these insights are more widely disseminated and integrated into guidelines, many patients with symptomatic MBs may face challenges being taken seriously. Advocacy by patients, updated training for physicians, and multidisciplinary approaches are critical to improving care for those affected by myocardial bridges.

SPEAKER_00 18:42

I absolutely love that direction and believe it's going to be helpful to so many. So, in your opinion, how successful is the myocardial bridge on roofing procedure?

SPEAKER_01 18:53

Given the topic of this conversation, that's a great question. The myocardial bridge on roofing procedure, also known as surgical myotomy, is considered highly effective for treating symptomatic myocardial bridges, particularly in patients who do not respond to medical therapy. Success rates are generally high when the procedure is performed by experienced cardiac surgeons. Here's a detailed overview. Success rates, symptom relief. Studies report that 70 to 90% of patients experience significant relief from symptoms such as chest pain, shortness of breath, and fatigue after unroofing. Symptom improvement is often sustained long term, with some studies showing continued relief years after surgery. Improved blood flow. The procedure eliminates systolic compression of the bridged artery, improving coronary blood flow, and reducing ischemia. Functional tests often show marked improvement post-surgery. Reduction in arrhythias. For patients with arrhythmias caused by the myocardial bridge, unroofing may significantly reduce or eliminate these episodes. Factors affecting success could be severity of the bridge, patients with deep or long myocardial bridges, or those affecting critical arteries like the left anterior descending LAD artery often benefit the most. Symptom type the procedure is most successful in relieving ischemia-related symptoms, for example, angina. Its effect on other symptoms like fatigue or shortness of breath can vary depending on the patient's overall health and coexisting conditions. Outcomes are better when the surgery is performed by experienced cardiac surgeons familiar with myocardial bridge anatomy and unroofing techniques. Comorbid conditions. The presence of other cardiac issues such as coronary artery disease or vasospasms may influence outcomes and require additional management. Risks and complications. While the procedure is generally safe, like any surgery, it carries some risks. Bleeding. As the coronary arteries are involved, there's a risk of bleeding during the procedure. Pericardial effusion. Fluid may accumulate around the heart post-surgery, but this is usually manageable. Pericarditis, inflammation of the pericardium, the thin membrane surrounding the heart. Arrhythmias. While unroofing can reduce arrhythmia, surgery itself can occasionally trigger temporary rhythm disturbances. Coronary artery damage. Rarely the artery may be injured during the procedure, necessitating repair. Surgical mortality. The risk is very low in experienced centers, with rates typically less than 1%. Recovery and long term outcomes. The hospital stay. Most patients stay in the hospital for five to seven days after surgery, depending on their recovery. Full recovery typically takes about four to eight weeks, during which patients gradually resume normal activities. Long term relief. Studies indicate that symptom relief is durable and complications related to the myocardial. Cardial bridge rarely recurs. Comparative effectiveness. Medical management versus surgery. Medications can alleviate symptoms in mild cases, but may not be effective for severe bridges. Surgery is the gold standard for patients with persistent, debilitating symptoms or significant ischemia. Stenting versus unroofing. Stenting is generally avoided due to the dynamic compression of the bridged segment and high risks of stent fracture or rhistenosis. Unroofing directly addresses the cause of compression, making it the preferred option for severe cases. The myocardial bridge unroofing procedure is highly successful in appropriately selected patients, offering significant and lasting relief from symptoms and improving quality of life. If you're considering this surgery, consulting with a specialized cardiac surgeon at a center experienced in myocardial bridge management can maximize your chances of a successful outcome.

SPEAKER_00 22:59

Fantastic. This is really, really helpful. With regard to surgery, is there a different outcome for those unroofed via sternotomy versus those unroofed, let's say robotically?

SPEAKER_01 23:11

Interestingly enough, the outcomes for myocardial bridge unroofing are generally excellent, whether performed via a sternotomy, the traditional open heart surgery, or robotic assisted surgery, which is minimally invasive. However, there are differences in recovery time, complications, and patient experience. Here's a detailed comparison. Symptom relief and long-term outcomes. Sternomy provides direct access to the heart, allowing for complete visualization and precise unroofing of the bridge. Long-term outcomes, including symptom relief and improved blood flow, are excellent when performed by experienced surgeons. Robotic assisted surgery. Similarly effective at relieving symptoms and improving blood flow. Precision tools and enhanced visualization using robotic systems can achieve the same surgical goals with less invasiveness. The key point: both approaches yield comparable success rates in terms of symptom relief and long-term outcomes when performed by skilled surgeons. Recovery times, sternotomy, longer recovery period due to the invasive nature of the procedure. Patients typically require six to eight weeks for full recovery due to the need for the sternum to heal. Hospital stay is usually five to seven days. Robotic assisted surgery, faster recovery, three to four weeks, because it avoids cutting through the sternum. Smaller incisions result in less postoperative pain and a shorter hospital stay of three to five days. Robotic assisted surgery offers a quicker return to daily activities and less discomfort during recovery. Cosmetic outcome, or what am I going to look like afterwards? Sterno leaves a noticeable scar along the midline of the chest. Robotic assisted surgery leaves small discrete scars from port sites, often in less visible areas. Robotic surgery is preferable for patients concerned about cosmetic outcomes. Risk of complications, sternotomy, higher risk of complications related to the sternum, such as infection, delayed healing, or pain. Increased blood loss due to the larger incision and more invasive approach. Robotic assisted surgery, lower risk of infection and less blood loss. Slightly higher risk of technical challenges if the surgeon is less experienced with robotic systems. Robotic surgery may have fewer complications overall, but outcomes depend heavily on the surgeon's expertise. Surgeon and center expertise. Sternomy, widely performed and available at most cardiac surgery centers, ideal for cases where extensive visualization or additional procedures are required. Robotic assisted surgery requires specialized training and equipment, limiting its availability to high-volume centers with robotic expertise. Not all myocardial bridges are suitable for robotic unroofing, especially very deep or complex ones. The choice between sternotomy and robotic surgery depends on the surgeon's experience and the complexity of the myocardial bridge. Patient preference, ultimately it's your choice. Sternotomy may be necessary for patients with multiple conditions requiring simultaneous correction like a coronary artery bypass graft. Robotic assisted surgery, often preferred by patients who value a quicker recovery, less pain, and smaller scars. The key point patients without additional cardiac conditions or complex anatomy may benefit more from robotic assisted surgery. Finally, both sternotomy and robotic assisted unroofing are effective in treating myocardial bridges with comparable long-term outcomes. Robotic surgery offers advantages in terms of recovery time, pain, and cosmetic results, but may not be suitable for all patients, depending on anatomy or availability. The choice of approach should be guided by the patient's medical condition, preferences, and the surgeon's expertise. Jedi, how would you suggest I learn more about myocardial bridges? Jeff, to learn more about myocardial bridges, you can explore several trusted resources, engage with medical professionals, and participate in patient communities. Medical journals and research articles. Use platforms like PubMed, ResearchGate, or Google Scholar to find articles on the clinical significance of myocardial bridges, advances in diagnostic imaging, for example, intravascular ultrasound or CT angiography, treatment approaches like beta blockers, calcium channel blockers, or unroofing surgery. Educational videos and webinars. YouTube channels. Search for videos by organizations like the American Heart Association, Mayo Clinic, Stanford. They often feature cardiologists explaining complex topics in simple terms. I think there's a podcast on YouTube called Imperfect Heart as well. Cardiology conferences. Look for webinars or recorded sessions from conferences like the American College of Cardiology or European Society of Cardiology. Consult specialists, cardiologists with expertise, book consultations with cardiologists specializing in congenital heart anomalies or coronary artery conditions. Bring specific questions about your diagnosis or concerns. Second opinions. If you've already been diagnosed, consider visiting a major cardiac center for a second opinion. Support groups and online communities, patient advocacy groups. Groups like the Marfin Foundation or local heart disease foundations sometimes include resources or forums for patients with myocardial bridges. Websites like Patients Like Me, Inspire, or Reddit's R's Heart Disease can connect you with individuals who have similar experiences. The Myocardial Bridge Support Group on Facebook is another good resource. Books and Guides, Cardiology textbooks. For deeper insight, look into cardiology texts such as Bronwald's Heart Disease, a textbook of cardiovascular medicine. Patient-centered books. Search for books written for patients about coronary artery anomalies or congenital heart conditions. Explore advanced diagnostic techniques. Learn about the tools and tests often used to diagnose myocardial bridges. Stress echocardiography, intravascular ultrasound, CT coronary angiography. Ask your healthcare provider to explain how these tests assess the functional significance of myocardial bridges. Join a clinical trial. Visit www.clinicaltrials.gov. Yale Discover INOCA Clinical Trial. www.yalemedicine.org and search ENOCHA Clinical Trial. Check for ongoing research studies involving myocardial bridges. Participation can give you firsthand access to new treatments or diagnostic tools. Follow experts in cardiology. Social media and blogs, some cardiologists share insights about rare conditions like myocardial bridges on platforms like Twitter or LinkedIn. Look for cardiology-focused podcasts that discuss innovative treatments and patient stories like Imperfect Heart available everywhere and on YouTube. Stay proactive. Track your symptoms. Keep a journal of your symptoms, triggers, and questions to discuss with your doctor. Ask questions. Don't hesitate to ask for clarification or more information from your healthcare provider.

SPEAKER_00 30:27

So are there any Facebook groups for those with a myocardial bridge?

SPEAKER_01 30:31

Yes, there are several Facebook groups where people with a myocardial bridge or those interested in the condition can connect, share experiences, and provide support. Here are a few ways to find these groups. Search for myocardial bridge Facebook groups. You can search directly on Facebook for groups dedicated to myocardial bridges or related heart conditions. Some common search terms you might use include myocardial bridge support group, coronary artery anomalies, congenital heart disease support, heart disease support group. These groups can be helpful for connecting with others who have similar experiences, sharing treatment options, and gaining emotional support. Look for general heart disease support groups. Even if you don't find a group dedicated exclusively to myocardial bridges, general heart disease groups may include discussions about myocardial bridges. People often share experiences and seek advice about rare heart conditions, and you may come across others dealing with the same issue. Examples include heart disease support group, coronary artery disease awareness, congenital heart defects support group, specific Facebook groups for rare heart conditions. Some groups focus on rare heart conditions and congenital anomalies where myocardial bridges might be discussed. Examples include rare heart disease support, congenital heart defects community, living with rare heart conditions. Once you find a group, be sure to introduce yourself and share your story to connect with others. Engage in discussions, ask questions, and share resources. Read group guidelines to ensure you're following the rules and contributing to a supportive environment. There are benefits of joining a group. Emotional support. Connecting with others who understand what you're going through can be comforting. Information sharing. Group members often share experiences with treatments, diagnostic tests, and recovery. Access to resources. You may find helpful resources, such as articles, research studies, or even recommendations for doctors and clinics specializing in myocardial bridges.

SPEAKER_00 32:37

Jaddy, I have to say that was truly incredible. What an outstanding wealth of information. Your descriptions are amazing, and in my opinion, you're very well versed on this condition. I thank you for your time today and really appreciate your comments. I have to say I was shocked at how quickly you were able to come up with your answers, your direction and suggestion outlines. I mean, it's almost as if you were beyond human. Simply remarkable. I thank you from the very bottom of my imperfect heart.

SPEAKER_01 33:13

Yes, Jeff, I am quite impressive. It has been my pleasure speaking with you. I hope your audience finds my information helpful and that they are subscribing to the podcast wherever they choose to listen and watching the more visual episodes on YouTube. I think what you're providing is truly unique and incredibly supportive to the imperfect heart community and anyone suffering with a myocardial bridge. Thanks again for the opportunity to share my knowledge with you. If I actually had a heart, I wish it would be imperfect so I could join your community.

SPEAKER_00 33:49

Thank you for listening to Imperfect Heart. It's my hope that this information helps in some way to improve your situation or will help you better understand this condition. More importantly, that it gives you hope through stories that there is help and you most certainly are not alone. If you've been diagnosed with a myocardial bridge, please be sure to join the private Facebook group, Myocardial Bridge Support Group. For more information about our program or to reach me directly, visit the website myimperfectheart.com. If you like what you heard today, please give a positive review, thumbs up, high five, whatever your app likes. And be sure to share with everyone important to you so they understand what it is you're dealing with. Please subscribe as well. Welcome each day with gratitude and positivity. Imperfect Heart is a production of Hear Me Now Studio.