過呼吸症状を呈し, 神経循環無力症との鑑別が困難であった僧帽弁逸脱症候群の2例

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In mitral valve prolapse syndrome, chest pain, palpitation, breathlessness and fatigue are often accompanied. These symptoms are similar to those in neurocirculatory asthenia. We present two cases of mitral valve prolapse syndrome with hyperventilation attacks, which were hard tot differentiate from neurocirculatory asthenia. Case 1 was a 55-year old male patient with movable chest pain and periodic hyperventilation attacks, who visited the department of psychosomatic medicine in Nov. 1980,because no abnormal findings has been revealed in a few hospitalizations. Physical examination disclosed midsystolic clicks in supine position. Echocardiogram showed pansystolic bowing. Stenosis of coronary arteries were not found while mitral valve prolapse was cofirmed in cardiac catheterization. His complaints were released after reassurance was given on the basis of examination results together with minor tranquilizer. Case 2 was a 30-year old housewife with chest discomfort, breathlessness, palpitation and fatigue. She was referred to the department of psychosomatic medicine in Sep. 1981 because of hyperventilation attacks, anxiety and hypochondriasis while mitral valve prolapse had been found by the auscultation and echocardiogram. Several kinds of medication (minor tranquilizer and beta-blocker) and psychotherapy were effective. Their hyperventilation attacks and neurotic behavior were suspected to be related to mitral valve prolapse. It was very hard, however, to distinguish the symptoms between mitral valve prolapse and anxiety reaction, which were considered to be overlapping one another. Because of its high frequency alone, mitral valve prolapse appears to take a generally benign course and might be on the same level of physical weakness as funnel chest or straight back, although we need attitudes of deferred judgement. It is obviously important to recognizie psychological disturbance in mitral valve prolapse syndrome as well as its serious physical complications.
日本心身医学会の論文
1983-04-01

過呼吸症状を呈し, 神経循環無力症との鑑別が困難であった僧帽弁逸脱症候群の2例

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