Hypertrophic Cardiomyopathy With Midventricular Obstruction and Apical Aneurysm : A Case Report
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概要
- 論文の詳細を見る
A 71-year-old woman had hypertrophic cardiomyopathy associated with midventricular obstruction and an apical aneurysm in the left ventricle. She had had abnormal electrocardiograms for more than 30 years and for the past year had been suffering from occasional attackes of dizziness and low systemic blood pressure. Holter 24-h electrocardiographic monitoring revealed ventricular paroxysmal contractions(676/day)with nonsustained ventricular tachycardia. Doppler echocardiography revealed paradoxical jet flow from the apical aneurysm to the left ventricular outflow during early diastole. Magnetic resonance imaging depicted midventricular hypertrophy and a dyskinetic thin apical wall, which were confirmed by angiography. Coronary angiograms showed no narrowing of the major extramural coronary arteries, but there was compression of aberrant coronary arteries apparently feeding the hypertrophic portion of the left ventricular wall. Stress thallium-201 myocardial imaging showed a persistent severe defect in the left ventricular apex. A hemodynamic study revealed low cardiac output and an intraventricular pressure gradient(approximately 90 mmHg)between the left ventricular apical high-pressure chamber and the subaortic low-pressure chamber. The present case represents a rare combination of hypertrophic cardiomyopathy, midventricular obstruction, and an apical aneurysm in an elderly woman. Myocardial ischemia may have played an important role in the genesis of the apical aneurysm.
- 社団法人日本循環器学会の論文
- 2001-09-20
著者
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SUZUKI Jun-ichi
Department of Advanced Clinical Science and Therapeutics, University of Tokyo
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NAGAI Ryozo
Department of Cardiovascular Medicine, University of Tokyo
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Takahashi Toshiyuki
Department of Cardiology, JR Tokyo General Hospital
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Takenaka Katsu
Department of Laboratory Medicine, University of Tokyo
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Hirata Yasunobu
Department Of Cardiovascular Medicine Graduate School Of Medicine University Of Tokyo
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Takahashi Toshiyuki
Department Of Cardiovascular Medicine Graduate School Of Medicine University Of Tokyo
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Harada Kazumasa
Department of Cardiology, Tokyo Metropolitan Geriatric Hospital
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Harada Kazumasa
Tokyo Metropolitan Geriatric Hospital Department Of Cardiology
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Takenaka Katsu
Department Of Cardiovascular Medicine The University Of Tokyo
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Yao Atsushi
Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine
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Sugishita Yasuyuki
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
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Shimizu Tatsuya
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
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Harada Kazumasa
Department Of Cardiology Tokyo Metropolitan Geriatric Hospital
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Suzuki Jun-ichi
Department Of Cardiovascular Medicine Graduate School Of Medicine University Of Tokyo
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Sugishita Yasuyuki
Department Of Cardiovascular Medicine Graduate School Of Medicine University Of Tokyo
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Yao Atsushi
Department Of Cardiovascular Medicine Graduate School Of Medicine The University Of Tokyo
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Yao Atsushi
Department Of Cardiovascular Medicine Graduate School Of Medicine University Of Tokyo
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Hirata Yasunobu
Department Of Advanced Clinical Science And Therapeutics Cardiovascular Medicine Graduate School Of
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Takahashi Tomiko
Department Of Cardiovascular Medicine University Of Tokyo
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Takahashi Toshiyuki
Department Of Cardiovascular Medicine University Of Tokyo Graduate School Of Medicine
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Takenaka Katsu
Department Of Laboratory Medicine University Of Tokyo Hospital
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Yao Atsushi
Department Of Cardiovascular Medicine The University Of Tokyo Hospital
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Shimizu Tatsuya
Department Of Cardiovascular Medicine Graduate School Of Medicine University Of Tokyo
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Takahashi Tomiko
Department Of Laboratory Medicine University Of Tokyo
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Takahashi Toshiyuki
Department Of Biology Keio University
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Takahashi Toshiyuki
Department Of Cardiovascular Medicine University Of Tokyo
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Toshimori Tsukasa
2nd Dept. Of Biochem. Miyazaki Med. Coll.
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Suzuki Jun-ichi
Department Of Advanced Clinical Science And Therapeutics Graduate School Of Medicine University Of T
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Nagai Ryozo
Department Of Cardiology Kitano Hospital Medical Research Institute
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Yao Atsushi
Department Of Cardiology Tokyo University Hospital
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Takahashi Toshiyuki
Department Of Biological Science Graduate School Of Science Hiroshima University
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Nagai Ryozo
Department Cardiovascular Medicine The University Of Tokyo Hospital
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Shimizu Tatsuya
Department Of Cardiology Jr Tokyo General Hospital
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Takahashi Toshiyuki
The 2nd Department Of Internal Medicine University Of Tokyo
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Takahashi Toshiyuki
Department Of Cardiovascular Medicine Tokyo Graduate School Of Medicine
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Sugishita Yasuyuki
Department Of Cardiology Kanto Central Hospital
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Takenaka Katsu
Department Of Cardiology Tokyo University
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Shimizu Tatsuya
Department Of Biochemistry And Molecular Biology Nippon Medical School
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Takahashi Toshiyuki
Department Of Dermatology Faculty Of Medicine University Of Tokyo
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Takahashi Toshiyuki
Department of Applied Chemistry, Faculty of Science and Engineering, Kinki University
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