Pseudoaneurysm of the Left Ventricle Progressing From a Subepicardial Aneurysm
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概要
- 論文の詳細を見る
A 56-year-old man presented with an inferior myocardial infarction and a huge pseudoaneurysm below the inferior surface of the left ventricle, which had progressed from a small subepicardial aneurysm over a 6-month period. Transthoracic echocardiography, Doppler color flow images, radionuclide angiocardiography, magnetic resonance imaging and contrast ventriculography all revealed an abrupt disruption of the myocardium at the neck of the pseudoaneurysm, where the diameter of the orifice was smaller than the aneurysm itself, and abnormal blood flows from the left ventricle to the cavity through the orifice with an expansion of the cavity in systole and from the cavity to the left ventricle with the deflation of the cavity in diastole. Coronary angiography revealed 99% stenosis at the atrioventricular nodal branch of the right coronary artery. At surgery the pericardium was adherent to the aneurysmal wall and a 1.5-cm orifice between the aneurysm and the left ventricle was seen. Pathological examination revealed no myocardial elements in the aneurysmal wall. The orifice was closed and the postoperative course was uneventful. Over-intense physical activity as a construction worker was considered to be the cause of the large pseudoaneurysm developing from the subepicardial aneurysm. These findings indicate that a subepicardial aneurysm may progress to a larger pseudoaneurysm, which has a propensity to rupture, however, it can be surgically repaired.
- 社団法人日本循環器学会の論文
- 1999-06-20
著者
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Iwasaka Toshiji
Second Department Of Internal Medicine Kansai Medical University
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Imamura Hiroji
Department of Thoracic Cardiovascular Surgery, Kansai Medical University
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Kurihara Hirohiko
National Defense Medical College
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Takayama Yasuo
Department Of Cardiology Rakusai Newtown Hospital
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SUZUKI Junichi
Second Department of Internal Medicine,Kansai Medical University.Morlguchi
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Kamihata Hiroshi
Second Department of Internal Medicine, Division of Cardiology, Kansai Medical University
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Suzuki Junichi
Second Department Of Internal Medicine Cardiovascular Center Kansai Medical University
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Imamura Hiroji
Depart. Of Surgery School Of Medicine Keio University
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TAKAYAMA YASUO
Second Department of Internal Medicine Kansai Medical University
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Koito Hitoshi
Second Department of Internal Medicine, Cardiovascular Center, Kansai Medical University
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Nakamura Chikako
Second Department of Internal Medicine, Cardiovascular Center, Kansai Medical University
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Takayama Yasuo
Department Of Cardiology Kansai Medical University Rakusai Newtown Hospital
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Takayama Yasuo
Second Department Of Internal Medicine・cardiovascular Center Kansai Medical University
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Iwasaka Toshiji
Second Department Of Internal Medicine Division Of Cardiology Kansai Medical University
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Nakamura Chikako
Second Department Of Internal Medicine Cardiovascular Center Kansai Medical University
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Imamura Hiroji
Department Of Cardiovascular Surgery Kansai Medical University
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