Two-chambered Right Ventricle : Report of Four Cases with Special Reference to the Clinical Diagnosis

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Four cases with two-chambered right ventricle are presented; Cases 1 and 2 were associated with infundibular pulmonary stenosis, Case 3 with co-arctation of the aorta, and Case 4 with ventricular septal defect and essential hypertension. Case 4 was 52 years old, being the oldest case ever reported in the literature. Physical, roentgenologic, electrocardiographic, vectorcardiographic, cardiac catheterization and angiocardiographic findings are discussed. Although selective right ventriculography is gene-rally the most reliable and definitive procedure for diagnosis, the coexistence of the following clinical findings would be helpful for diagnosis of two-chambered right ventricle prior to the cardiac catheterization and angiocardiography, especially in cases with isolated or predominant two-chambered right ventricle; (1) a widely distributed, diamond-shaped systolic murmur with the maximum point at the left lower sternal border, (2) a diminished second heart sound at the pulmonary area, (3) a cardiomegaly of somewhat globular shape with absence of poststenotic dilatation, (4) a predominant R pattern in V_1 through V_6 with absence of significant late R in aVR, and (5) a QRS loop inscribed mostly anteriorly and leftwards in the vectorcardiogram.
社団法人日本循環器学会の論文
1970-05-20