Usefulness of Delayed Enhancement Magnetic Resonance Imaging for Detecting Cardiac Rupture Caused by Small Myocardial Infarction in a Case of Cardiac Tamponade

元データ 2005-11-20 社団法人日本循環器学会

概要

Delayed enhancement magnetic resonance imaging (DE-MRI) has excellent spatial resolution and compared with other cardiac imaging techniques it can detect a small myocardial infarction (MI) or a subendocardial infarction. A 76-year-old man was admitted for loss of consciousness because of cardiac tamponade. The cause of tamponade was unknown, but electrocardiography and blood test suggested a recent MI. The removal of 100ml bloody fluid by immediate pericardiocentesis normalized his hemodynamics, and he regained consciousness. Neither echocardiography nor scintigraphy could determine the location of the MI or rupture, but DE-MRI clearly demonstrated a transmural enhancement in a very narrow range of the lateral wall of the left ventricle. Coronary angiography revealed a severely stenotic lesion in the obtuse marginal branch of the left circumflex artery. DE-MRI is a powerful tool for diagnosing small MI that are undetectable with other imaging. Therefore, DE-MRI should be applied in cases with cardiac tamponade by unknown causes.

著者

Satoh Hiroshi Division Of Cardiology Internal Medicine Iii Hamamatsu University School Of Medicine
URUSHIDA Tsuyoshi Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine
KATOH Hideki Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine
HAYASHI Hideharu Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine
MATOH Fumitaka Department of Emergency Medicine, Hamamatsu University School of Medicine
SHIRAKI Katsunori Division of Cardiology, Internal Medicine III, University School of Medicine
SAKAHARA Harumi Department of Radiology, Hamamatsu University School of Medicine
Takehara Yasuo Department of Radiology, Hamamatsu University School of Medicine
Katoh Hideki Division Of Cardiology Internal Medicine Iii Hamamatsu University School Of Medicine
Hayashi Hideharu Division Of Cardiology Internal Medicine Iii Hamamatsu University School Of Medicine
Hayashi Hideharu Internal Medicine Iii Hamamatsu University School Of Medicine
Urushida Tsuyoshi Division Of Cardiology Internal Medicine Iii Hamamatsu University School Of Medicine
Asai Masayoshi Division of Cardiology, Shizuoka City Hospital
Hayashi Hideharu Department Of Internal Medicine Iii Hamamatsu University School Of Medicine
Terada Hajime Divisions Of Cardiology Department Of Internal Medicine Iii
Terada Hajime Department Of Medicine Iii Hamamatsu University Of Medicine
Asai Masayoshi Department Of Internal Medicine Iii Hamamatsu University School Of Medicine
Asai Masayoshi Division Of Cardiology Shizuoka City Hospital
Takeuchi Yasuyo Department Of Internal Medicine Iii Hamamatsu University School Of Medicine
Takehara Yasuo Department Of Radiology Hamamatsu University School Of Medicine
Sakahara Harumi Department Of Nuclear Medicine And Diagnostic Imaging Kyoto University School Of Medicine
Matoh Fumitaka Department Of Emergency Medicine Hamamatsu University School Of Medicine
Shiraki Katsunori Division Of Cardiology Internal Medicine Iii University School Of Medicine
Sone Hirohito Department Of Nutrition Ochanomizu University
Shiraki Katsunori Division Of Cardiology Internal Medicine Iii Hamamatsu University School Of Medicine
Terada Hajime Third Department Of Internal Medicine Hamamatsu University School Of Medicine
Takehara Yasuo Department of Internal Medicine III, Hamamatsu University School of Medicine

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