Quantitative Assessment of Obstruction of the Aorta and Its Branches in "Aortitis Syndrome" The Value of Functional Phonoarteriography Using Vasoactive Drugs
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概要
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Phonoarteriographic study was carried on 41 cases of "aortitis syndrome". Despite the complexity of the arterial murmurs, stenotic arterial murmur is separable from non-stenotic (both accidental and pathological)arterial murmur based on the phonoarteriogram. Irrespective of the loudness, stenotic arterial murmur has crescendo-decrescendo configuration, i.e., early diamond in mild stenosis, mid-diamond in moderate stenosis and mid- to late diamond in severe stenosis. The last one is frequently transsystolic or even continuous. Moderate and severe stenosis are not easily separable on the routine phonoarteriogram, because the involvement of aorta and its branches varies from case to case and the configuration of the arterial murmur is influenced by the degree of involvement of the neighboring arteries and the degree of development of collateral vessels. However, the functional phonoarteriography using amyl nitrite or methoxamine has a value in the quantitative assessment of the degree of stenosis. With amyl nitrite inhalation, the arterial murmur of moderate stenosis increases as in the cases of mild stenosis, whereas the one of severe stenosis decreases and so it does the continuous murmur. Methoxamine has an opposite effect on the arterial murmur. Collateral vessels give no significant murmur except a few cases of kinking with marked angulation of artery, and it is late diamond with delayed onset. It is concluded that the routine as well as functional phonoarteriography has an important diagnostic value in the assessment of the obstructive arterial disease and warrants the use before a patient is submitted to more complicated diagnostic procedures such as aortography or arteriography.
著者
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INOUE Kiyoshi
Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo
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KAWAI Nobuyoshi
Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo
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YAMADA Tetsuro
Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo
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KAITO Goro
Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo
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Ueda Hideo
Second Department Of Internal Medicine Faculty Of Medicine University Of Tokyo
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Kobayashi Tohru
Second Department Of Internal Medicine
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Sakamoto Tsuguya
Second Department Of Internal Medicine University Of Tokyo
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