A case of delated cardiomyopathy with chronic effusive pericarditis.
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A 41-year-old man had a history of cardiomegaly on chest x-ray examination and electrocardiographic abnormalities at the age of 25, but remained asymptomatic. On admission to hospital, a chest radiograph showed a marked cardiac enlargement of 78% of cardiothoracic ratio, an electrocardiogram showed first-degree atrioventricular block and intraventricular conduction abnormalities, an echocardiogram showed a massive pericardial effusion, and myocardial imaging perfusion with thallium-201 showed a defect of anterior left ventricular wall. Histologic findings of pericardial biopsy were consistent with nonspecific active pericarditis. Subsequent cardiac catheterization showed decreased left ventricular ejection fraction of 30%, elevated left ventricular end diastolic pressure of 24 mmHg and enlarged left ventricular enddiastolic volume of 125 ml/m2, Coronary angiography revealed no coronary atherosclerotic lesions. Myocardial biopsy demonstrated marked muscular fibrosis, but no evidence of myocarditis.Based on these findings, we concluded that the myopericarditis lasting more than seventeen years caused a myocardial damage and, as a result, progressed to a dilated cardiomyopathy.
- 一般社団法人 国立医療学会の論文
一般社団法人 国立医療学会 | 論文
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