Kurokawa M, Sakata T, Etou H, Ookuma K, Kaji R, Nagafuchi M
Department of Internal Medicine I, Kyushu University, Fukuoka, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1990 Oct;28(10):1344-7.
A 61-year-old woman with low grade obesity index complained of general fatigue. Cardiomegaly had been present since the age of 45. According to a roentgenogram on admission, her cardia-thoracic ratio was 61%. Pericardial effusion was strongly suspected because of extra echo spaces on both posterior and anterior walls, and unsynchronized echocardiograph waves of epicardium and pericardium. However, values of dynamic CT measured at areas equivalent to the extra echo spaces were -120. On admission, T1-emphasized MRI image showed a high signal density in those areas. After significant weight reduction, the abnormal values and signs of the clinical examinations, as well as the patient's complaints were attenuated or disappeared. Together with these results, cardiomegaly of the patient was diagnosed to be due to excessive fat deposit between the epicardium and cardiac muscle. Dissociation between mildness of obesity index and excessive deposition of fat in the pericardium was discussed from the point of view of body mass index and time course of fat deposition.
一名肥胖指数较低的61岁女性主诉全身乏力。自45岁起就存在心脏扩大。根据入院时的X线胸片，她的心胸比率为61%。由于后壁和前壁均有额外的回声间隙，且心外膜和心包的超声心动图波形不同步，故强烈怀疑存在心包积液。然而，在与额外回声间隙相当的区域进行的动态CT测量值为-120。入院时，T1加权MRI图像显示这些区域有高信号密度。在显著减重后，临床检查的异常值和体征以及患者的主诉均减轻或消失。结合这些结果，该患者的心脏扩大被诊断为心外膜与心肌之间脂肪过度沉积所致。从体重指数和脂肪沉积的时间进程角度讨论了肥胖指数轻度与心包脂肪过度沉积之间的分离情况。
