Hanaoka Yousuke, Misumi Ikuo, Rokutanda Taku, Akahoshi Ryuichiro, Matsumoto Mitsuhiro, Sakamoto Tomohiro, Kaikita Koichi, Yamamuro Megumi, Sugiyama Seigo, Ogawa Hisao
Internal Medicine, Kumamoto Saisyunsou Hospital, Japan.
Intern Med. 2012;51(4):387-90. doi: 10.2169/internalmedicine.51.6542. Epub 2012 Feb 15.
A 70-year-old man was diagnosed with mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHCM) with apical aneurysm and paradoxic jet flow. At cardiac catheterization, pressure study showed that there was a markedly high pressure-gradient of 90 mmHg between the apex and the base in systole. Apical pressure was 350 mmHg after premature ventricular contraction. The apical aneurysm was already dilated and spherical in late systole; the absence of active relaxation was considered to be the cause of the paradoxic jet flow. In this report, we suggest the pathogenesis of left ventricular apical aneurysm and paradoxic jet flow in MVOHCM.
一名70岁男性被诊断为伴有心尖部室壁瘤及反常射流的心室中部梗阻性肥厚型心肌病（MVOHCM）。在心脏导管检查时，压力研究显示，收缩期心尖部与心底之间存在90 mmHg的明显高压阶差。室性早搏后心尖部压力为350 mmHg。心尖部室壁瘤在收缩期末期已扩张呈球形；主动舒张功能缺失被认为是反常射流的原因。在本报告中，我们提出了MVOHCM中心室心尖部室壁瘤及反常射流的发病机制。
