Saitoh M, Miyakoda H, Fukuki M, Yamasaki J, Fujimoto Y, Hasegawa J, Kotake H, Mashiba H
First Department of Internal Medicine, Tottori University School of Medicine, Yonago, Japan.
Jpn Heart J. 1990 Jan;31(1):121-6. doi: 10.1536/ihj.31.121.
We describe an extremely rare case of secundum atrial septal defect with aortic stenosis and coronary artery disease showing a single second heart sound throughout the respiratory cycle by echocardiogram with simultaneous phonocardiogram. Aortic valve closure corresponded to the single second heart sound. We were unable to detect pulmonary valve closure (PVC) on echocardiogram. Because of the presence of pulmonary hypertension, the pulmonary component of the second heart sound (P2) was presumed to be increased in intensity, and the PVC-P2 interval was thought to be abbreviated. Carotid pulse tracing showed a prolongation of the left ventricular ejection time. We concluded that the single second heart sound was due to both prolongation of left ventricular systole and pulmonary hypertension.
我们描述了一例极为罕见的继发孔型房间隔缺损合并主动脉瓣狭窄及冠状动脉疾病的病例，通过超声心动图同步心音图检查发现，在整个呼吸周期中呈现单一第二心音。主动脉瓣关闭与单一第二心音相对应。在超声心动图上我们无法检测到肺动脉瓣关闭（PVC）。由于存在肺动脉高压，推测第二心音的肺动脉成分（P2）强度增加，且PVC - P2间期缩短。颈动脉搏动描记显示左心室射血时间延长。我们得出结论，单一第二心音是由于左心室收缩期延长和肺动脉高压共同所致。
