Kida M, Hoshino T, Yokoyama S, Takayama S, Mori N, Yoshida H, Sakata K, Kaburagi T
J Cardiogr. 1985 Dec;15(4):1263-74.
A case of left ventricular apical diverticulum with marked hypertrophy of the left ventricular apical wall revealed by thallium-201 myocardial emission CT is reported. A 23-year-old woman was admitted to our hospital for evaluation of chest oppression. She was known to have had a heart murmur soon after birth, but she grew uneventfully, partaking in normal exercise. At the age of 21, she began to feel chest oppression during exercise. As the attacks became frequent, she was admitted to our hospital. Physical examination revealed an ejection systolic murmur in the second left intercostal space. Electrocardiography showed ST depression and T inversion in leads III, aVF and V4-6. M-mode echocardiography was normal. Two-dimensional echocardiography showed a small diverticulum at the apex of the left ventricle, which was also recognized by left ventriculography. It was about 8 X 12 mm in size. Thallium-201 myocardial emission CT disclosed marked uptake in the apex of the left ventricle, suggesting apical hypertrophy. Stress thallium-201 myocardial emission CT was negative. Coronary angiography was normal. The cause of chest oppression in this patient is uncertain, but the small diverticulum and hypertrophy of the cardiac apex may play a role in its pathogenesis.
报告一例经铊-201心肌发射CT检查发现的左心室心尖部憩室合并左心室心尖壁明显肥厚的病例。一名23岁女性因胸部憋闷入院评估。她出生后不久即被发现有心脏杂音，但成长过程顺利，可进行正常运动。21岁时，她开始在运动时感到胸部憋闷。随着发作频繁，她入住我院。体格检查发现左第二肋间有喷射性收缩期杂音。心电图显示Ⅲ、aVF及V4 - 6导联ST段压低和T波倒置。M型超声心动图正常。二维超声心动图显示左心室心尖部有一个小憩室，左心室造影也证实了这一点。其大小约为8×12毫米。铊-201心肌发射CT显示左心室心尖部有明显摄取，提示心尖肥厚。负荷铊-201心肌发射CT检查结果为阴性。冠状动脉造影正常。该患者胸部憋闷的原因尚不确定，但小憩室和心脏心尖肥厚可能在其发病机制中起作用。
