Hasegawa K, Sawayama T, Kakumae S, Nakamura T, Nezuo S, Samukawa M, Mitani K
Department of Medicine, Kawasaki Medical School, Kurashiki, Japan.
Heart Vessels. 1988;4(2):116-9. doi: 10.1007/BF02058999.
Two patients with extensive anterior myocardial infarction developed a hitherto unreported type of right ventricular outflow tract obstruction. A 71-year-old woman, who had had an acute infarction 10 years before, was admitted for sustained ventricular tachycardia. A loud ejection murmur was heard in the mid-precordium. The echocardiogram and left ventriculogram showed a septal aneurysm, with a systolic gradient of 21 mmHg between the right ventricular outflow tract and apex. The ejection murmur was detected in the outflow tract by intracardiac phonocardiography. The second patient was a 60-year-old man who had had an acute infarction at age 47. He was also referred because of ventricular tachycardia, and his clinical situation was almost the same as that of the first case. Our search of the literature failed to disclose any similar case with a loud ejection murmur confirmed by intracardiac phonocardiography to be due to an obstructive septal aneurysm.
两名广泛前壁心肌梗死患者出现了一种迄今未报道过的右心室流出道梗阻类型。一名71岁女性，10年前曾发生急性心肌梗死，因持续性室性心动过速入院。心前区中部可闻及响亮的喷射性杂音。超声心动图和左心室造影显示有室间隔瘤，右心室流出道与心尖之间存在21 mmHg的收缩期压差。通过心内心音图检查在流出道检测到喷射性杂音。第二名患者是一名60岁男性，47岁时曾发生急性心肌梗死。他也因室性心动过速前来就诊，其临床情况与第一例几乎相同。我们检索文献未发现任何类似病例，即经心内心音图证实由梗阻性室间隔瘤导致的响亮喷射性杂音。
