肥厚型心肌病患者运动诱发的舒张期矛盾性射流
Exercise-induced diastolic paradoxical jet flow in a patient with hypertrophic cardiomyopathy.
作者信息
Takeoka Mayumi, Yamano Michiyo, Kawasaki Tatsuya
机构信息
Central Clinical Laboratory, Matsushita Memorial Hospital, Sotojima 5-55, Moriguchi, Osaka 570-8540, Japan.
Department of Cardiology, Matsushita Memorial Hospital, Osaka, Japan.
出版信息
J Cardiol Cases. 2021 Jan 9;23(4):170-172. doi: 10.1016/j.jccase.2020.12.008. eCollection 2021 Apr.
Early diastolic flow from the apex toward the base of the left ventricle - diastolic paradoxical jet flow - may be observed at rest in patients with hypertrophic cardiomyopathy (HCM). We herein report a case of HCM with exercise-induced diastolic paradoxical jet flow, accompanied by an apical myocardial perfusion abnormality of the left ventricle. A 56-year-old man was referred for the further evaluation of abnormal electrocardiography at a medical check-up. Echocardiography showed myocardial hypertrophy predominantly in the apex of the left ventricle with a maximum wall thickness of 27 mm without an apical aneurysm. Paradoxical jet flow was not detected at rest, but developed after treadmill exercise and lasted for approximately six minutes. Exercise scintigraphy with thallium-201 showed reduced tracer uptake in the left ventricular apex with complete redistribution, findings consistent with myocardial ischemia of the left ventricular apex.
肥厚型心肌病（HCM）患者在静息状态下可能会观察到舒张早期从心尖向左心室底部的血流——舒张期矛盾性射流。我们在此报告一例HCM患者，其出现运动诱发的舒张期矛盾性射流，并伴有左心室心尖部心肌灌注异常。一名56岁男性因体检时心电图异常而前来进一步评估。超声心动图显示主要是左心室心尖部心肌肥厚，最大壁厚27毫米，无室壁瘤。静息时未检测到矛盾性射流，但在跑步机运动后出现，并持续约6分钟。用铊-201进行运动闪烁扫描显示左心室心尖部放射性示踪剂摄取减少且有完全再分布，这些表现与左心室心尖部心肌缺血一致。
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