Miyake T, Yokoyama T
Department of Cardiovascular Surgery, Kinki University School of Medicine, Osaka, Japan.
Jpn Circ J. 1993 Jan;57(1):77-83. doi: 10.1253/jcj.57.77.
Four term infants with transient murmurs resembling that of pulmonary artery stenosis were examined. A grade 3/6 systolic ejection murmur was transmitted clearly to the entire precordium and the back. This murmur was first detected 7 days after birth in 1 infant and at a 1-month medical check in the other 3. The murmur continued for 7 to 22 weeks, with an average of 12 weeks. It gradually localized in the region of the left sternal border, and eventually disappeared. At the first medical examination, peak velocities of over 2.0 m/s, in the left or right pulmonary artery, were detected by a pulsed Doppler. The diameter of the right pulmonary artery was small (mean, 58 +/- 8%; range, 46 to 64% of predicted normal). When the heart murmur disappeared, the diameter of the right pulmonary artery (mean, 97 +/- 28%; range, 70 to 126%) had increased significantly (p < 0.05). Peak velocities in the right pulmonary arteries had decreased significantly (2.22 +/- 0.37 m/s vs 1.13 +/- 0.10 m/s, p < 0.01). We suggest that hypoplasia of pulmonary artery branches, in relation to the main trunk, is the main cause of the murmur resembling pulmonary artery stenosis.
对4名患有类似肺动脉狭窄的短暂性杂音的足月儿进行了检查。3/6级收缩期喷射性杂音清晰地传导至整个心前区和背部。该杂音在1名婴儿出生后7天首次被发现，另外3名婴儿在1个月的体检中被发现。杂音持续7至22周，平均为12周。它逐渐局限于左胸骨缘区域，最终消失。在首次体检时，通过脉冲多普勒检测到左或右肺动脉的峰值速度超过2.0米/秒。右肺动脉直径较小（平均为预测正常直径的58±8%；范围为46%至64%）。当心脏杂音消失时，右肺动脉直径（平均为97±28%；范围为70%至126%）显著增加（p<0.05）。右肺动脉的峰值速度显著降低（2.22±0.37米/秒对1.13±0.10米/秒，p<0.01）。我们认为，相对于主干而言，肺动脉分支发育不全是类似肺动脉狭窄杂音的主要原因。
