Oki T, Iuchi A, Tabata T, Yamada H, Manabe K, Fukuda K, Abe M, Fukuda N, Ito S
Second Department of Internal Medicine, Tokushima University School of Medicine, Japan.
Jpn Heart J. 1997 Jan;38(1):139-44. doi: 10.1536/ihj.38.139.
We report a patient in whom hypertrophic cardiomyopathy, with both left ventricular hypertrophy and diastolic dysfunction, was masked by acute severe aortic regurgitation and marked left ventricular dilation. Upon admission, 1) two-dimensional echocardiogram of the left ventricle revealed a dynamic and flail vegetation on the aortic right coronary cusp and marked left ventricular dilation, 2) a massive aortic regurgitant signal was recorded by color Doppler flow imaging, and 3) transmitral flow velocity by pulsed Doppler echocardiogram revealed a pseudonormalization. However, symmetric hypertrophy of the left ventricular wall, a decrease in early diastolic wave and a compensatory increase in atrial systolic wave of the transmitral flow velocity appeared after successful aortic valve replacement.
我们报告了一名患者，其肥厚型心肌病合并左心室肥厚和舒张功能障碍，被急性严重主动脉瓣反流和明显的左心室扩张所掩盖。入院时，1）左心室二维超声心动图显示主动脉右冠状动脉瓣叶有动态且连枷样赘生物以及明显的左心室扩张，2）彩色多普勒血流成像记录到大量主动脉反流信号，3）脉冲多普勒超声心动图测得的二尖瓣血流速度显示为假性正常化。然而，在成功进行主动脉瓣置换术后，出现了左心室壁对称性肥厚、舒张早期波幅降低以及二尖瓣血流速度心房收缩波代偿性增加的情况。
