Ohtsuka T, Hamada M, Hara Y, Kuwahara T, Kodama K, Shigematsu Y, Iwata T, Hiwada K
Second Department of Internal Medicine, Ehime University School of Medicine, Shigenobu, Japan.
Jpn Circ J. 1998 May;62(5):385-8. doi: 10.1253/jcj.62.385.
A 57-year-old woman was admitted for examination because of chest discomfort. Transthoracic echocardiography was performed and she was diagnosed as having hypertrophic cardiomyopathy. An echocardiogram also revealed that she had midventricular obstruction with a pressure gradient of 125 mmHg determined by Doppler echocardiography. A phonocardiogram showed an early systolic sound and the beginning of the sound coincided with the time of septal-posterior wall contact. In addition, the timing also corresponded to the sudden obstruction of blood flow in the region of the midventricular narrowing. Furthermore, this sound markedly decreased with the reduction in pressure gradient caused by cibenzoline treatment. Thus, it was concluded that the early systolic sound was associated with midventricular obstruction and produced by a rapid deceleration of the interventricular flow caused by midventricular obstruction.
一名57岁女性因胸部不适入院检查。进行了经胸超声心动图检查，她被诊断为肥厚型心肌病。超声心动图还显示她存在心室中部梗阻，通过多普勒超声心动图测定压力阶差为125 mmHg。心音图显示收缩期早期声音，该声音的起始与室间隔-后壁接触时间一致。此外，该时间也与心室中部狭窄区域血流突然受阻的时间相对应。而且，这种声音随着西苯唑啉治疗导致的压力阶差降低而明显减弱。因此，得出结论：收缩期早期声音与心室中部梗阻有关，是由心室中部梗阻导致的心室间血流快速减速产生的。
