福田 信夫, 富永 俊彦, 苛原 恵子, 三河 哲也, 山本 光昭, 日下 芳子, 浅井 幹夫, 大木 崇, 仁木 敏晴, 森 博愛

Nobuo FUKUDA, Toshihiko TOMINAGA, Keiko IRAHARA, Tetsuya MIKAWA, Mitsuaki YAMAMOTO, Yoshiko KUSAKA, Mikio ASAI, Takashi OKI, Toshiharu NIKI, Hiroyoshi MORI

徳島大学医学部第二内科

The Second Department of Internal Medicine, Faculty of Medicine, University of Tokushima

キーワード : Ebstein's anomaly, Sail sound, Tricuspid regurgitation, Tricuspid valve motion

　To clarify the genesis of a "sail sound" and to determine the beginning of tricuspid regurgitation (TR), four　patients of Ebstein's anomaly were studied by phono- (PCG), echo- and pulsed Doppler echocardiographic (PDE) techniques. All patients had two tricuspid components (T₁ and T₂) of the first heart sound. A loud and clicky T₂ was considered to be so called "sail sound". Temporary or incomplete closure of the tricuspid valve (TV) occurred simultaneously with T₁ and finally complete coaptation of the TV coincided in time with T₂. In two patients, the right ventricular pressure pulse showed two notches in the upstroke portion corresponding to T₁ and T₂, respectively. The onset of TR occurred at the time of T₁ in either PCG or PDE.
　These results suggested that the genesis of "sail sound" was probably the tension of closing TV produced by the sudden halting of the closure in early systole rather than the coaptation itself of the TV, and that the appearance of TR prior to a "sail sound" was a characteristic finding of Ebstein's anomaly.