八木 登志員, 吉川 純一, 吉田 清, 赤阪 隆史, 赤土 正洋, 城 泰子, 前西 文秋, 加藤 洋

Toshikazu YAGI, Junichi YOSHIKAWA, Kiyoshi YOSHIDA, Takashi AKASAKA, Masahiro SHAKUDO, Yasuko JOU, Fumiaki MAENISHI, Hiroshi KATO

神戸市立中央市民病院循環器センター内科

Department of cardiology, Kobe General Hospital

キーワード : Pseudoaneurysm, Color flow mapping, Continuous wave Doppler, High pulse repetition frequency Doppler, Murmurs

A patient with ventricular pseudoaneurysm after acute posterior myocardial infarction was examined by two-dimensional echocardiography and Doppler echocardiography (color flow mapping, continuous wave and high pulse repetition frequency Doppler echocardiography). Two-dimensional echocardiography revealed an abrupt discontinuity of the posterior wall and a large echo free space posteriorly. The flows from the left ventricle to a ventricular pseudoaneurysm were observed in systole by color flow mapping. In early diastole the abnormal flows directed toward the left ventricular cavity from the ventricular pseudoaneurysm. Continuous wave Doppler and high pulse repetition frequency Doppler echocardiography demonstrated that the maximum velocity in systole was greater than 3.0 m/sec and that in early diastole greater than 1.5 m/sec. These shunt flows could be closely related to precordial murmurs.
We concluded Doppler echocardiography is useful in detecting the specific flow pattern in ventricular pseudoaneurysm.