八木 登志員¹, 吉川 純一¹, 吉田 清¹, 山浦 泰子¹, 穂積 健之¹, 前西 文秋¹, 桜井 英一¹, 加藤 洋¹, 馬場 雄治², 瓦谷 仁志²

Toshikazu YAGI¹, Junichi YOSHIKAWA¹, Kiyoshi YOSHIDA¹, Yasuko YAMAMURA¹, Takeshi HOZUMI¹, Fumiaki MAENISHI¹, Hidekazu SAKURAI¹, Hiroshi KATO¹, Yuuji BABA², Hitoshi KAWARATANI²

¹神戸中央市民病院循環器内科, ²済生会野江病院内科

¹Department of Cardiology, Kobe General Hospital, ²Saiseikai Noe Hospital

キーワード : Right ventricular papillary muscle rupture, Transesophageal echocardiography, Tricuspid valve prolapse

A patient with right ventricular papillary muscle rupture and rupture of ventricular septum after acute myocardial infarction was examined by transthoracic echocardiography and transesophageal echocardiography. Transthoracic echocardiography revealed an abrupt discontinuity of the ventricular septum and tricuspid valve prolapse of the anterior leaflet. By transesophageal echocardiography, ruptured right ventricular papillary muscle was observed in the right atrium. The turbulent flow from the left ventricle to the right ventricle in systole combined with massive tricuspid regurgitation was observed by Doppler color flow mapping and contrast echocardiography. In late diastole, abnormal flow directed toward the left ventricle from the right ventricle.
Thus, we concluded transthoracic echocardiography combined with transesophageal echocardiography is useful in the diagnosis of rupture of right ventricular papillary muscle.