八木 登志員¹, 吉川 純一¹, 吉田　 清¹, 赤阪 隆史¹, 赤土 正洋¹, 穂積 健之¹, 川井 順一¹, 深谷 隆², 富田 安彦², 浜重 直久³, 窪川 渉一³

Toshikazu YAGI¹, Junichi YOSHIKAWA¹, Kiyoshi YOSHIDA¹, Takashi AKASAKA¹, Masahiro SHAKUDO¹, Takeshi HOZUMI¹, Junichi KAWAI¹, Takashi FUKAYA², Yasuhiko TOMITA², Naohisa HAMASHIGE³, Shoichi KUBOKAWA³

¹神戸市立中央市民病院循環器センター内科, ²神戸市立中央市民病院循環器センター小児科, ³近森病院循環器内科

¹Department of Cardiology, Kobe General Hospital, ²Department of Pediatrics, Kobe General Hospital, ³Department of Cardiology, Chikamori Hospital

キーワード : Aneurysm of the left ventricle, Rupture of the papillary muscle, Traumatic heart disease

Transthoracic and transesophageal echocardiography was used to examine a 14-year-old girl with severe mitral regurgitation secondary to traumatic papillary muscle rupture and left ventricular septal aneurysm. The girl had been referred by her physician because of severe pulmonary edema. A transthoracic two-dimensional echocardiogram showed a large dissection between the myocardium and the anterior papillary muscle, while the middle scallop of the posterior leaflet attached to the anterior papillary muscle was shown to be prolapsing into the left atrium during systole. An eccentric severe regurgitant jet that produced an acceleration signal in the left ventricular chamber was apparent on color flow Doppler echocardiography. Furthermore, transesophageal echocardiography revealed an interventricular septal aneurysm. These abnormalities were confirmed on surgery. We found transthoracic echocardiography used in combination with transesophageal echocardiography to be helpful in the diagnosis of traumatic papillary muscle rupture and left ventricular aneurysm.