夛田 浩, 野上 昭彦, 内藤 滋人, 直田 匡彦, 中津川 昌利, 堀江 康人, 星崎 洋, 大島 茂, 谷口 興一

Hiroshi TADA, Akihiko NOGAMI, Shigeto NAITO, Masahiko SUGUTA, Masatoshi NAKATSUGAWA, Yasuto HORIE, Hiroshi HOSHIZAKI, Shigeru OSHIMA, Koichi TANIGUCHI

群馬県立循環器病センター循環器内科

Cardiology Division, Gunma Prefectural Cardiovascular Center

キーワード : Asymmetric septal hypertrophy, Sarcoidosis, Torsades de pointes

A DDDR-type permanent pacemaker was implanted in a 48-year-old woman who was transferred to our institution for investigation of complete atrioventricular block and torsade de pointes. The patient had increases of serum angiotensinconverting enzyme and lysozyme concentrations. Chest computed tomography showed swelling of the mediastinal and hilar lymph nodes; gallium-67 scintigraphy, abnormal uptake in the myocardium and mediastinum; thallium-201 scintigraphy, decreased uptake in the apical portion of the left ventricle; and echocardiography , marked hypertrophy localized in the basal portion of the ventricular septum and regional hypokinesis in the apical portion of the left ventricle. These abnormalities subsided after 5 months of steroid treatment. A diagnosis of cardiac sarcoidosis should be considered in patients with thickening in the basal portion of the ventricular septum, as well as those with wall thinning.