紺田 利子¹, 田辺 一明², 八木 登志員¹, 藤井 洋子¹, 宇井 一世¹, 川井 順一¹, 谷 知子², 盛岡 茂文²

Toshiko KONDA¹, Kazuaki TANABE², Toshikazu YAGI¹, Youko FUJII¹, Kazuyo UI¹, Junichi KAWAI¹, Tomoko TANI², Sigefumi MORIOKA²

¹神戸市立中央市民病院臨床検査技術部, ²神戸市立中央市民病院循環器内科

¹Division of Clinical Laboratory, Kobe General Hospital, ²Division of Cardiology, Kobe General Hospital

キーワード : echocardiography, harmonic signal, musical murmurs, pacemaker implantation, pulsed Doppler

We report a case of systolic and diastolic musical murmurs that developed 4 years after DDD pacemaker implantation. Echocardiographic examination disclosed no evidence of serious pacemaker-related complications. Pulsed Doppler examination with a sample volume at the right ventricular portion of a pacemaker lead showed prominent harmonic signals. The timing of the signals was consistent with that of musical murmurs. We considered vibration of the pacemaker lead as a possible origin of the musical murmurs. Systolic and diastolic musical murmurs can develop without serious cause in a patient with a transvenous pacemaker. Pulsed Doppler examination was useful in detecting the origin of musical murmurs.