真田 純一, 古川 重治, 屋宮 和哉, 田渕 博己, 宮原 健吉, 中村 一彦, 橋本 修治

Junichi SANADA, Shigeharu FURUKAWA, Kazuya OKUMIYA, Hiromi TABUCHI, Kenkichi MIYAHARA, Kazuhiko NAKAMURA, Shuji HASHIMOTO

鹿児島大学医学部第二内科

The second Department of Internal Medicine, School of Medicine, Kagoshima University

キーワード : infective endocarditis, vegetation, chordal rapture, mitral aneurysm, sidelobe

In order to assess the possibility of echocardiographic technique for detecting mitral valve lesions secondary to infective endocarditis, 12 cases of infective endocarditis were studied. The echocardiographic findings were all compared with the surgical findings. Four cases had brighter and massive echoes to be suspected of vegetation. One of them with thickening and calcification resulted from rheumatic valve disease, however, had no vegetative lesions. One case with a small vegetation could not be detected. Chordal ruptures were suggested by either systolic mitral prolapse, systolic overshooting of the mitral tip, diastolic mitral prolapse and diastolic delay of valvular opening and definitely diagnosed by detecting abnormal motion of the ruptured chordae itself, 2 of the 5 cases with chordal rupture that had shown only systolic and diastolic mitral prolapse could not be differentiated from those with chordal prolongation. In 2 cases, aneurysm was obtained as "sacklike" echo. In one case with thickening and calcification, however, the finding did not correlate to surgical finding, and that was thought to be artifact caused by "sidelobe". Two perforation cases could not be detected by echocardiographic technique.