起源不詳，高齢初発の肺塞栓症が強く疑われた1例

A Case of Pulmonary Embolism of Unknown Etiology in an Elderly Patient

要旨　患者は83歳，女性．胸部不快感，動悸を主訴に来院．心エコーにて右室拡大，肺高血圧所見を認めた．肺血栓塞栓症(以下PE)を考え，ヘパリン持続静注開始．凝固検査，肺血流シンチでPEが強く疑われた．抗凝固療法・強心剤にて肺高血圧・肺塞栓は改善し経過は良好．第36病日に退院．特に基礎疾患やリスクファクターがなく高齢者で発症する例は稀であり報告する．

　An 83-year-old woman presented with chest pain and palpitation. The electrocardiogram showed negative T waves in V_1～4 and sinus tachycardia. Echocardiogram showed right ventricular dilatation and pulmonary hypertension. These findings indicated possible acute pulmonary thromboembolism, and the pulmonary perfusion scintigraphy findings were also compatible with the disease. Anti-coagulation therapy was commenced. The course of the patient's recovery was uneventful and she was discharged on the thirty-sixth hospital day. There were no demonstrable risk factors for pulmonary thromboembolism such as malignancy, surgery or immobilization in this case.