心筋梗塞を合併したPickwickian Syndromeの1例

Pickwickian Syndrome Complicated with Myocardial Infarction:A Case Report

　極端な肥満を伴った肺胞低換気症候群はPickwickian Syndromeとよばれるが，本邦では，一之沢ら^1），沼野ら^2），西田ら^3）による症例報告があるのみである。著者らは最近，中等度の肥満を伴った肺胞低換気症候群で，経過観察中広汎な心筋梗塞を発生し，冠動脈造影上ほぼ正常所見を示した症例を経験し，病態生理学上きわめて興味深い症例と思われるので報告する。

A case of 42 year-old male with obesity, alveolar hypoventilation syndrome, erythrocytosis, pulmonary hypertension, right ventricular hyper-trophy and right ventricular failure, suggesting Pickwickian syndrome, is reported. On the course of followup, the patient had an attack of extensive anterior and high lateral wall myo-cardial infarction with good recovery. Coronary angiogram 11 months after the infarction showed 30% stenosis of anterior descending artery, and other coronary arteries and branches were within normal limits. Pathophysiology of the case is discussed.