高度な後天性大動脈弁閉鎖不全と心室中隔瘤を合併した大動脈弁下膜型狭窄症の1例

A case of discrete subaortic stenosis complicated by severe acquired aortic valvular regurgitation and ventricular septal aneurysma in middle-aged woman

　大動脈弁下膜型狭窄症は，欧米では大動脈狭窄症の10−20％に認められ^1），それ程稀な疾患ではないが，本邦での報告例は少なく，著者らが調べた限りでは，石合^2），榊原^3）らの報告の他，数例の報告をみるのみである。

　更に，後天性大動脈弁閉鎖不全を合併した症例となると，欧米では大動脈弁下膜型狭窄症の約半数例に認められると報告^4,5）されているが，中年で本症が初めて診断され，しかも高度の大動脈弁閉鎖不全を合併した症例は少なく^6〜8），本邦報告例はない。

The authors present a case of discrete subaortic stenosis complicated by severe aquired aortic valvular regurgitation and ventricular septal aneurysma in middle-aged woman.

A 49-year-old woman was referred to our clinic for evaluation of cardiac murmurs which were an ejection systolic murmur over the aortic area and a diastolic murmur along the lower left sternal boder. She stated that she had had heart murmur since childhood, but there was no histo-ry of rheumatic fever or familial heart murmurs.