最近の僧帽弁狭窄症—臨床像の変貌と診断上の問題点について

Mitral stenosis today:changing in clinical features, and its diagnostic problems

　心房細動を有する中・高年の女性で，過去に弁膜症・心雑音・心不全の既往がなく末梢動脈の栓塞症状で発病し，来院後はじあて僧帽弁狭窄症と診断される症例を最近多くみかけるようになった。

　最初に最近経験した1例を呈示する。

1) One hundred and six patients with mitral stenosis were subjected to a clinical study in relation to their age, sex, cardiac rhythm and peripheral arterial embolism (definite history and/or presence of functional disability).

2) The male to female ratio was 1 to 2. Patients with normal sinus rhythm (NSR) versusatrial fibrillation (Af) was 1 to 6, and arterial embolism has been complicated in only 1 (7%) in 15 patients with NSR and 43 (47%) in 91 patients with Af. Eighty percent or more had Af and 43% or more had arterial embolism between 4th and 7th decades. Fifty-four patients (51%) had never been told to have heart mur-mur or valvular disease before.