A Case of Idiopathic Dilatation of the Pulmonary Artery with Pulmonic Insufficiency Shinichi Nunoda 1 , Akira Genda 2 , Kuniaki Taga 1 , Kikuo Yasuda 1 , Masami Shimizu 1 , Tadashi Monji 1 , Hisakazu Iwai 1 , Norihiko Sugihara 1 , Ryoyu Takeda 1 1Second Department of Internal Medicine, School of Medicine, Kanazawa University 2Health Care Center, Kanazawa University pp.681-686
Published Date 1986/6/15
DOI https://doi.org/10.11477/mf.1404204890
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A rare case of idiopathic pulmonary artery dilatation with congenital pulmonic insufficiency is presented. The patient is a 38-year-old man. The chest roentgenogram revealed a prominent main pulmonary artery segment without evidence of enlargement of the cardiac chambers. The electrocardiogram was within normal limits. Cardiac catheterization revealed no evidence of a left-to-rightshunt or abnormal transvalvular pressure gradient. Pulmonary angiogram showed a dilated main pulmonary artery and a moderate degree of pulmonic insufficiency. The phonocardiogram showed the diastolic murmur of high frequency and short duration at the pulmonic area. Amyl nitrite and methoxamine did not modify the intensity of the murmur, however, aminophylline marke-dly decreased the murmur in this case. Pulsed Doppler echocardiogram showed a wide diastolic Doppler shift scatter in the right ventricular outflow tract, which was indicative of diastolic turbulence due to pulmonic regurgitation. This Doppler shift did not change after the administration of amyl nitrite and methoxamine. However, it decreased after the administration of aminophylline. It is concluded in this paper that the administration of aminophylline is useful for the non-invasive diagnosis of pulmonic insufficiency.

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