心エコーにて心筋症類似の所見を呈した甲状腺機能低下症の2例

Two Cases of Hypothyroidism with Echocardiographic Features Similar to Cardiomyopathy:One simulates hypertrophic and the other dilated cardiomyopathy

　症例1：68歳女性．労作時呼吸困難にて1991年3月本院入院．心胸比77％，心エコーにて心嚢液貯留および著明な左室壁肥厚（IVSTh 15mm）を認めた．FT₃0.20pg／ml,FT₄0.01ng／dl，TSH 51.8μU／mlを認め，甲状腺機能低下症による心嚢液貯留および心筋肥厚と診断．T₄製剤の投与にて心筋肥厚の改善を認めた．

　症例2：69歳女性．1989年8月，労作時呼吸困難にて本院入院．心胸比62％，心エコーにて左室拡張末期径65mm，左室拡張末期径55mm，％FS 16％と左室腔拡大および左室駆出率の低下を認めた．FT₃0.34pg／ml,FT₄0.18ng／dl,TSH34.2μU／mlを呈し，甲状腺機能低下症による心不全および心拡大と診断．2症例とも甲状腺機能の改善とともに心エコー所見および臨床症状の改善を認め，甲状腺機能低下が本症例の異常所見に関与していると思われた．

Two cases of hypothyroidism with echocardiographic features similar to cardiomyopathy were presented. In case 1 (a 68 year-old woman), moderate pericardial effusion and myocardial hypertrophy were observed on admission. In case 2 (a 69 year-old woman), dilation of the left ventricle, hypokinesis of the interventricular septum and the left ventricular free wall, and reduced left ventricular systolic function were observed on admission. These echocardiographic findings were simi-lar to hypertrophic or dilated cardiomyopathy.