冠動脈石灰化を認め，肺性心にて死亡した進行性全身性硬化症の1例

Coronary Calcification on Progressive Systemic Sclerosis with Cor Pulmonale

　症例は68歳，男性．主訴は呼吸困難．1990年よりレイノー症状出現．1992年初めより呼吸困難出現し，5月当科初診，精査入院となる．強指症，血清抗核抗体陽性，皮膚生検にてPSSと診断．ベルクロ・ラ音聴取，胸部X線写真にて蜂巣状陰影がみられ，低酸素血症あり．心電図では，洞頻脈，右軸偏位，および胸部誘導における陰性T波あり，右心カテーテル検査施行し，肺動脈圧57／23mmHgと肺高血圧症がみられた．胸部CTにて，下肺野蜂巣状，肺動脈拡大，冠動脈の明らかな石灰化あり．PSSの心病変は予後不良であり，肺性心に冠動脈の石灰化を認めた本例について検討したので報告する．

A 68-year-old male who had a history of dyspnea was admitted to our hospital because of dyspnea experi-enced during effort. Pulmonary artery pressure was elevated. Chest CT and coronary angiography showed coronary calcification with sclerosis, without major coronary risk factors. From skin biopsy and clinical and angiographical findings, we diagnosed this patient as having coronary calcification. We treated him with digoxin, furosemide and diltiazem, but 3 month later, pulmonary artery pressure had risen again. After 4 months, this was complicated by oliguria and hypoten-sion and he died.