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Kokyu to Junkan Volume 43, Issue 11 （November 1995）

呼吸と循環 43巻11号（1995年11月発行）

Japanese English

症例

左室病変を伴った不整脈源性右室異形成の1例 A Case of ARVD with Left Ventricular Involvement 内田昌嗣 ¹ , 松本万夫 ¹ , 浅野由起雄 ¹ , 山田裕一 ¹ , 崔正哉 ¹ , 須賀幾 ¹ , 牛山正之 ¹ , 斉藤淳一 ¹ , 山本俊夫 ¹ , 土肥豊 ¹ , 松尾博司 ¹ , 渡辺宏志 ² Masatsugu Uchida ¹ , Kazuo Matsumoto ¹ , Yukio Asano ¹ , Yuuichi Yamada ¹ , Masaya Sai ¹ , Chikashi Suga ¹ , Masayuki Ushiyama ¹ , Junichi Saitou ¹ , Toshio Yamamoto ¹ , Yutaka Dohi ¹ , Hirosi Matsuo ¹ , Hiroshi Watanabe ² ¹埼玉医科大学第二内科 ²埼玉医科大学第二病理 ¹The Second Department of Internal Medicine, Saitama Medical School ²The Second Department of Pathology, Saitama Medical School キーワード：不整脈源性右室異形成 , 左室病変 , 線維化 , arrhythmogenic right ventricular dysplasia , left ventricular involvement , fibrotic changes Keyword: 不整脈源性右室異形成 , 左室病変 , 線維化 , arrhythmogenic right ventricular dysplasia , left ventricular involvement , fibrotic changes pp.1129-1132

発行日 1995年11月15日 Published Date 1995/11/15

DOI https://doi.org/10.11477/mf.1404901152

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Abstract 文献概要
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　患者は41歳，男性．突然の動悸と胸部圧迫感を訴えて初回入院．精査の結果不整脈源性右室異形成と診断された．心室頻拍はジソピラミド300mg／日によりコントロールされ退院となった．約5年7カ月後，異なるQRS波形の心室頻拍が出現し心不全状態となって再入院となった．心室頻拍は薬剤に耐性で，心不全の改善をみないまま死の転帰をとった．解剖の結果，右室のみでなく左室にも病変が認められた．左室病変には右室病変と同様の脂肪浸潤と，さらにより強い線維化が認められた．左室病変を伴った不整脈源性右室異形成の剖検の報告は稀であり本病態を考えるうえで興味ある症例と思われたので報告した．

A case of arrhythmogenic right ventricular dysplasia (ARVD) with left ventricular involvement revealed by autopsy was reported. The patient was a 41-year-old male who had been admitted for sudden onset of palpi-tation and a sensation of chest oppression and who had been diagnosed as ARVD, was treated and controlled with disopyramide at 300mg/day. He was admitted again for exertional dyspnea and palpitation after 5 years and seven months. The ventricular tachycardia and congestive heart failure were resistant to medical treatment, and he died on the 13th hospital day. Autopsy revealed not only typical changes of marked depletion of the right ventricular musculature of the heart with marked infiltration of adipose tissue, but also focal infiltration of adipose tissue and prominent fibrosis in the left ventricle. Such an autopsy case of ARVD with left ventricular involvement has rarely been reported and was thought to be instructive in consideration of the genesis of ARVD.