当院で観察した右胸心7例の検討—洞不全症候群を合併した右胸心の1例を中心にして

Examination of Seven Cases of Mirror Image Dextrocardias in Our Hospital:A case of mirror image dextrocardia combined with sick sinus syndrome as a focus

　当院で経験した7例の右胸心を検討した。うち6例はSchmidt ＆ Korthの分類でI型，Van Praaghの分類でe型に，他の1例はSchmidt ＆ Korthの分類でII型，Van Praaghの分類で特殊な型に分類された．I型かつe型の6例は正常洞調律であったが，II型かつ特殊な型の1例は洞不全症候群を合併し，さらに多脾および下大静脈肝部欠損を呈した．文献的に右胸心と洞不全症候群との合併の報告は少ないが，多脾症や無脾症と洞機能不全の報告は多く，多脾症や無脾症の洞結節組織が正常の部位では低形成であるためとされている．右胸心の診療の際には脾臓の検索が重要であると考えられた．

We report here seven cases of mirror image dex-trocardias encountered in our hospital. Six of them were classified into type “I” according to the classification of Schmidt & Korth, and into the type “e” according to the classification of Van Praagh. Another case was classified into the type “II” or “uncertain” type. The six cases of type “I” and “e” were shown to have normal sinus rhythm on electrocardiogram, and the one case of type II was shown to be combined with sick sinus syndrome, polysplenia and absent inferior vena cava. Generally speaking, it has hardly ever been reported in the literature that a mirror image dextrocardia was combined with sick sinus syndrome. On the other hand, many cases with polysplenias and asplenias were report-ed to be complicated with sick sinus syndrome caused by the absent sinus node tissue in its normal situs. On account of this, we concluded that we must investigate the presence of splenic abnormalities, when confronted by a mirror image dextrocardia.