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Journal of Medical Ultrasonics

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1989 - Vol.16

Vol.16 No.05

Case Report(症例報告)

(0484 - 0491)

下大静脈内に流動つぶ状エコーを認めたstunned myocardiumの1症例

Spontaneous Granular Contrast Echoes in the Inferior Vena Cava in a Patient with Stunned Myocardium

酒井 和好, 石田 明弘, 味岡 正純

Kazuyoshi SAKAI, Akihiro ISHIDA, Masayoshi AJIOKA


Department of Cardiology, Tousei Public Hospital

キーワード : Spontaneous contrast echo, Inferior Vena Cava, Stunned myocardium, Asynergy

A case of intracavitary spontaneous contrast echoes ware examined. A 76-year-old woman with acute renal failure suddenly developed precordial pain with electrocardiographic evidence of acute ischemia of the anterior myocardial wall. Two-dimensional echocardiography revealed asynergic motion of the anterior left ventricular wall. Spontaneous contrast echoes were found in the inferior vena cava and the rightside cavities. It could be described as dense granular echoes. Faint contrast echoes were found in the left ventricle. This patient exhibited ST-segment elevation in the anteroseptal leads V1-V3, but there was no increase in the serum myocardial enzyme levels. Twenty days later, two-dimensional echocardiography revealed no spontaneous contrast and an improvement of the left ventricular wall motion. The mechanism of the echogenicity in the flowing blood involves red blood cell aggregation which is greater at low flow velocity. Furthermore, it is possible that hemoconcentration promoted red blood cell aggregation in this case.