幡野 浩一, 林 輝美, 酒井 良彦, 山口 浩一, 小林 さゆき, 松永 理一郎, 石井 幸子, 加瀬 誠, 上白土 洋俊, 諸岡 成徳

Hirokazu HATANO, Terumi HAYASHI, Yoshihiko SAKAI, Hirokazu YAMAGUCHI, Sayuki KOBAYASHI, Riichiro MATSUNAGA, Yukiko ISHII, Makoto KASE, Hirotoshi KAMISHIRADO, Shigenori MOROOKA

獨協医科大学越谷病院循環器内科

Department of Cardiology, Dokkyo University School of Medicine Koshigaya Hospital

キーワード : Dilated cardiomyopathy , Echocardiography, Electrocardiography, Left bundle branch block

Idiopathic dilated cardiomyopathy (DCM) shows a broad clinical spectrum, and symptoms of congestive heart failure usually appear during its early stage. A case DCM in a 35-year-old male patiant, who had been followedup by serial echocardiography for twelve years, from asymptomatic early stage to advanced stage with congestive heart failure, is reported here electrocardiograms showed gradual development of left ventricular conduction disturbance and P wave abnormality. These electrocardiographic abnormalities may have reflected myocardial involvement of both left ventricle and left atrium. Intraventricular conduction defects appeared before increase in the left ventricular systoric dimension and decrease in the ejection faction. Left ventricular systolic function deteriorated rapidly with the appearance of complete left bundle branch block. Thinning of the left ventricular wall developed in the advanced stage. Inflow velocity in the atrial contraction period decreased gradually in association with enlargement of the left atrium and the amplitude of the P wave. These findings suggest that left atrial contraction disturbance was caused by involvement of the left atrium of DCM.