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英文誌(2004-)

Journal of Medical Ultrasonics

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1998 - Vol.25

Vol.25 No.08

Case Report(症例報告)

(0869 - 0874)

抗凝固療法により縮小または消失した左室内巨大壁在血栓を伴う心筋梗塞の2症例一心エコー図法による経過観察

Two Cases of Acute Myocardial Infarction With a Large Left Ventricular Mural Thrombus Disappearing or Being Reduced by Anticoagulant Therapy: Observation by Echocardiography

田中 一江1, 宮澤 総介1, 2, 成味 純1, 2, 宮田 晴夫1, 2, 鈴木 厚子2, 杉浦 徹2, 横井 奈穂子1, 加藤 まり子1, 福田 淳1

Kazue TANAKA1, Sosuke MIYAZAWA1, 2, Jyun NARUMI1, 2, Haruo MIYATA1, 2, Atsuko SUZUKI2, Toru SUGIURA2, Naoko YOKOI1, Mariko KATO1, Atsushi FUKUDA1

1聖隷三方原病院生理検査室 , 2聖隷三方原病院循環器科

1Department of Clinical Laboratory, Seirei Mikatabara General Hospital, 2Department of Cardiology, Seirei Mikatabara General Hospital

キーワード : Acute myocardial infarction , Echocardiography, Mural thrombus, Pulsed Doppler echocardiography

The first of the two cases discussed here was that of an 80-year-old man admitted because of inferior-wall myocardial infarction. Ultrasonography showed an immobile mural thrombus in the left ventricle. A portion of the thrombus, which was approximately one third the size of the ventricular cavity, was partially protruding. After 8 weeks of warfarin potassium therapy, the thrombus was resolved, leaving no sign of the embolic event. Case 2 was that of a 62-year-old man who had been admitted because of anteroseptal myocardial infarction. An immobile mural thrombus was observed at the left ventricular apex by two-dimensional echocardiography 3 days after admission. The thrombus grew daily until it occupied half of the left ventricular cavity. Antithrombotic therapy decreased its size without embolic episodes, and only a thin, layered thrombus could be seen at the ventricular apex 11 months later. These results suggest that anticoagulant therapy is both safe and effective for resolving immobile left ventricular thrombi with a low incidence of embolization.