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英文誌(2004-)

Journal of Medical Ultrasonics

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2000 - Vol.27

Vol.27 No.08

Case Report(症例報告)

(1055 - 1061)

急性心筋梗塞発症を契機に発見された左房粘液腫の1例

A Case of Left Atrial Myxoma Detected after Seizure of Acute Myocardial Infarction

寺師 利彦1, 薗田 正浩1, 川畑 和代1, 塗木 徳人1, 福岡 嘉弘1, 山下 英世1, 山王 和寿1, 田中 康博1, 真田 純一2, 有馬 暉勝1

Toshihiko TERASHI1, Masahiro SONODA1, Kazuyo KAWABATA1, Norihito NURUKI1, Yoshihiro FUKUOKA1, Hideyo YAMASHITA1, Kazuhisa SANNOU1, Yasuhiro TANAKA1, Jun-ichi SANADA2, Terukatsu ARIMA1

1鹿児島大学医学部第二内科, 2鹿児島県立大島病院循環器科

1Department of Second Internal Medicine, University of Kagoshima Faculty of Medicine, 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima-ken 890-8520, Japan, 2Division of Cardiology, Kagoshima Prefectural Ohshima Hospital, 18-1 Manatsu-cho, Naze-shi, Kagoshima-ken 894-0015 , Japan

キーワード : Acute myocardial infarction , Coronary embolism , Left atrial myxoma

Coronary arterial embolization is an extremely rare and potentially lethal complication of atrial myxomas. A 61-year-old male patient was admitted on 3 April 1997 for chest pain accompanied by cold sweat and dyspnea after he had pruned trees in his garden. ST segment elevation in leads II, III, and aVF was indicated by electrocardiogram (ECG) at time of admission, and an echocardiogram showed severe hypokinesis of inferior-wall motion and a mobile tumor in the left atrium; however, emergency coronary angiography showed no significant finding, and there was no ST elevation in the ECG during the catheter examination. Further, the patient recalled having had severe lassitude of the legs in 1995 and 1996, and because systemic embolization, a common complication of this disease, suggested arterial embolization of the legs, he was assumed to have had an acute myocardial infarction caused by coronary embolism from the left atrial myxoma, which reperfused before the coronary angiography was conducted. A 40×40×30-mm tumor that protruded from the interatrial septal wall to the left atrium was surgically removed on 30 April 1997. Histologic examination of this tumor confirmed as a myxoma.