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英文誌(2004-)

Journal of Medical Ultrasonics

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2002 - Vol.29

Vol.29 No.04

Case Report(症例報告)

(J383 - J388)

Bland White Garland症候群の高齢生存の1例

A Long Surviving Clinical Case of Bland-White-Garland Syndrome

茨木 康彦1, 高橋 斎1, 大野 歩1, 福西 雅俊1, 谷口 雅1, 氏野 経士2, 木原 一2

Yasuhiko IBARAGI1, Hitoshi TAKAHASHI1, Ayumi OHNO1, Masatoshi FUKUNISHI1, Masa TANIGUCHI1, Keiji UJINO2, Hajime KIHARA2

1木原循環器科内科医院生理検査科, 2木原循環器科内科医院循環器科内科

1Clinical Laboratory, Kihara Cardiovasucular Clinic, 2Department of Internal Medicine, Kihara Cardiovasucular Clinic

キーワード : Bland-White-Garland syndrome, Doppler echocardiography, intramyocardial coronary flow

A man aged 72 years was admitted to this institution complaining of chest discomfort and exertional breathlessness. A soft, continuous murmur was audible at the upper left sternal border. The chest roentgenogram showed enlargement of the heart. Transthoracic echocardiography demonstrated anomalous origin of the left coronary artery from the pulmonary artery, which was associated with a retrograde blood-flow signal from the left coronary artery to the pulmonary artery by color flow mapping. Intramyocardial coronary flow at the interventricular septum showed a retrograde velocity pattern with two peaks in systole that were more dominant in diastole. Transesophageal echocardiography demonstrated a dilated right coronary artery originating from the sinus of Valsalva. A dilated left coronary artery was also detected, and color flow mapping showed it to be associated with retrograde coronary blood flow. This was not connected to the sinus of Valsalva. Aortography demonstrated the dilated right coronary artery supplying the retrograde collateral circulation flowing to the left coronary artery with slight opacification of the main pulmonary artery. We thus diagnosed this condition as a long-surviving case of Bland-White-Garland syndrome.