Transient intraventricular conduction disturbances in hypertrophic obstructive cardiomyopathy

Cheng-Hsiung Chen,Tsunetaro Sakurai,Masatoshi Fujita,Masakiyo Nobuyoshi,Chuichi Kawai

doi:10.1016/0002-8703(81)90237-4

Cheng-Hsiung Chen, Tsunetaro Sakurai + Show 3 more

https://doi.org/10.1016/0002-8703(81)90237-4

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ventricular septum, a 2.0 to 2.5 cm defect was demonstrated consistently in the left ventricular side of the septum (Fig. 1) and entered a large, irregularly defined space (aneurysm) communicating witb the right ventricular apex through an 0.5 cm defect in the right ventricular side of the septum (Fig. 2). The aneurysm showed maximal bulging into the right ventricle toward the end of ventricular diastole and became progressively smaller in ventricular systole. The changes resulted from the hypermobility of the thin right side of the septum. The left side of the septum was virtually immobile and no change occurred in the area of septal disruption. -mode echocardiograpby was confusing and nondiagnostic. The echocardiographic findings were confirmed at, surgery, at which time the aneurysm was plicated and the septal rupture into the right ventricle was repaired. The postoperative echocardiogram demonstrated no septal discontinuity and linear echo densities consistent with metallic sutures used to bnttress Teflon pledgets (Fig. 3). Recognition of a dissecting ventricular septal aneurysm following acute myocardial infarction is new and represents an extension of the capabilities of real-time ZDE. The potential now exists for early echocardiographic diagnosis of ventricular septai aneurysm prior to rupture which results in hemodynamic deterioration from ventricular shunting. Wood A: Perforation of the interventricular septum due to cardiac infarction. Br Heart J 6:191, 1944. Peel A: Dissecting aneurysm of the interventricular septum. Br Heart J 10:239, 1948. Scanlon d, Seward J, Tajik A: Visualization of ventricular septal rupture utilizing wide-angle two-dimensional echocardiography. Mayo Clin Proc 54:381, 1979. Farcot J, Boisante L, Rigaud M, Bardet J, Bourdarias J: Two-dimensional echocardiographic visualization of ventricular septal rupture after acute myocardial infarction. Am J Cardiol 45:370, 1980.

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