Echocardiogram in Paradoxus--Respiration Dependent Cyclic Changes in Mitral and Aortic Valve Motion: A Case Report

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  • SAKAMOTO Tsuguya
    Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo
  • TEI Chuwa
    Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo
  • HAYASHI Terumi
    Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo
  • ICHIYASU Hirofumi
    Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo
  • AMANO Keiko
    Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo
  • HADA Yoshiyuki
    Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo
  • SERIZAWA Tsuyoshi
    Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo

書誌事項

タイトル別名
  • Echocardiogram in Pulsus Paradoxus
  • Echocardiogram in Paradoxus Respiration
  • Respiration Dependent Cyclic Changes in Mitral and Aortic Valve Motion : A Case Report

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The mechanism of production of pulsus paradoxus was echocardiographically studied in a 74-year-old male with subacute effusive-constrictive pericarditis which developed to constrictive pericarditis under the observation. Echocardiography disclosed the following phenomena during inspiration: 1) mitral valve did not open until the atrial systole, probably because of the lack of antegrade mitral flow during rapid filling phase (the E wave was not observed), 2) concomitantly, aortic valve opening decreased markedly in its grade, and 3) left ventricular ejection time (LVET) decreased and pre-ejection period (PEP) increased, resulting in a higher PEP/LVET ratio (up to 1.32). The opposite was true during expiration (PEP/LVET ratio was 0.40).<br>This is probably the first case, in which the mechanism of pulsus paradoxus was investigated by aortic and mitral valve echograms.

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