A Patient with a Sigmoid-Shaped Septum who Complained of Chest Pain with Latent Left Ventricular Outflow Tract Obstruction and was Diagnosed by Dobutamine Stress Echocardiography

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  • Tano Ayako
    Division of Cardiology, Department of Medicine, Nihon university School of Medicine
  • Kasamaki Yuji
    Division of Cardiology, Department of Medicine, Nihon university School of Medicine
  • Ohta Masakatsu
    Division of Cardiology, Department of Medicine, Nihon university School of Medicine
  • Kofune Tatsuya
    Division of Cardiology, Department of Medicine, Nihon university School of Medicine
  • Okumura Yasuo
    Division of Cardiology, Department of Medicine, Nihon university School of Medicine
  • Hujii Nobuyuki
    Division of Cardiology, Department of Medicine, Nihon university School of Medicine
  • Aizawa Yosihiro
    Division of Cardiology, Department of Medicine, Nihon university School of Medicine
  • Kunimoto Satoshi
    Division of Cardiology, Department of Medicine, Nihon university School of Medicine
  • Nakai Toshiko
    Division of Cardiology, Department of Medicine, Nihon university School of Medicine
  • Hiro Takafumi
    Division of Cardiology, Department of Medicine, Nihon university School of Medicine
  • Watanabe Ichiro
    Division of Cardiology, Department of Medicine, Nihon university School of Medicine
  • Hirayama Atsushi
    Division of Cardiology, Department of Medicine, Nihon university School of Medicine

Bibliographic Information

Other Title
  • 虚血性心疾患類似の胸痛発作で発症し，ドブタミン負荷心エコーにて潜在性左室流出路狭窄を有するＳｉｇｍｏｉｄ　ｓｅｐｔｕｍと診断された一例
  • 症例報告 虚血性心疾患類似の胸痛発作で発症し,ドブタミン負荷心エコーにて潜在性左室流出路狭窄を有するSigmoid septumと診断された一例
  • ショウレイ ホウコク キョケツセイ シンシッカン ルイジ ノ キョウツウ ホッサ デ ハッショウ シ ドブタミン フカシン エコー ニテ センザイセイ サシツ リュウシュツロ キョウサク オ ユウスル Sigmoid septum ト シンダン サレタ イチレイ

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A 56-year-old man was admitted to the hospital with episodes of shortness of breath and chest pain on effort immediately after standing. Physical examination revealed a systolic murmur at the left sternal border in the fourth intercostal space. Transthoracic cross-sectional echocardiography showed a sigmoid-shaped septum protruding markedly into the left ventricle. Treadmill exercise testing revealed no ischemic ST-T changes. Dobutamine stress echocardiography (DSE) resulted in left ventricular outflow tract obstruction (LVOTO) accompanying the chest symptoms. Latent LVOTO occurs rarely in cases of sigmoid-shaped septum, which are considered normal during the aging process. We conclude that we should pay attention to latent LVOTO among the causes of unexplained chest pain in patients with sigmoid-shaped septum, and that DSE is necessary to make the diagnosis of latent LVOTO.

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