WordNet

of or relating to the heart; "cardiac arrest"
a cardiovascular disease characterized by a saclike widening of an artery resulting from weakening of the artery wall (同)aneurism
the opening into the stomach and that part of the stomach connected to the esophagus

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心臓の
動脈瘤(りゅう)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/06/20 06:59:30」(JST)

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An aneurysm of heart refers to an aneurysm involving cardiac tissue.

Classification

The word aneurysm refers to a bulge or ‘pocketing’ of the wall or lining of a vessel commonly occurring in the blood vessels at the base of the septumn, or within the aorta. When it concerns the heart muscle, it is called a cardiac aneurysm and is usually seen in the left ventricle of the heart.

Ventricular aneurysm

Ventricular aneurysms are the most common type of aneurysm of the heart, occurring most often following a stroke or TIA, due to a weakening of a scarred wall and pressure from blood flows, particularly during systole.^{[citation needed]}

Atrial septal aneurysm

Signs and symptoms

As it tends to develop slowly, symptoms may go unnoticed. Often the only way of finding out that it has occurred at all is when other medical conditions present, which are usually very serious such as blood clots causing strokes and blockages in other blood vessels. These blood clots form as the blood in the ventricle does not pump out as it should and can collect and thicken in the bulged area, releasing clots into the system.^{[citation needed]}

Causes

Seen mainly syama in the walls of the left ventricle (lower chamber) of the heart, it is thought to occur here as the blood in this area carries the highest amount of pressure forcing the walls to bulge. It can develop very slowly over many years and does not often cause any problems during this time. Another possible cause of a cardiac aneurysm is as a consequence of a heart attack, known medically as a myocardial infarction. Again it develops slowly due to a rise in pressure. It maybe also congenital.

Investigations

It should not be confused with a coronary artery aneurysm, which is an aneurysm of the vessels supplying the heart, not the heart itself.

It should also not be confused with a pseudoaneurysm^[1]^[2] or a myocardial rupture (which involves a hole in the wall, not just a bulge.)

Diagnosis

When a person visits the hospital or doctor with other symptoms, especially with a history of heart problems, they will normally be required to undergo an electrocardiogram, which monitors electrical activity within the heart and shows abnormalities when a cardiac aneurysm is present. It can also appear as a bulge on a chest x-ray, and a more accurate diagnosis will then be made using an echocardiogram, which uses ultrasound to ‘photograph’ the heart and how it functions while it beats.

Treatment

As some people live with this type of aneurysm for many years, diagnosis and treatment will not be given. If, however, it has been properly diagnosed, blood thinning agents may be given to help reduce the likelihood of blood thickening and clots forming, along with the use of drugs to correct the irregular rhythm of the heart (seen on the electrocardiogram), and occasionally surgery will be offered. If surgery is indicated, it is often to try to remove the bulge and repair the damaged area and can be quite difficult so will be used as a last option as it carries many risks.

Most people who live with a cardiac aneurysm do so without knowing it. It is far better to reduce the risk of heart attack and keep blood pressure within healthy limits in order to reduce the likelihood of an aneurysm occurring along with all of the possible side-effects and consequences. Lifestyle choices play a very important role in this prevention and careful consideration should be given when participating in highly unhealthy activities such as heavy drinking which causes dehydration/blood to thicken and smoking which is a vasoconstrictor that decreases blood flow, especially to the heart.

References

^ Zoffoli G, Mangino D, Venturini A et al. (February 2009). "Diagnosing left ventricular aneurysm from pseudo-aneurysm: a case report and a review in literature". J Cardiothorac Surg 4 (1): 11. doi:10.1186/1749-8090-4-11. PMC 2654444. PMID 19239694.
^ Brown SL, Gropler RJ, Harris KM (May 1997). "Distinguishing left ventricular aneurysm from pseudoaneurysm. A review of the literature". Chest 111 (5): 1403–9. doi:10.1378/chest.111.5.1403. PMID 9149600.

UpToDate Contents

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1. 急性心筋梗塞後の左室瘤および仮性左室瘤 left ventricular aneurysm and pseudoaneurysm following acute myocardial infarction
2. 脳動脈瘤の治療 treatment of cerebral aneurysms
3. 胸部大動脈瘤の疫学、危険因子、病因、および自然史 epidemiology risk factors pathogenesis and natural history of thoracic aortic aneurysm
4. 腹部大動脈瘤の血管内修復 endovascular repair of abdominal aortic aneurysm
5. 無症候性腹部大動脈瘤のマネージメント management of asymptomatic abdominal aortic aneurysm

English Journal

Nonsyndromic thoracic aortic aneurysm and dissection: Finally answers.

Martín M1, Barriales V2, Rozado J2, Fidalgo A2, Iglesias DG2, Solache-Berrocal G3, Morís C2, Cabo RA4, Rodríguez I3.
International journal of cardiology.Int J Cardiol.2016 Jul 1;214:133. doi: 10.1016/j.ijcard.2016.03.182. Epub 2016 Mar 26.
PMID 27060273

A High Performance Pulsatile Pump for Aortic Flow Experiments in 3-Dimensional Models.

Chaudhury RA1, Atlasman V2, Pathangey G3, Pracht N3, Adrian RJ4, Frakes DH3,2.
Cardiovascular engineering and technology.Cardiovasc Eng Technol.2016 Jun;7(2):148-58. doi: 10.1007/s13239-016-0260-3. Epub 2016 Mar 16.
Aortic pathologies such as coarctation, dissection, and aneurysm represent a particularly emergent class of cardiovascular diseases. Computational simulations of aortic flows are growing increasingly important as tools for gaining understanding of these pathologies, as well as for planning their sur
PMID 26983961

Treatment of Hypertension in Coarctation of the Aorta.

Nakamura K1, Stefanescu Schmidt A2.
Current treatment options in cardiovascular medicine.Curr Treat Options Cardiovasc Med.2016 Jun;18(6):40. doi: 10.1007/s11936-016-0462-x.
OPINION STATEMENT: The treatment of hypertension in coarctation of the aorta (CoA) is ideally managed by early surgical or transcatheter repair to reduce the risk of irreversible aortopathy and refractory hypertension, in addition to other associated sequelae including premature coronary artery dise
PMID 27091737

Japanese Journal

Pulmonary Thromboembolism Caused by Prolonged Compression at the Femoral Access Site and a Venous Aneurysm of the Ipsilateral Popliteal Vein

Annals of Vascular Diseases 9(1), 58-61, 2016
NAID 130005145614

エンドリークによる開腹再手術の工夫

日本血管外科学会雑誌 25(0), 81-84, 2016
NAID 130005137747

Pulmonary Thromboembolism Caused by Prolonged Compression at the Femoral Access Site and a Venous Aneurysm of the Ipsilateral Popliteal Vein

Annals of Vascular Diseases advpub(0), 2016
NAID 130005125964

Related Pictures

★リンクテーブル★

リンク元	「心室瘤」「heart aneurysm」
関連記事	「cardiac」

「心室瘤」

Aneurysm of heart
	Heart left ventricular aneurysm short axis view
Classification and external resources
ICD-10	I25.3
ICD-9	414.1
MeSH	D006322

　　[★]

英: ventricular aneurysm
同: 心臓瘤 cardiac aneurysm
関: 左室瘤、左心室瘤

概念

左室の表面が限局性に突出し、同時に内腔の膨出を伴った状態、あるいは左室造影上収縮期、拡張期の全経過を通じて本来の左室腔より膨隆しているものを心室瘤と呼ぶ。

病型

真性心室瘤：左室壁が瘤壁を形成

好発部位：左室前壁・心尖部
頻度：急性心筋梗塞例の5-10%に見られる。
予後：急性期には破裂することがあるが、慢性期には破裂することはないが、不整脈のfocusとなり致死性不整脈を起こしたり、壁在血栓を形成し血栓塞栓症を発症しうる。

仮性心室瘤：心室壁の破裂に伴う血栓の周辺部が心嚢と癒着・線維化して瘤壁を形成

好発部位：後壁に好発
予後：破裂の危険が高く緊急手術の適応

疫学

心筋梗塞をきたした患者の10%前後に発生

病因

心筋梗塞(最多)
先天性・外傷性・細菌性心内膜炎による心筋膿瘍

検査

心エコー
心電図：心筋梗塞発症後に異常Q波が出現する誘導でST上昇が持続するときには、壁運動異常(akinesis/dyskinesis)が生じていると考えられ、心室瘤が疑われる。(ECGP.177)　(普通ST上昇は数日の経過で正常化(cf.心筋梗塞#心電図の異常波形と時間経過 )

治療

手術療法

心室瘤切除術
ドール手術：心筋梗塞後左室瘤に対する左室形成術

Dor V, Saab M, Coste P, Kornaszewska M, Montiglio F., Left ventricular aneurysm: a new surgical approach., Thorac Cardiovasc Surg. 1989 Feb;37(1):11-9.
PMID: 2522252

「heart aneurysm」

　　[★]

心室瘤

関: cardiac aneurysm、ventricular aneurysm

「cardiac」

　　[★]

adj.

心臓の、心の、心臓性、強心の

関: cardio、cardiotonic、heart、mind

[pmid19239694-1] Zoffoli G, Mangino D, Venturini A et al. (February 2009). "Diagnosing left ventricular aneurysm from pseudo-aneurysm: a case report and a review in literature". J Cardiothorac Surg 4 (1): 11. doi:10.1186/1749-8090-4-11. PMC 2654444. PMID 19239694.

[pmid9149600-2] Brown SL, Gropler RJ, Harris KM (May 1997). "Distinguishing left ventricular aneurysm from pseudoaneurysm. A review of the literature". Chest 111 (5): 1403–9. doi:10.1378/chest.111.5.1403. PMID 9149600.

匿名

検索

案内

案内

cardiac aneurysm