心肌缺氧是否需要心導管手術？-心臟血管專科

心肌缺氧 是否要做心導管手術？

醫生您好，我前幾天因為坐著就會喘喘去看了心臟內科，醫生叫我跑完運動心電圖之後，說我有心肌缺氧，就排了心肌灌注攝影，報告結果如下1.Area of perfusion defects in the anterior, inferior and inferoseptal walls(score 2-3) of LV during treadmill stress phase with partial recovery of perfusion in the same sites after rest redistribution. (post stress LVEF=68 %, rest LVEF =67%, N>50%, stress perfusion defect area is 11% of coronary territory, the reversibility is 91% of perfusion defect). 2.The lung heart ratio during stress & rest is 0.32 and 0.36, respectively. (N<0.5).The transient ischemic dilatation(TID) of LV is 0.71(N<1.1). 3.Semiquantitative 17-segment analysis of myocardial perfusion in the LV yielded summed stress score (SSS) of 14. (SSS 1~3: normal, 4~8: mildly abnormal , 13 and above: severe abnormal). 4.The 5-point scoring system is as the following: 0--normal, 1-mild reduction of uptake (not definitely abnormal, 2-moderate reduction (definitely abnormal), 3-severe reduction of uptake, 4-absent uptake. (J Nul Cardiol 2009;16:165). 結 論：1.Myocardial ischemia in the anterior, inferior and inferoseptal walls(definitely abnormal, severe reduction of uptake) of LV was demonstrated. SSS>13: high risk. 2.Follow-up examination is recommended. 3.The overall sensitivity is about 80% to 90%.(Essentials of NM and Molecular imaging 2019;5:146)以下是掃描攝影的圖片https://imgur.com/a/bXfz9Xt?third_party=1#_=_因為我沒有三高 抽血檢查基本上完全沒有紅字但四年前有檢查出二尖瓣脫垂三尖瓣閉鎖不全非常容易緊張也有這些喘的症狀但當時做運動心電圖是陰性醫生開粉紅色的阻斷劑給我吃有可能是因為二尖瓣脫船導致心肌缺氧嗎?我的症狀是坐著的時候會想要喘一大口氣但慢跑之類的起來就沒什麼太大問題不會喘到跑不下去喝咖啡、茶就會非常非常的喘請問這之後就一定要做心導管檢查嗎?另外做完心臟超音波醫生說我心臟超音波血流都正常卻心肌缺氧覺得有點奇怪因為我剛做完TI201攝影 輻射挺高的有點害怕心導管的輻射量因為我才25歲謝謝醫生