運動心電圖顯示心肌缺氧，是否需要提前服用心律及血管擴張劑？-心臟血管專科

運動心電圖臨界異常？

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Patient Name: LIU Y.N DOB: 1981/09/18 Patient ID: 22188275-81361 Age: 39 yrs Height: 157 cm Gender: FEMALE Weight: 63 kg Race: Study Date: 2021/09/14 Referring Physician: D48997 Test Type: -- Attending Physician: D33667 Protocol: BRUCE Technician: T32432 BRUCE: Total Exercise Time 07:05 Max HR: 169 bpm 93％ of max predicted 181 bpm HR at rest: 95 Max BP: 159/69 mmHg BP at rest: 111/79 mmHg Max RPP: 23550 mmHg*bpm Maximum Workload: 10.1 mets Max. ST: -2.20 mm, 0.00 mV/s in III ; EXERCISE STAGE 2 06:00 Arrhythmia: A:11, PSVC:3 ST/HR index: 1.78 μV/bpm Reasons for Termination: Target heart rate achieved ----------------------------------------------------------------- ----------------------------------------------------------------- Stage HR(bpm) BP(mmHg) HRxBP TM Speed mph TM Grade ％ ----------------------------------------------------------------- REST 96 111/79 10656 1.2 0.0 ----------------------------------------------------------------- Stage1 123 149/71 18327 1.7 10.0 ----------------------------------------------------------------- Stage2 150 159/69 23850 2.5 12.0 ----------------------------------------------------------------- Stage3 164 - - 3.4 14.0 ----------------------------------------------------------------- Stage4 4.0 16.0 ----------------------------------------------------------------- Stage5 5.0 18.0 ----------------------------------------------------------------- Stop Exercise 151 150/69 22650 0.0 0.0 ----------------------------------------------------------------- RECOVERY 102 113/74 11526 ----------------------------------------------------------------- Result : Borderline ----------------------------------------------------------------- COMMENT : The patient exercised according to the BRUCE for 7:05 min:s, achieving a work level of Max. METS: 10.10. The resting heart rate of 94 bpm rose to a maximal heart rate of 169 bpm. This value represents 93 ％ of the maximal, age-predicted heart rate. The resting blood pressure of 111/79 mmHg , rose to a maximum blood pressure of 159/69 mmHg. The exercise test was stopped due to Target heart rate achieved *there are ＞1mm downsloping ST depression over lead III, AVF, but the original data shows a borderline ischemic change *cannot exlcude請問醫生本身有焦慮病史 、血脂肪高目前血脂肪有吃藥控制、免疫系統ESR過高定期追中目前醫生沒開藥 最近晚上睡覺突然心臟一下跳快或慢合併會熱的發汗 於是先到門診拿藥吃 門診有給我鎮定劑 我有先吃了 但由於吃了後心臟偶感灼熱感 又偶爾會有一絲絲微微抽痛 後來去心臟科看醫生 醫生讓我做了運動心電圖說有很輕微缺氧 叫我開始吃藥保養所以看了 心律早晚一顆 律靜膠囊早晚一顆 維諾心糖衣錠早晚半顆請問醫生 我本身血壓大概都在 105/60左右 這樣吃了兩種會影響血壓的藥 怕會容易低血壓 再來鎮定劑我沒有吃律靜 我吃之前常吃的易舒錠 每晚半顆 我就覺得很好睡白天也很鎮定了您覺得我需要再重新檢查嗎 我這樣的報告 是否該考慮提前吃心律錠 及 維諾心 類似血管擴張劑？
目前維諾心我一直沒吃 只有吃心律 及 晚上鎮定劑 謝謝醫生 再麻煩您幫我再確認心電圖

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劉小姐，40~49歲女性，詢問日期：2021/09/17