心臟血管專科檢查結果分析：運動心電圖和心肌灌注檢查結果如何解讀？-心臟血管專科

有需要再進一步檢查嗎？

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小弟自從11/2發生胸悶心跳變快，去診所做了心電圖說我心臟有問題就開了轉診單要我去急診室 結果抽血X光心電圖都沒異常就幫我掛門診檢查做了運動心電圖TET No:1102361 一.測驗方式: Bruce; 二.未跑完全程的原因: Target heart rate achieved; 三.Result: 1.Resting EKG: Normal sinus rhythm Predicted MHR(%)=Peak HR/Age predicted MHR=157/177 = 89% Modified Time Index=MBP*HR*(10^-2)=140 X157/100 = 220units 2.Exercise duration: 6’31’’ 3.BP response: Stage 0------ 1------ 2------ 3------ 4------ 5------ 6------ Minutes ST 3’ 3’ 31＆quot; R1 R3 R5 BP 107/65 126/72 140/73 140/73 138/71 127/71 111/71 Stage 7------ 8------ 9------ 10----- 11----- 12----- 13----- Minutes BP 4.EKG Changes: a.ST Segment abnormalities: ST segmental elevation 1 mm in V5-6 beginning at 3 min of exercise and lasting for 3 min into the recovery phase b.T or U wave changes: Normal c.QRS complex changes: Normal 5.Arrhythmia: Nil 6.Chest Pain: Nil 四.Interpretation: Positive for ischemia顯示陽性。 又進一步做了心肌灌注Under standardized dipyridamole stress test， (1) no significant inducible ischemia in the myocardium， (2) adequate LV systolic function. ================================================================================ Study: 26025B Stress ＆ redistribution myocardial perfusion study with SPECT (壓力與重分佈心肌斷層灌注掃描). INDICATION: Diagnosis of coronary artery disease， R/O myocardial ischemia. CLINICAL HISTORY: 43M. Chest tightness， tachycardia. Smoking. TET: Positive for ischemia. UCG: Adequate LV systolic function (LVEF:57.9%)， No obvious regional wall abnormality. NUCLEAR MEDICINE STUDY: Thallium-201 myocardial perfusion imaging (MPI)， dipyridamole ＆ resting. RADIOPHARMACEUTICAL: Thallium-201 3 mCi intravenous. SCINTIGRAPHIC FINDINGS: Thallium-201 myocardial perfusion imaging was performed after standardized dipyridamole stress protocol (dipyridamole: 0.56mg/Kg， continuous IV infusion in 4 minutes) and resting state， respectively. The initial and 4-hour delayed images showed no definite perfusion defect in the myocardium. (1) Post-stress LVEF = 71%， rest LVEF = 79%. (2) Wall motion: no obvious regional wall motion abnormality. IMPRESSION: Under standardized dipyridamole stress test， (1) no significant inducible ischemia in the myocardium， (2) adequate LV systolic function. Comment: ＞ The mean sensitivities and specificities of vasodilator SPECT for detecting CAD (greater and equal 50% stenosis) are 86% and 73%， respectively. (Reference: J Am Coll Cardiol 2003;42:1318-33.)報告如上醫生說沒顯示異常我到底是正常還是異常該轉掛身心科嗎

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楊，40~49歲男性，詢問日期：2021/12/26