超音波檢查顯示心臟異常，左心房和左心室大小是否有變化？-心臟血管專科

超音波詢問？

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我去年2021/11 月檢查 心臟超音波，我自己有稍微注意到左心房的數值，但醫生說還好
然後最近定期回診2022/11/11 也照了心臟超音波，雖然報告還沒出來，
但我看到影像有寫

-LA Dimen 4.6 cm
-AV Cusp Sep 2.3 cm
-AoR Diam 3.2 cm
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LA/Ao(MM) 1.44

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-LVIDs 3.2cm
-LVPWd 1.2cm
-LVIDd 5.0 cm
-IVSd 1.0 cm
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EDV(MM-Teich) 118 ml
IVS/L VPW (MM) 0.833
ESV(MM-Teich) 41.0 ml
FS(MM-Teich) 36.0%
EF(MM-Teich) 65.3%

去年11/28 的心臟超音波報告:
Tape: DVD G #236 Clinical Dx:
M-mode+Section Scan: Aortic Root (20∼37mm): 25
LAD (19∼40mm): 43
LVIDd (35∼51mm): 47
LVIDs (28∼35mm): 32
VS (6∼10mm): 10
PW (6∼10mm): 10
Comment:(M-mode,2-D, Doppler ＆ Color Flow Mapping)
1. Preserved LV ＆ RV systolic function, LVEF = 60 %.
2. Preserved LV diastolic function, E/A= 1.4, Em/Am= 1.5, E/Em= 7.5, Em= 12.4 cm/s.
3. Dilated: LA.
4. MR: Mild.
5. TR: Minimal.
6. PR: Mild.
7. The TDI suggest decreased LV systolic reserve function. (Lat Sm= 6.4cm/sec)

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去年10/02的心臟超音波報告
Conclusion
• LV enlargement
• Preserved global contractility of left ventricle
• LVEF by M-mode is 60.4 %
• Regional wall motion abnormality, cause to be determined
• Grade I diastolic dysfunction (Impaired relaxation)
• MVP, borderline
• Mild mitral regurgitation
• Mild pulmonary regurgitation
• Mild tricuspid regurgitation
• Estimated systolic pulmonary artery pressure is 21.3 mmHg
MMode/2D Measurements ＆ Calculations RWT: 0.34 Time Measurements MM R-R int: 0.82sec
MMode/2D Value References Ao root diam: 3.1cm [ 2.0-3.8 cm]
LVIDd: 5.8cm [ 3.7-5.3 cm]
ACS: 1.9cm [ 1.6-2.6 cm]
LVIDs: 3.9cm [ 2.4-3.6 cm]
LA dimension: 3.5cm [ 1.9-4.0 cm]
EDV(Teich): 166.6ml [ 80-180 ml] [ 0.5-2.1 cm]
ESV(Teich): 65.9ml [ 16-83 ml]
MV E-F slope: 17.3cm/sec [ 8.0-15.0 cm/sec]
EF(Teich): 60.4% [ 50-70 %]
IVSd: 1.0cm [ 0.7-1.1 cm]
FS: 32.8% [FS 34-44 %]
LVPWd: 1.0cm [ 0.9-1.1 cm]
MM HR: 73.0BPM [ 60-100 BPM] [EPSS ＜0.8 cm] CO(Teich): 7.3l/min [ 2.5-7.2 l/m] [RWT 0.22-0.42]
Doppler Measurements ＆ Calculations Ao V2 max: 84.2cm/sec LV V1 max
PG: 2.4mmHg
Ao max PG: 2.8mmHg LV V1 max: 77.0cm/sec
TR max vel: 167.0cm/sec sPAP: 21.3mmHg
TR max PG: 11.3mmHg
MV E max vel: 82.9cm/sec [＞=50y,62 ± 14,＜50y,72 ± 14] MV A max vel: 56.8cm/sec [＞=50y,59 ± 14,＜50y,40 ± 10] MV E/A: 1.5 [sPAP ＜ 35mmHg] MV dec time: 0.18sec [DT 0.16-0.22 sec] LV IVRT: 0.05sec [ 0.07-0.09 sec] Ventricles • Increased dimension of LV • LVEF by M-mode is 60.4 %
• Hypokinesis in the segments of LV including anteroseptal wall
• Mitral inflow: E/A ratio : 1.5
• Isovolemic relaxation time is 0.05 sec
• Deceleration time of mitral inflow 0.18 sec
• Tissue Doppler: E’/A’ ＜1
• Septal E’ : 10.6 cm/s
• Lateral E’ : 11.9 cm/s
• E/E’(Lateral) : 6.9 Atrium
• Normal sizes of atrial chambers Valves
• Increase thinkness of MV with borderline elongated chordae of MV Valves
• Increase thinkness of MV with borderline elongated chordae of MV

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想問 怎麼去年10月看起來是左心室 超過標準，然後去年11月變成左心室正常，左心房超過標準 (去年11/28 LAD (19∼40mm): 43 )
然後今年的11/11 左心房好像也超過標準 (-LA Dimen 4.6 cm ) <-不知道這是否是左心房的數值

1.請問這樣是左心房擴大嗎?需要治療嗎?

2.為什麼去年相差一個月的心臟超音波檢查 會差那麼多?

3.請問有可能一個月左心房就突然超過標準嗎?
那時候去年2021/ 08月檢 查是 LA dimension: 3.5cm [ 1.9-4.0 cm]
怎麼去年2021/11 月突然 LAD (19∼40mm): 43
現在2022/11/20變成 -LA Dimen 4.6 cm

我是去年8月因為APC所以開始吃 心律不整的藥(早晚 吃一次 康肯1.25mg 跟 心利正 150mg) 吃到現在
然後每三個月回診，剛好醫生說照一下心臟超音波，完整報告還未出來，但我看影像上面寫的 -LA Dimen 4.6 cm
就覺得是不是我左心房又擴大 這是惡化嗎?我該怎麼做比較好呢?
這樣是不是會心臟衰竭之類的?

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鈞，20~29歲男性，詢問日期：2022/11/20