心肌灌注檢查結果顯示左心室末端血管阻塞，該如何處理？-心臟血管專科

極度踏車運動試驗 和 心肌灌注報告？

---

醫生您好
近一年來有胸悶 心悸等狀況 分別到醫院做了以下2種檢查
最近這次的心肌灌注檢查報告圖片說有心臟末端血管的阻塞
醫生開了bokey的藥，我擔心如果吃了心血管相關的藥物
就要一輩子吃藥。
目前也沒有三高，生活作息正常，平常有慢跑習慣，戒菸10年了。
醫生建議我再做心臟電腦斷層檢查
以下是2種檢查的報告
麻煩醫生給我些建議

極度踏車運動試驗GXT 20220803檢查
1.The baseline EKG was normal sinus rhythm
2.Totaal exercise time was 9:38 minutes.
The maximal cardiac workload was 166BPM and 93%target heart
rate was achieved.Treadmill exercise test was terminated
3.No significant ST change was noted during exercise and recovery phase.
4.Conclusion:negative for treadmill exercise test.

心肌灌注造影的報告20230316檢查
Finding(s) /Interpretation(s)
Scintigraphic findings:The Tc-99m sestamibi stress /rest myocardial
perfusion gated single photon emission commputed tomography
(SPECT)scan shows :
1 Moderate severity, reversible perfusiondefects in the anterior wall, mid anteroseptal wall,apical/basal
inferior wall and inferolateral wall of the left ventricle,suggesting stress-induced myocardial ischemia.
2.Fixed perfusion defects/reverse redistribution of the fhallium activity in the apex,apical anteroseptal wall,
basal inferoseptal wall and mid inferior wall of the left ventricle,maybe due to myocardial
ischemia/damaged myocardium
3.No significant regional wall motion abnormality in the left ventricle
4.Ejction Fractuon(EF)of left ventricle:Stress EF=60% Resting EF=55% Further
correlation/management and colose follow-up should be recommended.

---

劉先生，40~49歲男性，詢問日期：2023/04/13