心臟超音波顯示典型二尖瓣脫垂及右心室擴大，但第二次檢查未發現，該如何解釋？-心臟血管專科

心臟超音波？

主任您好，想請教您111/08/26做的心臟超音波，醫生說是典型的二尖瓣膜脫垂，還有右心室擴大跟左心室肥厚，但112/2/15在長庚重新做一次醫生說完全沒有，也沒看到，有可能報告會有落差嗎，以前做了4-5次心臟超音波沒有醫生說過有心室擴大跟二尖瓣脫垂，這是誤診不用理他嗎？
不然那醫生講話都讓人焦慮，我的幾百下VPC好像是那醫生嚇出來的…以主任30多年行醫VPC可以不用理他可以不處理，那主任請問您如果會感覺到漏拍的話要怎麼避免心跳產生VPC？
謝謝主任不好意思麻煩您了！以下報告111/08/26■18005超音波心臟圖(-M-MODE-SECTOR-SCAN)□18006杜卜勒氏超音波心臟圖■18007杜卜勒氏彩色心臟血流圖(A).MEASUREMENTS OF MME:1.AO ROOT(20-37): 32.5 MM 2.LA (19-39): 27.7 MM 3.AV OPENING(15-26): 20.4 MM4.RVD(7-23): 27.0 MM 5.MV EF SLOPE(80-150): 152 MM/SEC 6.EF(54-90): 81.6 %7.FS(28-44): 50.0 MM 8.LVEDD(36-50): 41.9 MM 9.LVESD(20-36): 20.9 MM10.IVS(6-11): 11.9 MM 11.LVPW(6-11): 12.1 MM(B).2-D FINDINGS: 1.CARDIAC CHAMBER ＆ GREAT VESSEL □NORMAL ■DILATATION OFRV □ THICKENING OF 2.REGINAL WALL MOTION ■NORMAL □HYPOKINESIA □AKINESIA □DYSKINESIA 3.VALVE OR ANNULUS LESIONS: ■MV □AV □TV □PV □ NOTE: 4.OTHERS: □CONGENITAL CARDIAC ANOMALIES □PERICARDIAL LESION □CARDIAC MASS OR THROMBUS(C).COLOR-MAPPED DOPPLER FINDINGS: 1.□MS: TMF-VMAX M/SEC(0.6-1.3);P MAX MMHG P 1/2TIME MSEC,MVA C㎡;(2D MVA C㎡);MVEA:0.68 /0.57 2.□MR: □MILD,□MOD. □SEVERE,MVP:□ EQUIVOCAL,□ TYPICAL MR-VMAX M/SEC,PG MMHG 3.□AS: □MILD(＜50),□MOD.(50-75), □SEVERE(＞75) TAF-VMAX 1.29 M/SEC(1.0-1.7),PMAX 6.65 MMHG 4.□AR: □MILD,□MOD. □SEVERE, AR-VMAX M/SEC,PG MMHG,LVEDP MMHG 5.□TS: TTF-VMAX M/SEC(0.3-0.7),PMAX MMHG 6.□TR: □MILD,□MOD,□SEVERE.VTR M/SEC,PAP MMHG,PG MHG 7.□PS: □MILD(＜50),□MOD.(50-75), □SEVERE(＞75) TAF-VMAX M/SEC(0.6-0.9),PMAX MMHG 8.□PR: □MILD,□MOD. ,□SEVERE, PR-VMAX M/SEC,PG MMHG,LVEDP MMHG(D).判讀:LVH,CONCENTRIC(左心室肥厚)RIGHT VENTRICULAR ENLARGEMENT(右心室擴大)MVP WITHOUT MR(二尖瓣脫垂無閉鎖不全)NO REGIONAL WALL MOTION ABNORMALITY(無局部心室收縮力異常)112/02/15Report: Indications： Echo machine：Philips IE33 Patient source：OPD 【Atrium and Aortic Root】 AO (mm) = 29 LA (mm) = 36 【Left Ventricle】 IVS (mm) = 10 PW (mm) = 10 EDD (mm) = 48 ESD (mm) = 29 EDV (ml) = 106 ESV (ml) = 32 LV mass (g) = 176 LVEF： by M-mode measurement：69.6 % LV Wall motion: Normal wall motion 【Right Ventricle】 TAPSE＝30mm 【Diastolic function】 Mitral inflow　E/A：81/54 (E/A ratio＝1.5) Septal E/e：5.9； Lateral E/e：5.0； 【Valve】 MS: nil; MR: Mild; AS: nil; AR: nil; TS: nil; TR: Mild; Vmax＝ 2.29m/s＝ 21mmHg PS: nil; PR: nil; 【Other findings】 IVC diameter：mm with sniff collapse ＞ 50% Pericardial effusion：None Intracardiac thrombus：No Congenital lesions：None Abbreviations LA: Left Atrium, LV: Left Ventricle, RV: Right Ventricle.Ao: Aortic Root IVS: Interventricular Septum, PW: Posterior Wall, MS: Mitral Stenosis, MR: Mitral Regurgitation. AS: Aortic Stenosis, AR: Aortic Regurgitation. TR: Tricuspid Regurgitation, TS: Tricuspid Stenosis. PR: Pulmonary Regurgitation, PS: Pulmonary Stenosis 【Conclusion】 1. No cardiac chamber dilatation No LV thickness 2. Normal LV systolic function with normal wall motion 3. Normal RV systolic function with normal wall motion 4. Normal diastolic function. 5. Trivial MR and TR.