心房顫動與心臟衰竭患者是否需接受侵入式心導管檢查？-心臟血管專科

一定要做侵入式的心導管檢查嗎？

請教醫生：因本身有心房顫動以及心臟衰竭指數稍高，已吃普栓達、臟得樂、得安穩、耐比洛、使排通錠控制，目前心率穩定控制在60-70 血壓、血糖、三酸甘油酯等都在正常範圍，沒有胸痛、胸悶等症狀，但日前醫生安排運動心電圖、心肌灌注掃描，TECHNIQUE: Following the intravenous injection of 2 mCi of Tl-201 Chloride after intravenous administration of dipyridamole (Persantin) 0.56 mg/kg in 3-5 minutes, SPECT imaging of the heart was performed using a Cardiac-centered CZT camera with ECG gating (8-frame acquisition). After an equilibration period of approximately 3-4 hours, the patient was imaged in a similar fashion while at rest. Single photon emission tomograms of left ventricle were reconstructed in horizontal and vertical long axis, as well as short axis projections. Bull’ s eye analysis was performed on paired, registered (stress/redistribution) short axis images. Data of ECG-gated SPECT were analyzed and displayed. SCINTIGRAPHIC FINDINGS: (1) Perfusion defect of the left ventricle (LV) is noted: * Mild-to-moderate perfusion defect at basal anterolateral wall, with reverse redistribution ＆ partial reversibility. (2) Lung uptake is normal. * Lung-to-heart ratio of stress: 0.27 * Lung-to-heart ratio of rest: 0.28 (3) Extent of perfusion defects by Bull’s eye analysis: * Stress → rest: LAD: 8%→ 4%, LCX: 0%→ 0%, RCA: 0%→ 0%. * Reversible defect: LAD 3%, LCX 0%, RCA 0%. * Fixed defect: LAD 5%, LCX 0%, RCA 0%. * Total perfusion defect: stress 4%; rest 2%; reverse 2% * Severity of perfusion defects: SSS of 0, SDS of 0. (4) ECG-gated SPECT results: * Stress/Rest LVEF: 71%/67%. * No obvious wall motion abnormality. IMPRESSION: Positive MPI study is summarized below: (1) Mild-to-moderate ischemia at basal anterolateral wall. (2) Stress/Rest LVEF: 71%/67%; No wall motion abnormality. (Remark) * MPI (myocardial perfusion image) focused on LV of heart. Report報告出爐後，原就診醫生建議進一步做心導管檢查，想請問，我的狀況有嚴重到需要做侵入式心導管檢查嗎，因為我平日沒有胸痛、悶、喘等症狀。