心臟血管專科檢查報告分析及建議-心臟血管專科

有關心臟不適及臉、頭部問題？

何醫師您好，一年半以前我胸口發麻、下巴刺痛、左肩及左手臂疼痛、左手手指極為手腕痠痛；接著出現右邊頭皮發麻及右臉頰發麻，所以陸續前往兩家大型醫院檢查心臟及腦部。
心臟的部分兩位醫師都說沒有問題，可是我很不舒服、所以有去做胃鏡檢查（有胃食道逆流）；也會有上腹痛（剛好也有做斷層掃描 但內臟器官醫師告知沒有問題），頭部的部分有一項電臉部傳導到腦幹的檢查有問題，所以做了腦部核磁造影，醫師也說沒有問題，甲狀腺的部分也沒問題。
用藥後有減緩但沒有完全消失（偶爾會發作）。
上個月因為睡眠問題困擾，其實一直都有、但前陣子嚴重許多（基本上我很難入睡、睡著了也只能睡3-4小時），沒幾天 我的左臉、左頭皮、右臉、右頭皮開始發麻，也有左眼瞼及左手手指不自覺抽蓄，接著我的兩頰也會痠痛，之後開始我的胸口又開始發麻、左邊牙齒疼痛、左邊內耳抽痛、左肩（斜背包包的地方）及左手腕手指又開始疼痛。
請問 我需要再前往心臟專科做其他檢查嗎？
例如心導管檢查？
我左邊的疼痛不曉得是否與我習慣像濟公臥姿（臥左邊）把身體的重量都給了肩膀和手肘，也習慣是側睡。
牙齒及下巴的部分，我有發現我會不自覺咬牙切齒及舌頭頂牙齒，不知是否有關聯呢。
因為一直就醫可是沒有確切的結果，身體的疼痛很困擾，文章偏長 十分抱歉，還請醫師能指點一二，感恩；同時也附上檢查資料。
沒有糖尿病、血壓會在115-130/78-90，但體重偏重？
膽固醇沒有紅字。
第一家心臟超音波M-Mode: RVD(7~25): 32 mm IVSD(6~11): 11 mm LVDd(37~56): 40 mm AoRoot(20~37): 30 mm IVS excursion(6~11): mm LVDs(26~34): 25 mm AV.opening(15~26): 19 mm LVPWD(6~11): 9 mm EPSS(＜5): mm LA(9~40): 38 mm LVPW excursion(9~14): mm EF(＞53%): % Structure abnormality: Pericardial effusion : ☉No ○Yes Ant: cm, Post: cm, estimated amount cc 2D-Structure analysis MV: Normal TV: Normal AV: Normal PV: Normal Others: -Wall motion analysis: Normal LV wall motion -EF :72~% Color Doppler: Mild MR Comments: 1. Normal LV wall motion, LVEF 72%2. Mild MR第二家心臟超音波# 120 Clinical Dx: M-mode+Section Scan : Aortic Root(20~37 mm): 30 LAD(19~40 mm): 38 LVIDd(35~51 mm): 44 LVIDs(28~35 mm): 28 VS(6~10 mm): 10 PW(6~10 mm): 10 Comment : (M-mode,2-D, Doppler ＆ Color Flow Mapping) ● Normal heart chamber size. ● Preserved LV and RV systolic function,LVEF= 66 % ● Preserved LV diastolic function: E/A= 1.1, Em/Am= 1.2, Em= 12.4 cm/s, E/Em= 7.4. MR: Minimal. TR: Minimal. PR: Mild. ● Other: (V ) Poor acoustic window.腹部斷層掃描Wgole Abdomen CT with ＆ without IV-contrast enhancement study plus CTU shows:＞ Slight dilatation of right pelvicalyceal system and partial ureter, no obvious hyperdense ureteral stone or soft tissue lesion identified.＞ Diffuse mild fatty liver.＞ No definite abnormal attenuation or enhancing mass lesion in the liver, spleen, pancreas, gallbladder, or kidneys. Few right renal cysts.＞ Within normal appearance of the appendix and bowel loops. ＞ Clear peritoneal fat without obvious ascites.＞ Maintained bony structure without definite fracture.＞ Degenerative change with spur formation at thoracolumbar spine.＞ No definite enlarged para-aortic or mesenteric LN.＞ No active pulmonary lesion at included lungs noted.Impression:1. Slight right hydroureteronephrosis, r/o occult stone or ureteral stricture in distal portion, or inflammation.2. Mild fatty liver.Clinical correlation and follow-up recommended.腦部核磁造影The supine position superconductive 1.5T brain MRI with surface coil was performed for this suspect trigeminal neuragia patient. the pulse sequences including axial T1WI, T2WI, SWI and FLAIR. coronal and axial thin 1mm slice thickness posterior fossa T1WI and T2WI studies.no intravenous gadolinium was given. the axial functional brain images ( DWI and ADC maps) were also performed. Findings:1.no focal mass lesion, no abnormal signal intensity change nor midline shifting seen within the brain parenchyhma. 2.no acute intracranial hemorrhage is seen.3.the intracranial vessels still show normal flow voiding.4.the ventricular size is normal 5.clear appearance of bilateral paranasal sinuses and bilateral mastoid antri. 6.bilateral cerebellopontine cisterns and parasellar regions show no focal mass lesion; the cisternal segments of bilateral trigeminal nerves are well-seen. no external compressive mass effect nor displacement occurs.7.the axial functional whole brain images ( diffusion weighted images and ADC maps) show no acute ischemic infarction, no acute inflammatory lesion nor tumor mass lesion. 8.the 3D intracranila T.O.F MR angiography shows no vascular malforamtion or saccular aneurysm. no apparent focal vessel luminal stenosis or flow interruption occurs. Impression: bilateral cerebellopontine cisterns and parasellar regions show no focal mass lesion; the cisternal segments of bilateral trigeminal nerves are well-seen. no external compressive mass effect nor displacement occurs. the axial functional whole brain images show no acute ischemic infarction, no acute inflammatory lesion nor tumor mass lesion. the 3D intracranila T.O.F MR angiography shows no vascular malforamtion nor apparent focal vessel luminal stenosis redundant course. suggest correlate clinically and regular follow up.