心肌缺血檢查是否必要？-心臟血管專科

中度心肌缺血？

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何醫生您好：
我最近有去醫院做（壓力與重分佈心肌斷層灌注掃描）並於回診回去看報告
當時醫生僅說心肌有中度缺氧狀況，直接問我是否要做心導管檢查！
我在健保App查到我的報告，想請您幫我看看報告的結果。

HISTORY AND INDICATIONS: 1. Non-exertional chest tightness/dyspnea, relief after resting, r/o CAD, for functional evaluation and risk stratification 2. Baseline ECG: sinus rhythm/Inferior infarct, old RISK FACTORS: H/T(+); DM(-); Hyperlipidemia(+); Smoking(+); Family History(-) PROCEDURES: 1. Gated myocardial perfusion scan was performed with intravenous infusion of 13.16mCi and 33.0mCi of Tc-99m MIBI at rest and peak-stress. 2. Stress was undertaken by vasodilator-stress with intravenous infusion of 0.56 mg/kg of persantin. 3. No significant discomfort are noted during persantine stress. 4. BP(basal-＞peak): 115/75 -＞ 107/68; HR: 69 -＞ 91 FINDINGS: 1. Stress/rest perfusion abnormalities: positive - Grade: moderate - Size: medium - Reversibility: partial - Segments: apical-mid-basal inferolateral, apical inferior and basal-mid inferoseptal segments 2. Semi-quantitative perfusion scores: SSS=8, SRS=3, SDS=5 3. Wall motion study for poststress: normokinesis; rest: normokinesis 4. Post-stress LVEF= 61%, rest LVEF= 62% 5. LV cavity size: medium; Stress-induced LV dilation (TID): negative 6. Stress-induced transient lung uptake: negative 7. Stress-induced heart rate increase: positive 8. Coronary calcifications on the co-registered CT images: severe CONCLUSIONS: 1. The perfusion images may suggest moderately myocardial ischemia involving the apical-mid-basal inferolateral, apical inferior and basal-mid inferoseptal segments of LV. 2. The functional analysis revealed normal LV systolic function without regional wall motion abnormality. 3. Flow-limiting CAD involving the territory of RCA/LCX may be considered. SUGGESTIONS: Further clinical correlation is recommended. ABBREVIATIONS: SSS=Summed Stress Score; SRS=Summed Rest Score; SDS=Summed Difference Score ”HIGH-RISK” INDICATORS: 1. Extensive and/or severe reversible myocardial perfusion defects. 2. Transient ischemic dilation of the LV. 3. Transient lung reuptake after stress. 4. Ischemia in the setting of prior myocardial infarction. 5. Substantially reduced LVEF on poststress MPI or decrease in LVEF between poststress and rest gated MPI study. 6. Pattern of stunned myocardium on poststress MPI. Thank you for the opportunity to evaluate your patient.
請何醫師替我看看報告的內容，是否真的需要心導管檢查，謝謝。

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黃先生，50~59歲男性，詢問日期：2024/12/11