S***h 发帖数: 173 | 1 和去年的核肌灌注运动测试比较(台湾的翻译可能, 是注射了药液, 然后跑步测试。
), 医生说按片子来看, 今年的结果像是运动后大面积心肌缺血。 加上和医生说过
, 最近几个月, 胸闷, 胸口有疼痛感, 医生建议做心血管造影,有问题当场就做支
架。
心脏的事情有点担心, 几点疑问是:
1.医生的推断主要是根据今年的测试结果。 但是, 去年的测试表明, 没有任何问题
, 特别是血管堵塞的情况, 一年的时间会造成很严重的心血管堵塞么? (平时运动
少, 饮食油腻)
胸口闷和疼痛还可以通过什么其他的手段确诊?
2. 年龄不到三十,还有什么其他的选择么? 如果决定做支架,以后会有什么问题或并
发症么? 有人和我建议说有种64位的什么技术, 可以比较精确的做出判断,但保险公
司不包。 请问美国这个技术普遍么? 是否值得做这个测试?
3. 医生说造影和支架现在很普遍。 因为没经历过, 还是有点担心美国这边临床的支
架经验和技术。 需要在去看一下其他的心脏科医生(for second opinion)么? 通过什
么手段可以知道某位医生在其领域的水平如何呢?
下周就要做了, 请各位给些建议。 谢谢 |
S***h 发帖数: 173 | 2 医生的报告里的一段话:
Exercise Stress Myocardial Perfusion Imaging With Single Isotope SPECT:
Protocol: The patient had myocardial perfusion imaging performed using a
same day protocol, with injection of 9 mci of TC-99m Sestamibi at rest, and
the injection of 30 mci of TC-99M Sestamibi at stress. Imaging was
performed by gated SPECT techniques.
Finding: No artifact is seen. Moderate anterior, inferior and inferolateral
reversible ischemia. Transient ischemic dilatation is absent. LVEF is
calculated at 57 |
gq 发帖数: 321 | 3 based on your stressed myocarcia study, you have multiple coronary artery
stenosis..
stent placement is a choice但时间久了支架也会再狭窄..
given your age, a contrast CT with 3D reconstruction may be suggested
to rule out some anatomic variances..
go and discuss with a cardiac specialist.
and
inferolateral
【在 S***h 的大作中提到】![](/moin_static193/solenoid/img/up.png) : 医生的报告里的一段话: : Exercise Stress Myocardial Perfusion Imaging With Single Isotope SPECT: : Protocol: The patient had myocardial perfusion imaging performed using a : same day protocol, with injection of 9 mci of TC-99m Sestamibi at rest, and : the injection of 30 mci of TC-99M Sestamibi at stress. Imaging was : performed by gated SPECT techniques. : Finding: No artifact is seen. Moderate anterior, inferior and inferolateral : reversible ischemia. Transient ischemic dilatation is absent. LVEF is : calculated at 57
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S***h 发帖数: 173 | 4 Thank you, GQ.
在想去再找为医生for second opinion, 但是其他的医生可能也会要求做这个跑步测试
, 短期内做两次一样的测试, 保险公司可能不会批。
【在 gq 的大作中提到】![](/moin_static193/solenoid/img/up.png) : based on your stressed myocarcia study, you have multiple coronary artery : stenosis.. : stent placement is a choice但时间久了支架也会再狭窄.. : given your age, a contrast CT with 3D reconstruction may be suggested : to rule out some anatomic variances.. : go and discuss with a cardiac specialist. : : and : inferolateral
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S***h 发帖数: 173 | 5 有其他variance可能性大概有多大呢?
看作支架的都是六七十岁的人, 现在做这个, 很担心对将来的影响。
【在 gq 的大作中提到】![](/moin_static193/solenoid/img/up.png) : based on your stressed myocarcia study, you have multiple coronary artery : stenosis.. : stent placement is a choice但时间久了支架也会再狭窄.. : given your age, a contrast CT with 3D reconstruction may be suggested : to rule out some anatomic variances.. : go and discuss with a cardiac specialist. : : and : inferolateral
|
gq 发帖数: 321 | 6 shouldn't be this case.
你可以把这次的检查给他看,不应该重做一次的
【在 S***h 的大作中提到】![](/moin_static193/solenoid/img/up.png) : Thank you, GQ. : 在想去再找为医生for second opinion, 但是其他的医生可能也会要求做这个跑步测试 : , 短期内做两次一样的测试, 保险公司可能不会批。
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S***h 发帖数: 173 | 7 GQ, 你熟悉这个跑步测试么? ---Exercise Stress Myocardial Perfusion Imaging
With Single Isotope SPECT
准确性怎么样? |
f******I 发帖数: 769 | 8
Imaging
CT contrast is not standard of care,
of all the non-invasive cardiac tests there are false positive and false
negative, so your pre-test probability should factor into how you make your
decesion,
nowadays left heart cath is fairly easy to do with minimum risk, plus i was
told when the contrast being infused you will have the sensation of rush
that is better than sex,
【在 S***h 的大作中提到】![](/moin_static193/solenoid/img/up.png) : GQ, 你熟悉这个跑步测试么? ---Exercise Stress Myocardial Perfusion Imaging : With Single Isotope SPECT : 准确性怎么样?
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S***h 发帖数: 173 | 9 Can anyone please recommend a good cardiac specialist in New York City area?
Thanks in advance! |
S***h 发帖数: 173 | 10 Yifanbbs fatman?
Anyway, thanks for your input.
I am thinking to see another doc for second opinion. What is good way to
search for a good cardiac specialist? Any web site?
your
was
【在 f******I 的大作中提到】![](/moin_static193/solenoid/img/up.png) : : Imaging : CT contrast is not standard of care, : of all the non-invasive cardiac tests there are false positive and false : negative, so your pre-test probability should factor into how you make your : decesion, : nowadays left heart cath is fairly easy to do with minimum risk, plus i was : told when the contrast being infused you will have the sensation of rush : that is better than sex,
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S***h 发帖数: 173 | |