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】
: 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
|
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】
: 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
|
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】
: 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】
: 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。
|
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】
: 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？
|
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】
:
: 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,
|
S***h
发帖数: 173 | |
