主任對不起打擾您，最近躺著心律70-80一起來就會變到100-110，走一走就會105-120，坐回床上就會降回80-90 這是有可能是什麼心律不整嗎？本身有點焦慮體質，還是我這樣的心跳是正常的，還是有可能是姿勢式的心律問題，目前備用藥只有心律錠跟贊安諾需要時吃，以下有去年跟今年的報告這是今年二月的HOLTER EKG Code No. Clinical diagnosis Technical quality of record Good Dominant rhythm Sinus Total Beats 107704 Min HR  43 BPM at 063346 sinsu bradcyardia Avg HR  75 BPM Max HR  154 BPM at 132547 sinsu tachcyardia PVCscoupletsTripletsVT 76000 PACscoupletsAT  3300 Dropdelay＞2.0secLate  00 Longest N-N  1.6 sec at 080951 【Conclusion】  Sinus rhythm with a rate ranging 43154 bpm and a mean of 75 bpm.  Rare isolated PACs.  Rare isolated PVCs.  No significant long pause. 這是一年前的HOLTER EKG DATE OF 24-HOUR RECORDING Study for ARRHYTHMIA ANALYSIS RESULT 1 Quality of recording GOOD 2 Dominant rhythm SINUS 3 Total Beats 112778 beats 4 Minimum heart rate 45 beatsminute 015623 sinus bradycardia 5 Average heart rate 80 beatsminute 6 Maximum heart rate 158 beatsminute 132821 sinus tachycardia 7 VPC couplet triplet bigeminy 236000 8 APC couplet AT 5400 longest beats bpm at  9 VT idioventricular rhythm 00 10 Ventricular pause ＞ 2 seconds 0 COMMENTS  sinus rhythm with mean HR 80 BPM min 45BPMMax 158 BPM  Rare isolated APCs  few isolated VPCs 0.2  No significant long pause. 今年二月的心臟超音波Report Indications： Echo machine：Philips IE33 Patient source：OPD 【Atrium and Aortic Root】 AO mm  29 LA mm  36 【Left Ventricle】 IVS mm  10 PW mm  10 EDD mm  48 ESD mm  29 EDV ml  106 ESV ml  32 LV mass g  176 LVEF： by M-mode measurement：69.6  LV Wall motion Normal wall motion 【Right Ventricle】 TAPSE＝30mm 【Diastolic function】 Mitral inflow　EA：8154 EA ratio＝1.5 Septal Ee：5.9； Lateral Ee：5.0； 【Valve】 MS nil MR Mild AS nil AR nil TS nil TR Mild Vmax＝ 2.29ms＝ 21mmHg PS nil PR nil 【Other findings】 IVC diameter：mm with sniff collapse ＞ 50 Pericardial effusion：None Intracardiac thrombus：No Congenital lesions：None  Abbreviations  LA Left Atrium LV Left Ventricle RV Right Ventricle.Ao Aortic Root IVS Interventricular Septum PW Posterior Wall MS Mitral Stenosis MR Mitral Regurgitation. AS Aortic Stenosis AR Aortic Regurgitation. TR Tricuspid Regurgitation TS Tricuspid Stenosis. PR Pulmonary Regurgitation PS Pulmonary Stenosis 【Conclusion】 1. No cardiac chamber dilatation No LV thickness 2. Normal LV systolic function with normal wall motion 3. Normal RV systolic function with normal wall motion 4. Normal diastolic function. 5. Trivial MR and TR. 今年二月的運動心電圖Treadmill Exercise Test Report Treadmill Bruce Protocol 1 Resting EKG：Sinus arrhythmia. 2 Exercise duration：13 min 11 sec Max. METs 17.4 3 Stress tension：Resting HR initially 59 bpm rose to a max. HR of 160 bpm which represents 102 of the maximal age-predicted HR. 4 Exercise provoked ST-T change：Nil 5 Exercise provoked arrhythmia：Nil 6 BP change：13683 to 21672 mmHg 【Interpretation】 1. Adequate exercise loading. 2. Negative for ischemia. 3. Isolated PVCs and ventricular couplet noted during recovery stages. 這是109年的心臟超音波Report IVS 9 mm LVEDD 47 mm LVESD 31 mm PW 8 mm EF by Linear method 63  Sinus of Valsalva 26 mm Left Atrium 23 mm 1.Heart size dilatation of  nil 2.Pericardial effusion nil 3.Valvular measurement MS  nil MR  nil AS  nil AR  nil TS  nil TR  nil Vmax  ms Max. gradient  mmHg PS  nil PR  nil 5.Mitral EA    cms EE’’ med  lat  aver . 6.Others IVC diameter 10 mm with inspiratory collapse ＞50  Doppler ＆ ECHOCARDIOGRAPHIC REPORT Rhythm and Appearance . Sinus tachycardia Left ventricle . Systolic function Normal . Wall motion Normal . Diastolic function Normal Right ventricle . Systolic function Normal 這是110年的心臟超音波M-Mode Data 1.IVS 11 mm6-11 5.RVD mm7-23 9.A.O root 30 mm20-37 2.LVPW 10 mm6-11 6.LVEDV ml76-115 10.LA 32 mm19-39 3.LVEDD 49 mm36-57 7.LVESE ml39-48 11.EPSS mm 4.LVESD 30 Mm20-36 8.EF 70 64-83 Doppler and Color flow Findings 1.MS Mean PG mmHg Pt12 MSEC mva  cm2 2.AS mild ＜50 mod 50-57 severe ＞75 Mean PG mmHgPeak PG  mmHg 3.MR ■ mild □ moderate □ severe 4.AR □ mild □ moderate □ severe 5.TR □ mild □ moderate □ severe PG  mmHgPASP  mmHg 6.PR □ mild □ moderate □ severe 7.MV flow E 87 cmS A 56 cmS EA  1.5 Interpretation 1.Normal LV and LA size 2.Normal LV wall thickness 3.Preserved LV gross systolic function the estimated EF70 4.No regional wall motion abnormality 5.Trivial MR 再麻煩主任我的心臟這樣會有問題嗎？我真的每天都在擔心心臟生活已經有點灰暗了…已經影響我的生活了，不是心跳快就是有點漏拍，再來就焦慮恐慌了…麻煩主任您了…對不起報告有點多，給主任的專業開導我真的會比較放心，再麻煩主任幫我看看有何問題，還需要做什麼檢查嗎？謝謝何主任真的謝謝您平安
您好 很好啊 漏拍的量也不多 心超運動心電圖 24小時都是正常的 簡單的說 您的心臟比我的好 沒事 心跳快不會怎麼樣 別擔心 平安 彰化醫院關心您