敬愛的 吳醫師您好：在下因為曾患感染性心內膜炎造成二尖瓣逆流嚴重，於2021年12月初進行了二尖瓣修補手術，以下是手術前二次及手術後二次的心臟超音波報告，想請您幫忙解讀， 1、今年825的追綜檢查報告是否樂觀？ 2、心臟變大的情形？ 3、平常生活上有沒有需注意的事項？ 4、可以進行慢跑運動來保養身體嗎？謝謝您。 一、20210730手術前 2 BSA 1.9 m Interpretation Summary Eccentric LVH Aortic root dilatation.39mm Left ventricular systolic function is preserved cutoff 60 is normal in severe MR Ruptured mitral valve chordae P2 leaflet.Hx of prior IE ？ Mitral regurgitation severe with pulmonary vein reversal. EROA 0.91cm2？ LVESD 36mm ESDi 19mmm2 No resting pulmonary HTN. consider surgery if LVESD progresses rapidly or over 40mm MMode2D Measurements ＆ Calculations IVSd 1.0 cm LVIDd 6.0 cm FS 40.2  LV massCd 256.4 grams 2 LVIDs 3.6 cm EDVTeich 180.9 ml LV massCdI 134.6 gramsm LVPWd 1.0 cm ESVTeich 54.2 ml LVIDs Index 1.9 cm EFTeich 70.0  RWT 0.34 2 2 Ao root diam 3.9 cm LVOT diam 2.1 cm LVAd ap4 42.9 cm LVAd ap2 38.9 cm 2 LVOT area 3.5 cm LVLd ap4 9.3 cm LVLd ap2 8.8 cm EDVMOD-sp4 167.0 ml EDVMOD-sp2 145.0 ml EDVsp4-el 169.0 ml EDVsp2-el 145.9 ml 2 2 LVAs ap4 25.2 cm LVAs ap2 19.7 cm LVLs ap4 7.4 cm LVLs ap2 7.1 cm ESVMOD-sp4 70.1 ml ESVMOD-sp2 45.9 ml ESVsp4-el 72.2 ml ESVsp2-el 46.7 ml EFMOD-sp4 58.0  EFMOD-sp2 68.3  EFsp4-el 57.3  EFsp2-el 68.0  SVMOD-sp4 96.9 ml SVsp4-el 96.8 ml EDVMOD-bp 175.5 ml SVMOD-sp4 Index 26.7 ml ESVMOD-bp 54.9 ml EFMOD-bp 68.7  Doppler Measurements ＆ Calculations MV E max vel 97.7 cmsec MV dec time 0.18 sec Ao V2 max 119.4 cmsec LV V1 max PG 4.3 mmHg MV A max vel 63.7 cmsec Ao max PG 5.7 mmHg LV V1 mean PG 2.0 mmHg 2 MV EA 1.5 AVAVD 3.0 cm LV V1 max 104.1 cmsec LV V1 mean 64.6 cmsec LV V1 VTI 16.8 cm 2 MR max vel 240.0 cmsec MR PISA 5.7 cm SVLVOT 58.5 ml PA V2 max 79.5 cmsec 3 MR max PG 43.3 mmHg SVLVOT index 30.7 ml PA max PG 2.5 mmHg MR flow rate 219.1 cm sec 2 2 MR mean vel 364.5 cmsec PA acc slope 579.2 cmsec MR ERO 0.91 cm MR mean PG 59.5 mmHg PA acc time 0.13 sec MR volume 117.2 ml MR VTI 128.3 cm MR PISA radius 0.95 cm MR alias vel 38.5 cmsec TR max vel 239.0 cmsec TR max PG 23.7 mmHg Page 1 of 2 Left Ventricle Eccentric LVH. Left ventricular systolic function is borderline reduced. Mitral Valve Ruptured mitral valve chordae posterior leaflet. Mitral regurgitation severe. Great Vessel Aortic root dilatation. Mode 2D Color. 二、2021111手術前 2 BSA 1.9 m Interpretation Summary Eccentric LVH Left ventricular systolic function is preserved Ruptured mitral valve chordae P2 leaflet.Hx of prior IE ？ Eccentric Mitral regurgitation moderate-severe The LV systolic function is normal The left atrium is borderline dilated. Tricuspid regurgitation mild Pulmonic regurgitation mild MMode2D Measurements ＆ Calculations IVSd 0.75 cm LVIDd 6.4 cm FS 36.3  LV massCd 188.0 grams 2 LVIDs 4.1 cm EDVTeich 209.1 ml LV massCdI 98.4 gramsm LVPWd 0.72 cm ESVTeich 73.4 ml LVIDs Index 2.1 cm EFTeich 64.9  RWT 0.22 Ao root diam 3.4 cm ACS 1.9 cm LA dimension 4.3 cm Doppler Measurements ＆ Calculations MV E max vel 103.0 cmsec MV dec time 0.19 sec Ao V2 max 97.0 cmsec PA V2 max 55.8 cmsec MV A max vel 89.7 cmsec Ao max PG 3.8 mmHg PA max PG 1.2 mmHg MV EA 1.1 Ao V2 mean 62.5 cmsec PA acc time 0.20 sec Ao mean PG 1.9 mmHg Ao V2 VTI 19.6 cm TR max vel 165.6 cmsec TR max PG 11.0 mmHg Left Ventricle Eccentric LVH. The LV systolic function is normal. No regional wall motion abnormality was noted. Left Atrium The left atrium is borderline dilated. Mitral Valve Ruptured mitral valve chordae posterior leaflet. Mitral regurgitation moderate to severe. Right Heart The right ventricle is normal in size and function. Normal right atrial size. Tricuspid regurgitation mild. Pulmonic regurgitation mild. Page 1 of 2 Great Vessel Aortic root dilatation. PE There is no pericardial effusion. Mode 2D Color. 三、20221006手術後 2 BSA 1.9 m Interpretation Summary The left ventricle is grossly normal in size and shape. No regional wall motion abnormalities noted. The LV systolic function is normal. sp Mitral valve repair with artificial chordae and annuloplasty ring Moderate mitral regurgitation. Mild tricuspid regurgitation. MMode2D Measurements ＆ Calculations IVSd 0.83 cm LVIDd 5.1 cm FS 44.9  LV massCd 149.8 grams 2 LVIDd Index2.2-3.0 2.6 EDVTeich 126.2 ml LV massCdI 77.1 gramsm LVIDs 2.8 cm ESVTeich 30.5 ml LVIDs Index1.3-2.1 1.5 EFM52F54 75.8  LVPWd 0.83 cm RWT 0.32 Ao root diam 4.0 cm asc Aorta Diam 3.3 cm 2 Ao root area 12.3 cm ACS 2.0 cm LA dimension 4.0 cm Doppler Measurements ＆ Calculations MV V2 max 159.9 cmsec Ao V2 max 92.8 cmsec LV V1 max PG 2.5 mmHg PA V2 max 57.8 cmsec MV max PG 10.2 mmHg Ao max PG 3.4 mmHg LV V1 mean PG 1.4 mmHg PA max PG 1.3 mmHg 2 MV V2 mean 101.8 cmsec LV V1 max 79.5 cmsec PA acc slope 383.8 cmsec MV mean PG 4.7 mmHg LV V1 mean 54.7 cmsec PA acc time 0.15 sec MV V2 VTI 43.4 cm LV V1 VTI 16.6 cm TR max vel 232.3 cmsec TR max PG 21.6 mmHg Left Ventricle The left ventricle is grossly normal in size and shape. The LV systolic function is normal. No regional wall motion abnormalities noted. Left Atrium The left atrial size is normal. Right Heart The right ventricle is normal in size and function. Right atrial size is normal. Mitral Valve sp Mitral valve repair with artificial chordae. An annuloplasty ring is noted in the mitral position. Page 1 of 2 CFMDoppler There is moderate mitral regurgitation. There is mild tricuspid regurgitation. Mode 2D Color. 四、2023825手術後 2 BSA 1.9 m Interpretation Summary The left ventricle is borderline dilated. The LV systolic function is normal The left atrium is mildly dilated. Prior mitral valvuloplasty annuloplasty ring Mitral regurgitation moderate Tricuspid regurgitation mild-moderate MMode2D Measurements ＆ Calculations IVSd 1.0 cm LVIDd 5.3 cm FS 38.6  LV massCd 213.6 grams 2 LVIDd Index2.2-3.0 2.8 EDVTeich 136.3 ml LV massCdI 112.3 gramsm LVIDs 3.3 cm ESVTeich 42.9 ml LVIDs Index1.3-2.1 1.7 EFM52F54 68.5  LVPWd 1.1 cm RWT 0.40 Ao root diam 3.2 cm asc Aorta Diam 3.1 cm 2 Ao root area 8.2 cm ACS 2.1 cm LA dimension 4.3 cm Doppler Measurements ＆ Calculations MV E max vel 180.3 cmsec MV V2 max 198.2 cmsec MV dec time 0.20 sec Ao V2 max 121.4 cmsec MV A max vel 159.1 cmsec MV max PG 15.7 mmHg Ao max PG 5.9 mmHg MV EA 1.1 MV V2 mean 118.8 cmsec MV mean PG 6.5 mmHg MV V2 VTI 49.0 cm LV V1 max PG 2.8 mmHg PA V2 max 58.7 cmsec TR max vel 260.6 cmsec LV V1 mean PG 1.0 mmHg PA max PG 1.4 mmHg TR max PG 27.2 mmHg 2 LV V1 max 83.9 cmsec PA acc slope 394.0 cmsec LV V1 mean 53.9 cmsec PA acc time 0.15 sec LV V1 VTI 16.5 cm Left Ventricle The left ventricle is borderline dilated. The LV systolic function is normal. No regional wall motion abnormality was noted. Left Atrium The left atrium is mildly dilated. Mitral Valve Prior mitral valvuloplasty annuloplasty ring. Mitral regurgitation moderate. Page 1 of 2 Right Heart Tricuspid regurgitation mild-moderate. Mode 2D Color. 近期胸悶、喘 至心臟內科檢查，請醫師幫我看看報告，謝謝您 心臟超音波報告： M-mode and doppler Cardiac chamber sizeWall thickness Aortic root 20-37 26mm LAD 19-40 30mm LVIDd 35-51 34mm LVIDs 28-35 23mm VS 6-10 6mm PW 6-10 6mmDopplerM-mode Mitral EA 1.9 Lat. E' 20.3cms ELat. E' 4.4 •Normal heart chamber size. •Preserved LV and RV systolic function LVEF 62.•Preserved LV diastolic function. Valve MR Minimal. •TR  minimal. oPR mild. Pericardiumtumorother Pericardial effusion  small amount 0.3 cm. 運動心電圖報告： Purpose1V Dx 2  PTCA 3  PTMV 4  Drugs 5  CABG 6  Rehabilitation 7  Arrhythmia 8  Screening 9  Others Pre-excercise ECG Blood Pressure 11779 Medications   Yes V No Patient Fasting  Yes V  No Stage SpeedGradeMPHGrade 1.710 2.512 3.414 4.216 5.18 Minutes 2’ 5’ R2’ R5’ Blood Pressure 12974 14272 15977 12877  Minutes Blood Pressure      Exercise Terminated Because of A. Maximal Effort F.VDyspnea K. Chest tightness B.V90 Maximal Heart Rate Obtained G. Arrhythmia L. Can’t catch-up speed C. ST Segment Shift H. Leg Pain M. Exercise intolerane D. Chest Pain I. Hypotension N. Vasovagal Reponse E. Fatigue J. Dizziness O. Total Time6’25’’ MHR X MSBP 160X 142 22720 Maximal Achieved Rate 160 Maximal Predicated Rate178 90 Predicated Rate 158 INTERPRETATION OF EXERCISE ECG 1.  Normal ECG at maximal effort 2.  Normal ECG at submaximal90predicated heart rate 3.V Normal ECG at ”inadequate” heart rate of 4.  Abnormal ST junction and segment elevated 5.  Abnormal ST segment depression A.Downsloping mm B.Flat mm C.Upsloping mm from j point to at least 0.08 seconds 6.  OtherSpeciafy Comment 1.  Positive 2.V Negative 3.  Inconclusivespecify 4.  Complicationspecify 5.Other 主任不好意思可以麻煩您幫我看一下心超報告嗎：UCG No  LOCATION  Ao 20-37mm 31 mm IVSd2D 7-10mm 10 mm AV 16-26mm 20 mm IVSs2D 7-10mm 10 mm LA 19-40mm 34 mm LVIDd2D 35-53mm 40 mm LAAo mm LVIDs2D 25-36mm 29 mm RVDd 5-21mm mm LVPWd2D 8-11mm mm RVDs 5-21mm mm LVPWs2D 8-11mm mm LVEF M-mode  IVSdM-mode 7-10mm mm LVEF Simpson  IVSsM-mode 7-10mm mm LVEF AFI  LVIDdM-mode 35-53mm mm LVEF 2D  LVIDsM-mode 25-36mm mm GS  LVPWdM-mode 8-11mm mm LVPWsM-mode 8-11mm mm Color and Doppler Findings MV E Vel 84 cms AV Vmax 131 cms MV DecT ms AV maxPG mmHg MV A Vel 58 cms PV Vmax cms MV EA Ratio PV maxPG mmHg E’ Sept cms TR Vmax 10 cms EE’ Sept TR maxPG mmHg A’ Sept cms RAP cms S’ Sept cms RVSP 20 mmHg AR PHTP12t ms IVC Ins mm IVC Exp mm IVC Coll  IVC 1.1 cm 2D and M-Mode findings ARmild MRmild TRmild PRmild Impression 1.Mild AR 2.Mild MR 3.Preserved LV systolic function with LVEF58 4.Normal RV function 5.Normal pulmonary pressure with mild TR and mild PR 6.RVSP20 mmHg 7.IVC1.1 cm 請問主任有AR跟PR正常嗎？之前好像沒有發現過，之前只有MR跟TR，這是有心臟變不好的意思嗎？還有什麼異常嗎？ 另外請教主任剛剛頭暈做了一個Apple watch心電圖httpslurl.ccVrRlX  突然波型變長這算心律不整嗎？就是心跳突然變慢一點的意思嗎？有點擔心再麻煩主任，謝謝您平安 李醫師你好，麻煩您幫我看看心超檢查內容是什麼？有什麼問題嗎？ 非常感謝醫師。 11267 ECHO 經胸前超音波Transthoracic echocardiography M-mode Normal data 1️⃣AortaLA 23-3718-38mm 26  32 2️⃣IVSLVPW 6-12 5-11mm 8  8 3️⃣LV-Diamter DiasSys 36-5220-36mm 48  30 4️⃣LVEDDLVESD Volume 46-10810-54ml 108  35 5️⃣LV SV EF 32-95ml49-76 73  68 6️⃣LVEF Simpson’’s method 4-chamber view  study parametersTSOCHF No A Dilated heart size None Thickening None B Pericardial effusion No Tamponade No C Intracardiac massthrombus No D Mitral flow patternE ＜ A E A DT E Tissue Doppler Velocity Sep e’’ Ee’’ Lat e’’ Ee’’ F Valve lesion AV normal - AS -4 AVAcm2 mean PGmmHg peak PGmmHg - AR -4 VCWmm P12tms MV normal - MS -4 MVAcm2 mean PGmmHg - MR 14 VCWmm jet TV normal - TS -4 TVAcm2 mean PGmmHg - TR 14 PG 19mmHg VCWmm PV normal - PS -4 mean PGmmHg peak PGmmHg - PR -4 1trivial 2mild 3moderate 4severe 5massive 6torrential G Congenital lesion None H LV wall motion Normal I Global LV performance good J Global RV performance adequate TAPSE mm K LV diastolic function abnormal Grade III criteria L Other findings M 2D-Echo Machine Philips EPIC 7 N 住院病人ISBAR交班 No  Conclusion Good LVP and adequate RVP Trivial MRTR  Aoaortic root ARaortic regurgitation ASaortic stenosis EFejection fraction HCVDhypertensive cardiovascular disease IVCinferior vena cava IVS interventricular septum LAleft atrium LVleft ventricle LVPWleft ventricular posterior wall MRmitral regurgitation MSmitral stenosis PR pulmonary regurgitation PSpulmonary stenosis PGpressure gradient RAright atrium RVright ventricle TRtricuspid regurgitation TStricuspid stenosis TAPSETricuspid annular plane systolic excursion VCWvena contracta width. 麻煩醫師幫忙看心超檢查結果是否結構、功能有異常？ 好像有看到舒張功能異常的部份是否嚴重？ 謝謝您！ ECHO 經胸前超音波Transthoracic echocardiography M-mode Normal data 1. AortaLA 23-3718-38mm 26  32 2. IVSLVPW 6-12 5-11mm 8  8 3. LV-Diamter DiasSys 36-5220-36mm 48  30 4. LVEDDLVESD Volume 46-10810-54ml 108  35 5. LV SV EF 32-95ml49-76 73  68 6. LVEF Simpson’’s method 4-chamber view  study parametersTSOCHF No A Dilated heart size None Thickening None B Pericardial effusion No Tamponade No C Intracardiac massthrombus No D Mitral flow patternE ＜ A E A DT E Tissue Doppler Velocity Sep e’’ Ee’’ Lat e’’ Ee’’ F Valve lesion AV normal - AS -4 AVAcm2 mean PGmmHg peak PGmmHg - AR -4 VCWmm P12tms MV normal - MS -4 MVAcm2 mean PGmmHg - MR 14 VCWmm jet TV normal - TS -4 TVAcm2 mean PGmmHg - TR 14 PG 19mmHg VCWmm PV normal - PS -4 mean PGmmHg peak PGmmHg - PR -4 1trivial 2mild 3moderate 4severe 5massive 6torrential G Congenital lesion None H LV wall motion Normal I Global LV performance good J Global RV performance adequate TAPSE mm K LV diastolic function abnormal Grade III criteria L Other findings M 2D-Echo Machine Philips EPIC 7 N  Conclusion Good LVP and adequate RVP Trivial MRTR Tape no Begins   Ends   實驗室號2613 -------------------------------------------------------------------------------- LV-D48 40-56 mm LA 38 25-40 mm PA systolic pressure21 mmHg LV-S29 20-38 mm AO 28 22-40 mm Pericardial effusion mm LVS 11  7-12 mm RV 25 21-27 mm Quality 04 21-27 mm LVPW10  7-11 mm RVW  5- 8 mm Study Difficulty  5- 8 mm -------------------------------------------------------------------------------- LV Function01 RV Function01 -------------------------------------------------------------------------------- Structure MV N TV N AV N PV Regurgitation grading 0-1 3 0-1 3 0-1 3 3 -------------------------------------------------------------------------------- 0. - Normal chamber size is present. 1. - Minimal mitral regurgitation is present. 2. - Minimal tricuspid regurgitation is present. 3. - Minimal aortic regurgitation is present. 4. - A large ”a” wave is present on the left atrial flow curve indicative of 5. decreasd left ventricular compliance. 6. - The ejection fraction of left ventricle is estimated 60 7. - The left ventricle is normal in systolic function. -------------------------------------------------------------------------------- SUPERVISORDOC10429 你好我是二尖瓣膜脫垂患者 超音波檢查，請問醫生這是很嚴重嗎 就是會喘、胸悶、心跳有時會跳很快，心臟會對以後有什麼影響，會自己好嗎。 M-Mode RVD725 13 mm IVSD611 8 mm LVDd3756 40 mm AoRoot2037 25 mm IVS excursion611 mm LVDs2634 27 mm AV.opening1526 17 mm LVPWD611 8 mm EPSS＜5 mm LA940 22 mm LVPW excursion914 mm EF＞53 61  Structure abnormality Pericardial effusion  ☉No ○Yes Ant cm Post cm estimated amount cc 2D-Structure analysis MV  MVP TV  AV  PV  Others -Wall motion analysis normal LV wall motion -EF 55 Color Doppler E＞A mild MR mild TR PG22 mmHg mild AR mild PR PG6 mmHg Comments ID464441. Normal LV wall motion with preserved LV systolic function2. mitral valver prolapse3. mild MRTRARPR 醫師好，2020年心臟超音波檢查，有肺動脈高壓，但是醫師都沒告知，沒開藥，也沒有要我進一步檢查，目前也沒有任何肺高壓症狀，喘，腫，暈，咳通通沒有，也沒有不舒服，這是我的報告Echo No  Chinical diagnosis  M-Mode and Sector scan  Aortic root 2.0-3.7 cm 3.16 LAD 1.9-4.0 cm 4.72 IVS 0.6-1.0 cm 1.33 LVIDd 3.5-5.7 cm 4.44 LVPW 0.6-1.0 cm 1.28 LVIDs 2.8-3.5 cm 2.96 EF 50 - 83   62.2 FS 28 - 44   33.3 RV 0.6-1.0 cm 1.AV  Normal 2.MV  Normal 3.PV  Normal 4.TV  Normal 5.Regional wall motion  Fair 6.Pericardial effusion  Absent 7.Others  8.Global function  9.Technical difficulty  DopplerColor Flow Findings  AR  Mild MR  Trivial PR  None TR  Mild AS None MeanP.G 0.0 mmHG  PeakP.G 0.0 mmHG  AVA 0.00 cm2 MS None MeanP.G 0.0 mmHG  PeakP.G 0.0 mmHG  MVA 0.00 cm2 TS None MeanP.G 0.0 mmHG  PeakP.G 0.0 mmHG  TVA 0.00 cm2 PS None MeanP.G 0.0 mmHG  PeakP.G 0.0 mmHG  PVA 0.00 cm2 Estimated PASP 37 mmHg EA ratio Normal Shunts Others Comment 1. Dilated LA 2. Concentric 請問醫生，這樣我需要進一步檢查或服藥嗎？沒有不舒服。謝謝您 醫生您好 想請您協助判讀該份心臟超音波結果，有無異常與需要注意的地方，謝謝 Conclusion 1. No cardiac chamber dilatation 2. Normal LV systolic function with normal wall motion 3. Normal RV systolic function with normal wall motion 4. Normal diastolic function. 5. Mild TR Data 1 Dimensions thickness and systolic function Aortic root23 mm LA31 mm - IVS8 mm LVpw10 mm LV mass Index77 gm2 Relative wall thickness0.48 LVEDD44 mm LVESD19 mm LVEFM87  2DSimpson  RV TAPSE28 mm - - 2 Wall motion abnormality nil - 3 Diastolic function . Mitral EA1.4 DT143 ms Pul vein SD ＞1 tricuspid EA ＞1 Septal E’’9.84 cms septal EE’’7.8 4 Valvular heart disease Anatomy AV normal MV normal TV normal PV normal AV AS nil Jet velocity1.5 ms - AR nil - MV MS nil - MR nil - TV TS nil TR mild Peak TR velocity ms TR Pressure gradient mmHg PV PS nil PR nil PA systolic pressure mmHg 5 Pericardium Normal effusion none 6 Congenital heart None 7 Others Mass thrombus none IVC diameter ＜2.1cm ＞50 collapse 另外，靜態心電圖結果顯示1.規則竇性節律、2.RSR'波於V2，想請問這代表的意思 謝謝 因最近量血壓突然升高，有時收縮壓衝到165，但在家裡測量時平均大約在110125左右，舒張壓大約在8090左右舒張壓部分是不是偏高 我平時睡眠不是很好，淺眠或失眠容易醒 有時候感覺換氣不順手麻腳麻但是過幾個小時後又好了，不確定是否是因為情緒影響 目前看診的這位醫師沒有多說什麼只有說我的血壓範圍還算正常，回家再持續追蹤就好，就給我一疊報告回家了，我回家後才開始看內容 我能否正常跑跳打籃球運動呢 需要後續再找醫師看診追蹤嗎 心臟超音波報告我看見4. mild TR. 不知道這是什麼意思，會變嚴重嗎很擔心身體會不會出了什麼問題. -----抽血報告----- LDL-C 檢驗值130 較高 T-Cholesterol 檢驗值211 較高 HDL-C 檢驗值62 Glucose 檢驗值83 Estimated GFR 檢驗值6084 僅供參考mLmin1.73m² Na 檢驗值141 K 檢驗值4.6 ALTGPT 檢驗值16 Free-T4 檢驗值0.98 TSH 檢驗值1.852 Cortisol 檢驗值4.04 -----以下24H血壓計報告----- Indication：Suspected hypertension 【findings】 24 hr averge SBPDBP  12278 mmHg hypertension  13585 Averge  awake SBPDBP  12987 mmHg hypertension  14090 Averge  sleep SBPDBP  11366 mmHg hypertension  12575 Nocturnal BP dipping 1020：yes SD  12.824.5 Morning BP surge MBPS：rise in SBP50 andor DBP22 during 6AM   10AM than night BP ：No 【Conclusion】 1. Normal BP with nocturnal dipping. 2. Negative for morning surge. -----以下心臟超音波報告-----  Report  M-Mode Transthoracic evhocardiography Indications： Echo machine：GE Vivid E9 Patient source：OPD 【Atrium and Aortic Root】 AOmm  31 LAmm  27 【Left Ventricle】 IVSmm  8 PWmm  7 EDDmm  49 ESDmm  32 EDVml  115 ESVml  41 LV mass mg  125 LVEF： by M-mode measurement ：65 LV wall motion：Normal wall motion 【Other findings】 Pericardial effusion：None Intracardiac thrombus：No 【Conclusion】 1. No cardiac chamber dilatation 2. No LV wall thickness 3. Normal LV systolic function with normal wall motion 4. mild TR. 醫師您好 我這裡有一份心臟超音波報告想請醫師幫我看一下 臨床診斷 supraventricular tachycardia indication cardiomyopathy or ischemic heart disease cardiologist comments 1. delated RV chamber chamber size RVD21.1MM 正常值10-20 2.MVP with trivial MR 3. FAIR lv function without reginal wall motion abnormality 4. trivial TR PR 5. no pericardial effusion 6. APCS 我自己看主要是有些瓣膜的問題 還有稍微右心房的問題 本身3年前有做過PSVT電燒 最近心跳有點漏拍 掛HOLTER 有7000次心房早期收縮 正在吃律博克 醫師說修養一下次數下來可以慢慢減藥 想請問醫師 我的報告上有寫 Cardiomyopathy or ischemic heart disease 是很嚴重的問題嗎 我一直都是正常運動過生活 因為問了我的主治醫師 他說問題不大 也沒跟我多解釋 所以想來問問其他醫師的看法或建議 預先感謝醫師抽空回覆 醫師您好，麻煩幫忙判讀一下心臟超音波報告∼謝謝您 檢查日期20220315 Conclusion • LA enlargement • Preserved global contractility of left ventricle • LVEF by M-mode is 58.0  • No significant regional wall motion abnormality • Impaired diastolic function of left ventricle • Trivial aortic regurgitation • Mild mitral regurgitation • Mild tricuspid regurgitation • Estimated systolic pulmonary artery pressure is 26 mmHg • EKG Sinus rhythm MMode2D Measurements ＆ Calculations RWT 0.31 Time Measurements MM R-R int 0.91sec MMode2D Value References Ao root diam 2.9cm  2.0-3.8 cm LVIDd 5.0cm  3.7-5.3 cm ACS 1.9cm  1.6-2.6 cm LVIDs 3.5cm  2.4-3.6 cm LA dimension 4.3cm  1.9-4.0 cm EDVTeich 117.4ml  80-180 ml  0.5-2.1 cm ESVTeich 49.3ml  16-83 ml MV E-F slope 3.9cmsec  8.0-15.0 cmsec EFTeich 58.0  50-70  IVSd 0.77cm  0.7-1.1 cm FS 30.7 FS 34-44  LVPWd 0.94cm  0.9-1.1 cm MM HR 65.9BPM  60-100 BPM EPSS ＜0.8 cm COTeich 4.5lmin  2.5-7.2 lm RWT 0.22-0.42 Doppler Measurements ＆ Calculations MV dec slope 205.2cmsec2 Ao V2 max 143.1cmsec Ao max PG 8.2mmHg AI max vel 340.1cmsec LV V1 max PG 1.1mmHg AI max PG 46.3mmHg LV V1 max 52.6cmsec AI dec slope 230.0cmsec2 AI P12t 433.1msec TR max vel 199.7cmsec sPAP 26.0mmHg TR max PG 16.0mmHg MV E max vel 89.5cmsec ＞50y62 ± 14＜50y72 ± 14 MV A max vel 126.4cmsec ＞50y59 ± 14＜50y40 ± 10 MV EA 0.71 sPAP ＜ 35mmHg MV dec time 0.44sec DT 0.16-0.22 sec LV IVRT 0.06sec  0.07-0.09 sec Ventricles • Normal sizes of ventricular chambers • LVEF by M-mode is 58.0  • No significant regional wall motion abnormality • Mitral inflow EA ratio  0.71 • E 89.5 cmsec • A  126.4 cmsec • Septal E’  4 cms • Lateral E’  3 cms Atrium • Increased dimension of LA 請問醫師有遇過周產期心肌病變的產婦嗎？他們的預後如何呢？ 剛生完心臟射出率45-48 兩個月後 心臟射出率54（m模式），57（2D，這樣算很低嗎？會不會又往下掉？ 何主任您好，今年2月2號去健檢中心做全身健康檢查，抽血報告和其他身體狀況都正常，唯獨心電圖顯示竇性心搏緩脈，身體偶爾會感覺懶懶的，其他並無任何不適，不會頭暈，胸悶或喘，10年菸齡，最近正在戒菸，檢查報告顯示 心率53 RR 1132 PR interval 127 QRSD 99 QT 407 QTc 383 ——— P 49 QRS 85 T 59 總膽固醇高密度膽固醇比值3.4 冠狀動脈鈣化指數0 上網爬文了一些資料，說竇性心搏緩脈會增加猝死的機率，實在擔心，請問需要進一步前往心臟門診接受治療嗎？  Report  M-Mode Transthoracic echocardiography Indications  Congestive heart failure Echo machine  GE Vivid E9 Patient source  OPD 【Atrium and Aortic Root A0 mm  29 LA mm  28 【Left Ventricle IVS mm  9 PW mm  9 EDD mm  52 ESD mm  37 EDV ml   127 ESV ml  59 LV mass mg  176 LVEF  by M-mode measurement  54  by 2D simpson measurement  57.5  LVEDVLVESVm18637 LV Wal1 motion Normal wall motion 【0ther findings Pericardial effusion None Intracardiac thrombus No EA  9168 【Conclusion】 1. No cardiac chamber dilatation 2. No LV wall thickness 3. Normal LV systolic function with normal wall motion 4. Mild MR and TR P  17.5 mmhg. 醫師您好，請問這個報告有什麼需要注意的嗎 射血分數這樣會太低嗎？ 續 醫師您好，請問射血分數跟年紀有關係嗎？ 我目前才27歲，這樣是不是太低呢？（很擔心）因為正常值50-70我才54 另請問，因11月底生完被判定周產期心肌病變，那時候射出率是48，隔約2個月現在54，請問這樣是恢復當中嗎？是否還可能變低或慢慢提升呢？ 醫師您好 續問 1.請問醫師m模式跟2D模式差在哪呢？真的搞不懂 2.一般不是都看m模式嗎？ 3.為何兩者模式會差別這麼多呢？ 4.醫師請問您用過的孕婦有這種情況，後續都有慢慢恢復嗎？請問大概恢復區間多久呢？有沒恢復的嗎？ 因剛生完遇到這種病真的很晴天霹靂很擔心很擔心，麻煩醫師回覆了謝謝您 醫師您好 續問 1.請問這樣射血分數會算很低嗎？（正常值是多少呢？）因目前才27歲，醫生是說沒事還年輕會恢復的，且因剛生產完兩個月，吃藥心臟就會慢慢恢復，請問是真的嗎？因為每天都在擔心 2.請問醫師，在檢查心臟超音波的時候，會因為當下很緊張，而影響當下射血分數嗎？（因本身焦慮恐慌嚴重），很怕當下檢查會緊張到不行 謝謝您 以下有兩份報告，麻煩您過目 這是1130的心超 Result  Interpretations and summary  Mildly dilated left ventricle with global hypokinesia left ventricular ejection 47 by area-legnth assessed at bi-plan Normal right ventricular size and contractility estimated RV systolic pressure 30 mmHg normal MR mild-to-moderate AR mild TR mild PR mild Measurement  AO 26.0 AV Opening 16.0 28.0 RV Shape and Motion  Mildly dilated LV LV RWMA Global hypokinesia LA Normal Right Heart Normal Valve and Flow  Aortic valve AV flow Mitral valve E EA1.1 Tricuspid vlave TR Pulmonary valve PV flow Regurgitation AR mild MR mild-to-moderate TR mild PR mild Other  Pericardial effusion No pericardial effusion Pleural effusion No pleural effusion 檢查項目 Echocardiogrpy超音波18005C18007 LA mm mm mm  mm  IVSd 10.1 mm  LVEFM LVPWd 9.2 55.0 mm mm  LVEFA-L 46.6 LVEDD LVOT LVESD 41.8 mm Estimated LV mass 203 Estimated LV mass index 117 LV shape 149.cms Ao PG peak 9.0 mmHg 63.8cms DTE 124. ms 20 mmHg 223.cmsec TRPG 104.cmsec PV acc time 135 mmHg A 60.0cms 129的心超 検查項目M22-051 ECHO CARDIOGRAPHY 查詢列印時間20221209 084703--  Report  Indications  Echo machine  GE Vivid E9 Patient source  OPD Atrium and Aortic Root AO mm  31 LA mm  28 【Left Ventricle IVS mm  10 PW mm  10 EDD mm  50 ESD mm  38 EDV ml  118 ESV ml 61 LV mass g 185 LVEF  by M-mode measurement  48  by 2D simpson measurement  57.63  LVEDVLVESVm18437 LV Wall motion Normal wall motion 【Diastolic function Mitral inflow EA6374 EA ratio0.85 【Valve】 MS nil MR Mild AS nil AR nil TS nil TR Mild Vmax 2.32ms 21.5mmHg PS nil PR nil 【0ther findings Pericardial effusion  None Int racardiac thrombus  No Congenital lesions  None  Abbreviations  LA Left Atrium LV Left Ventricle RV Right Ventricle.Ao Aortic Root 12 21x27CM Cardiac Echo 【Conclusion 1. Global hypokinesis with borderline LV performance. 2. Decreased LV compliance. 3. Mild MR and TR. 問題一：請問我心臟衰竭是不是很嚴重？ 射血分數這樣算很低嗎？ 問題二：請問除了射血分數低之外，報告還有其他問題嗎？ 問題三：醫師有診斷出周產期心肌病變，說是生產引起的心臟衰竭，但是基本上都會恢復，請問您有遇過這樣的產婦嗎？ 因為長期感到胸悶 頭暈 手腳冰冷 故去看心臟科做檢查 分別做了心臟超音波與運動心電圖 因為還有一周多才能回診 想詢問醫師是否方便協助 感謝 心臟超音波檢查結果 Normal LA ＆ LV size Good LV contractility LVEF  64 by M-mode Probable LV diastolic dysfunction MR mild TR mildM-mode LA volume indexBP  LVEFM-mode  64  LVEFarea-length   LV mass  145 gm LV mass index  Ao  30 mm20-37 AV  18 mm16-26 LA  27 mm19-40 RV  mm 5-20 IVS  9 mm 7-10 LVPW  8 mm 8-13 LVEDD  46 mm35-53 LVESD  30 mm20-35 -------------------------------------------------------------------------------- ＜Aorta ＆ Aortic Valve＞ Tricuspid AV ＜Mitral Valve＞ Myxomatous change ＜Left Ventrical＞ No regional wall motion abnormality ＜Right Heart ＆ Septum＞ Nothing Particular ＜Other Findings＞ No pericardial effusion -------------------------------------------------------------------------------- Color Flow Mapping MR  mild TR  mild -------------------------------------------------------------------------------- Doppler Flow Measurement AV peak flow 99 cmSec peak PG 4 mmHg MV e wave 57 mm a wave 65 mm dec. time 275 mSec TR peak flow 133 cmSec peak PG 7 mmHg septal E’ 14.00 cmSec EE’ 4.10 運動心電圖結果 Conclusion  Negative 陰性 Duke Treadmill Score  8 Low risk 5 Intermediate risk 4-10 High risk ＜-10Pre-exercise condition  NYHA Class  Class1  Chest pain  Atypical angina  CCS Class  Class1 Resting ECG  noraml -------------------------------------------------------------------------------- Vital Sign    Resting  12891 HR89  Exercise Stage 1  14873 HR122  Exercise Stage 2  15568 HR147  Exercise Stage 3  16367 HR171  Recovery 0 min  15267 HR169  Recovery 1 min  16873 HR132  Recovery 3 min  13393 HR124  Recovery 5 min  13193 HR117 Reason for termination  DyspneaTarget HRChest discomfort  Exercise time  08 min 16 sec Maximal HR  91 173190 -------------------------------------------------------------------------------- ST change ：  II  -1.2 Upslope  III  -1.0 Upslope  aVF  -1.1 Upslope Event  BP drop- Chest pain- 感謝再麻煩醫師
術後仍有中度的二尖瓣膜逆流，請定期回門診追蹤規則服藥並規律運動。 心臟超音波報告顯示只有極輕度的二尖瓣逆流及輕度的三尖瓣逆流，心臟的其他功能及構造正常。 運動心電圖報告顯示為正常。 您好 超音波 Apple watch心電圖都是正常喔 別擔心 平安 彰化醫院關心您 根據妳的心臟超音波報告，心臟並無大礙，頂多就是舒張功能異常，這可能是年紀所導致的變化，不用太在意。 但由於我並未直接診視妳，相關問題還是要經由妳的看診醫師解釋比較恰當。 您好 心超結果大致正常，不必多慮 平安 衛福部彰化醫院關心您 報告顯示有輕微的二尖瓣、三尖瓣及主動脈瓣逆流，心臟的收縮功能及其他結構都正常。 您好， 根據所述，心臟除輕微二尖瓣膜脫垂，無明顯瓣膜閉鎖不全，心臟構造及功能大致正常，繼續臨床追蹤即可. 建議與您信任的醫師諮商 平安 衛福部彰化醫院關心您 根據妳的心超報告，的確是符合肺高壓的診斷。進一步的檢查可以查看看是否有其他肺部疾病或是血栓疾病或是風溼免疫科的疾病。 肺高壓若沒有症狀，其實不一定要用藥，因為肺高壓的用藥多數副作用都很明顯，只有在利明確大於弊的情況才會使用。 肺高壓的治療複雜，大多都是醫學中心才會成立專責小組追蹤病人的情況。 您好 根據您提供的心臟超音波結果，整體上看起來是一個正常的心臟超音波結果，並沒有明顯的異常或需要特別注意的地方。心臟大小、收縮舒張功能及瓣膜功能都正常。輕度的三尖瓣逆流現象，通常沒有大礙。 心電圖結果規則竇性節律是正常的。RSR'波於V2可以是正常，有時可能與一些心臟疾病有關，例如冠心病或心臟肥大。因此，建議您諮詢您的醫生，看是否需進一步評估。 輕度的三尖瓣逆流對心臟功能不會有影響，建議調整生活作息，並規律運動。 您好 我也覺得問題不大 觀察即可 別擔心 平安 彰化醫院關心您 報告顯示：心臟收縮功能正常，僅有輕度的左心房擴大以及輕度二尖瓣跟三尖瓣逆流。 54已經在正常範圍，如果不放心可以再半年或一年後再追蹤。 您好 竇性緩脈53很好啊 會增加猝死的機率沒有吧 沒這回事 不需要進一步門診 沒事 別擔心 戒菸就好 平安 彰化醫院關心您 您好 這個報告正常 別擔心 平安 彰化醫院關心您 您好 才2 個月就明顯回升 是恢復當中很好啊 還可能慢慢提升 給他一點時間回復吧 54不會太低 別擔心 平安 彰化醫院關心您 您好 m模式跟2D模式差在哪 是測量方式不同 非專業搞不懂正常 簡單說是一維和2 維 的測量 一般說3D就是3維 要不是仙丹一吃就好 給一點時間恢復吧 8 成在3個月到半年會明顯改善 為您禱告 會好 的 平安 彰化醫院關心您 1.正常的左心室收縮功率為50以上，建議定期追蹤即可。 2. 不會。 您好 問題一：心臟衰竭不是很嚴重 射血分數不算很低 by 2D  57.63  不低 問題二：除了射血分數之外，其他還好 問題三 當然有遇過這樣的產婦 您不是罕見 別擔心 平安 彰化醫院關心您 心臟超音波顯示心臟構造及功能正常，僅有輕度的二尖瓣及三尖瓣脫垂。運動心電圖結果顯示正常。