I Can See Health

"Dr. Fan, what's wrong?"

Lu Chen looked at Fan Zhiping who was walking in front of him strangely.

Didn't he go to treat patients?

"This electrocardiogram..." Fan Zhiping took out the electrocardiogram and placed it in front of Lu Chen's desk. "It always feels weird, but I can't say why it's weird."

Lu Chen lowered his head and looked at the electrocardiogram.

His first impression was that he did not see P waves, but there were small F waves of different shapes, so this was atrial fibrillation.

However, it doesn’t look like atrial fibrillation!

Because the heart rhythm of atrial fibrillation is absolutely uneven, but the heart rhythm of this electrocardiogram is neat!

…

Ke Yue is now also very interested in electrocardiograms.

Ever since Director Lin Cui severely criticized her, she has worked hard to learn electrocardiography.

After two months of hard work, my ability to read electrocardiograms has improved greatly.

She put her head in front of Lu Chen and immediately looked confused.

"Isn't this atrial fibrillation?"

No p-waves were seen, but the small, sawtooth f-waves were clearly visible.

This is one of the most important ways to identify atrial fibrillation.

Atrial fibrillation is an eternal pain in Ke Yue's heart.

She was sure that the electrocardiogram in front of her was definitely atrial fibrillation!

However, such a simple electrocardiogram.

As the deputy chief physician of the Department of Cardiology, Fan Zhiping couldn't possibly not see it!

Ke Yue's words also attracted other people in the group.

Sun Guoguo happened to be okay and came to Lu Chen's side and picked up the electrocardiogram on the table.

"This is..." Sun Guoguo raised her eyebrows, "This electrocardiogram is really strange! There is no P wave, but there is the small F wave of atrial fibrillation, but the heart rhythm is regular."

It looked like atrial fibrillation, but when I thought about it, it didn't look like it!

"With a consistent heartbeat?"

Ke Yue was stunned and quickly looked at the electrocardiogram again.

Sure enough, the heart rhythm is regular, that is to say, the time between each beat of the heart is the same.

This completely violates the electrocardiographic characteristics of atrial fibrillation.

…

This electrocardiogram is really strange, and so far, Lu Chen has no clue.

This was the first time he saw this kind of electrocardiogram.

"What's the condition of the patient?" Lu Chen looked up at Fan Zhiping with the electrocardiogram.

"This is a heart transplant patient." Fan Zhiping paused and began to tell the patient's medical history.

Patient, male, 61 years old.

In 2014, he was diagnosed with coronary heart disease, atrial fibrillation, cardiac insufficiency, and type 2 diabetes.

In the first half of this year, the patient received a heart transplant due to end-stage heart disease. The patient underwent the bicaval technique, which preserved the recipient's left atrium and great vessels and removed the right atrium and ventricle.

Postoperative outpatient review was conducted regularly, and the heart donor did not have any relevant past medical history. The patient experienced acute cellular rejection 7 months after transplantation.

"Heart transplant?" Lu Chen frowned.

Heart transplant patients are still rare.

Generally speaking, a transplanted heart can last about five years.

After understanding the patient's medical history, the patient still had no thoughts about this electrocardiogram.

Sun Guoguo also shook his head.

"I can't tell what the electrocardiogram is yet. I can only wait for Teacher Li's ward rounds tomorrow and ask her for her opinion."

Lu Chen nodded, that was all he could do now.

But he was a little unwilling to do so.

He has been studying electrocardiogram for so long and will not give up easily.

The more difficult the electrocardiogram was, the more passionate and motivated Lu Chen became.

…

Twenty minutes later.

Junior Sister Xiao Yu, who helped Fan Zhiping, returned to the doctor's office with a stack of examination sheets.

"Brother, these are some results of the patient's last review."

"Okay, thank you." Lu Chen nodded and began to look through the patient's previous auxiliary examinations.

Cardiac ultrasound: left ventricular ejection fraction was 60%, right ventricular function was normal, tricuspid and mitral valves had moderate regurgitation, and left atrium was severely dilated.

According to the medical record, the patient had no symptoms of palpitations, chest pain or dyspnea recently during his last follow-up visit in the outpatient clinic, and there were no positive signs in the physical examination.

"Where is his medication?" Lu Chen asked.

“There’s a medication list at the end.”

Lu Chen turned directly to the end.

The patient is currently taking medications regularly: tacrolimus 1 mg po bid, sirolimus 4 mg po qd, prednisone 3 mg po qd, bisoprolol 1.25 mg po qd, and rivaroxaban 15 mg po qd.

(Note: po means oral administration, qd means once a day, bid means twice a day)

Among them are immunosuppressants, hormones, anticoagulants, and drugs to improve cardiac function after heart transplantation.

The patient's medication is relatively routine.

"The patient did not feel any discomfort when he came to the hospital this time. It was mainly for review." Fan Zhiping added at the side.

"Yeah." Lu Chen nodded.

He synthesizes all test results, as well as the patient's medical history.

However, the diagnosis of the patient's electrocardiogram was still not apparent.

Fan Zhiping suddenly whispered: "How about I send this electrocardiogram to the Jinghua Electrophysiology WeChat group so that everyone can discuss it?"

"Okay." Lu Chen said, "Relying on the collective wisdom, maybe we can come up with ideas."

Seeing that Lu Chen agreed, Fan Zhiping took a photo of the electrocardiogram and sent it to the Jinghua Electrophysiology WeChat group.

…

Jinghua Electrophysiology Exchange Group.

People in the group send ECG questions every day.

There are easy ones and there are also more difficult ones.

Lu Chen often speaks in the group before the national skills examination.

However, since preparing for the exam, he has not been in the group for more than a month.

On the contrary, Fan Zhiping can be said to be one of the most active people in the group. He is usually very enthusiastic about helping others answer electrocardiograms or discussing academic issues about electrocardiograms with everyone.

After Fan Zhiping posted this strange electrocardiogram to the group, it immediately attracted the attention of most people.

"Lao Fan, isn't this atrial fibrillation?"

"Yes, it's obvious atrial fibrillation! Why did you send this electrocardiogram to check?"

As soon as Fan Zhiping posted it in the group, someone couldn't wait to speak.

However, before Fan Zhiping could explain, someone raised a question: "Look carefully, everyone, the heart rhythm of this electrocardiogram is regular! Are you sure it's atrial fibrillation?"

"Hey, from what you said, it seems so."

"Judging from the P wave, it's atrial fibrillation, but judging from the heart rhythm, it's not!"

"Think about it, if it was just a picture of atrial fibrillation, Lao Fan wouldn't show it to us!"

“This should be @Professor Lu!”

"..."

Everyone in the group was talking about it, but they didn't say anything about it.

After Lu Chen looked through the WeChat chat history, he found no useful information.

He could only put the electrocardiogram aside for the time being, and look through the electrocardiogram data again when he returned to his dormitory.

…

Fan Zhiping held the electrocardiogram in his hand, but felt quite helpless.

As soon as he came to the eighth district of the heart, this electrocardiogram gave him a disincentive.

Fortunately, the electrocardiogram is somewhat difficult.

Otherwise, this would make everyone underestimate the cardiology department in Feng M County.

However, just one day after arriving, Fan Zhiping could feel that the academic atmosphere in the Eighth District was much stronger than that of the county hospital.

The doctors at their county hospital spend all their free time talking about stocks and options. How can they discuss academic issues?

If someone can take the initiative to look through internal medicine books, he is considered a good person.

However, in the Eight Districts of Jinghua Second Hospital, if everyone encounters any problem that they do not understand, they will immediately look up relevant information or even find literature to solve the problem, and discuss it together to find the answer to the problem.

These are things that doctors from county hospitals cannot compare with!

Fan Zhiping felt something in his heart.

Although he felt a little helpless, he also tried to pick up books and documents to slowly enrich himself.

In this profession of doctor, you really have to live and learn.

…

After getting off work at noon, Lu Chen packed a meal in the canteen.

Returning to his dormitory, he began to look up the electrocardiogram data while eating.

The knowledge of electrocardiogram is vast, far more than what he has mastered now.

However, his current electrocardiogram reading skills are only at a basic level.

In the system mall, intermediate skills cannot be exchanged for the time being. Only when you unlock a higher-level mall, you may be able to redeem higher-level skill cards and skill books.

Now, Lu Chen could only rely on his own efforts to slowly unearth information related to this strange electrocardiogram from the data in the electrocardiogram.

About half an hour later.

Other people in the dormitory also came back from lunch one after another.

"Lu Chen, are you back so early today?"

Wang Zihao walked up to Lu Chen and patted him gently on the shoulder.

"Well, I need to check something." Lu Chen smiled, "I just packed the food back."

"You are really fascinated by electrocardiograms. You are holding the electrocardiogram book and starting to chew on it."

Wang Zihao also admired Lu Chen.

Some people are not only talented, but they also work harder than you!

Originally I wanted to play a few games before going to bed, but Wang Zihao thought it would be better to read some literature before going to bed!

Otherwise, the gap will become wider and wider.

"Hey, Lao Wang, you don't play games anymore?" Another roommate said in surprise, "A new hero just came out. He's so powerful! Don't you want to try it?"

Wang Zihao curled his lips and said, "I read the skill introduction. Isn't this just a combination of two hero skills in another game, UU Kanshu www.uukanshu.net? It's just a suture monster. It's nothing fun. Just play."

"All right."

The other two roommates can only play in double queue.

…

However, the speaker has no intention, but the listener has intention.

When Lu Chen heard what Wang Zihao said about the suture monster, an inspiration suddenly flashed in his mind.

"Two heroes combined, Stitch Monster..."

"Two hearts, heart transplant..."

When he looked at the electrocardiogram that "looked like atrial fibrillation" again, he suddenly had an enlightenment!

"I see!"

Behind the silent heart, there is another wonderful world.

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