I Can See Health

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Director Li Yao was the only one present who smiled. She looked at Lu Chen and said, "Continue talking."

Lu Chen nodded, wondering if it was because of the "clinical insights" he received last time.

He quickly sorted out all the patient's information in his mind and began to integrate and analyze it.

"Judging from the symptoms, the patient's chest pain, chest tightness, heart failure and other symptoms may be caused by hypertrophic cardiomyopathy."

"However, the diagnosis of hypertrophic cardiomyopathy is still somewhat sloppy. Similar myocardial changes may occur in other diseases. It is not necessarily caused by primary genetic inheritance, but may also be myocardial hypertrophy caused by acquired diseases."

Lu Chen had always been puzzled until he saw the patient's body shape.

"Look at the patient, he has a typical moon face and buffalo back."

When Lu Chen said this, everyone was even more surprised.

"Have you ever seen a full moon face or a buffalo back?" Lu Chen looked at Wei Zhongwen standing aside.

Wei Zhongwen nodded, "I've seen it in books, but I haven't seen it in reality."

Lu Chen said seriously: "If I guess correctly, the patient in front of me has a typical full moon face and buffalo back."

Logically speaking, a buffalo back and a full moon face are not uncommon.

But everyone's attention is not on this, but on the heart and myocardium.

So when Lu Chen proposed a full moon face and a buffalo back.

Everyone was very surprised. After looking at everyone carefully, many people began to nod again.

In particular, the patient's limbs are thin and small, which is similar to some patients who have been taking hormones for a long time.

Central obesity and thin limbs all around are the result of the redistribution of protein and fat.

Lu Chen continued: "The patient has either been taking hormones for a long time, or the hormone levels have increased due to diseases in the body."

But the patients and their families were stunned for a while.

"I have never taken hormones!" the patient said immediately.

Lu Chen smiled and said, "That's right, that means you may have a hidden disease."

"This disease is constantly secreting hormones. Excessive secretion of hormones will cause your blood sugar to rise, lead to your blood lipids to rise, and lead to central obesity like a moon face and a buffalo back."

"More importantly, it can also cause heart damage and cause cardiac hypertrophy."

Lu Chen finally spoke up.

"Is the patient suffering from Cushing's syndrome?" Wei Zhongwen couldn't help but ask.

Any doctor or medical student, you just have to mention moon face and buffalo back to him.

He must have thought of Cushing's syndrome because it is so classic.

The so-called Cushing's syndrome refers to a general term for diseases caused by excessive secretion of glucocorticoids (hormones for short) from the adrenal glands due to various causes.

Many diseases can cause the adrenal glands to overproduce hormones, so this is a syndrome rather than a specific disease. The most common cause is a pituitary tumor, followed by tumors of the adrenal gland itself.

"Well, that's what I thought about it." After Lu Chen finished speaking, he looked at Li Yao, waiting for her to express her stance.

I saw a bright smile on Li Yao's face.

It seems that she is very satisfied with Lu Chen's analysis, "Yes, if it weren't for the reminder from the family, I would have ignored the patient's central obesity. If you look carefully, the patient's skin is also relatively thin, which all reminds me It’s Cushing’s syndrome.”

Everyone looked at the patient's skin and marveled.

"The patient's skin really looks thinner and more transparent."

Everyone believed in Li Yao and Lu Chen's analysis.

Moreover, it can explain all the positive symptoms of patients from beginning to end, including high blood pressure, hyperlipidemia, hyperglycemia, central obesity, cardiac hypertrophy, thin skin, etc.

Especially the patient's high blood pressure. According to the patient himself, he has not been able to control it well after changing many medications. On the one hand, it is related to his irregular medication, and of course, it may also be related to the disease itself.

…

Next, Li Yao used easy-to-understand metaphors to tell the patients and their families about the disease.

The pituitary gland and adrenal glands are both endocrine organs of our body.

Among them, the pituitary gland is the leader and the adrenal gland is the subordinate.

Therefore, if the patient really has Cushing's syndrome, the next step is to find out whether there is a problem with the pituitary gland, the leader, or with the adrenal gland, a subordinate.

"Director Li, how should we check for this disease next?" the patient's wife asked nervously.

Li Yao did not answer directly, but turned back to look at everyone.

"Where is the pituitary gland? The pituitary gland is inside our brain. Where is the adrenal gland? As the name suggests, it's right above our kidneys, almost right around our waist."

"No matter where the problem is, the first priority is to determine whether the patient has Cushing's syndrome."

…

The patients and their families had mixed feelings after hearing that they had Cushing's syndrome.

Fortunately, Director Li Yao said that if it is a simple tumor, it can be cured by just cutting it off.

Sadly, it is also possible that cancer causes excessive secretion of hormones, which can be tricky.

On the same day, a blood test was arranged to check related hormones, and blood hormone levels were also checked for three periods of time.

They are the blood hormone levels at 16:00 in the afternoon, 0:00 in the morning, and 8:00 in the morning of the next day.

The purpose of such separate examinations is to see whether the hormone secretion in the patient's body is still regular.

…

Li Yao is worthy of being the director of the department. Not only this case, but every subsequent case, she analyzed it very well.

Point out all the things that people usually don’t think of.

Seemingly difficult cases are analyzed step by step, and finally a correct diagnosis and the best treatment measures are obtained.

After checking the ward, Dong Hao was finally found.

Dong Hao was lying on the hospital bed, and Li Yao's expression was also stunned.

Lu Chen immediately explained: "Teacher, Senior Brother Dong Hao had a panic attack before and was diagnosed with paroxysmal supraventricular tachycardia. This time he came to the hospital for radiofrequency ablation surgery."

Li Yao understood.

"You just graduated from the Department of Cardiology. Xiaodong, you should be very familiar with this disease, right?"

Dong Hao gave a bitter smile, "Director Li, I feel like I am living a typical case. I compared every symptom of mine with the book, and everything seems to be right!"

"Don't worry too much. UUReading www.uukanshu.net" Li Yao smiled, "The technology of radiofrequency ablation is now very mature, and there are very few side effects and complications."

"Yes, I know, Director Li." Dong Hao nodded slightly.

However, Li Yao frowned and said: "But, Xiaodong, I still have to remind you that after surgery, there is a risk of recurrence. Because we cannot eliminate all abnormal pathways!"

For some people, paroxysmal ventricular appeal recurs within a few months or a few years after surgery!

"Don't worry, Director Li, Junior Brother Lu Chen has told me all these surgical precautions," Dong Hao said.

Even if it is the most familiar friend, these communication records are indispensable, and all need to be signed by the patient or guardian.

…

Li Yao's ward round lasted for a full hour and a half.

it is finally over!