I Can See Health

Li Yao's expression remained unchanged. She had encountered this kind of patient many times. She patiently explained: "First of all, as long as you want to extract a tooth, you not only need to lower your blood pressure before surgery, but you also need to do a regular electrocardiogram to evaluate the heart condition; secondly, toothache is not a problem." It must be a problem with the teeth themselves, or the pain may be caused by heart disease.”

"Ah? I heard that heart disease is caused by chest pain or chest tightness. Could heart disease also cause toothache?"

A trace of doubt flashed in the eyes of the man in front of him.

"Besides, I have never had heart disease before, and neither have my parents!"

Li Yao shook her head slightly: "The sudden onset of heart disease does not necessarily mean that there is any past medical history. Moreover, many diseases do not have one symptom. A small number of patients with coronary heart disease have symptoms, which is toothache! So now you not only need To lower blood pressure, you also need to do an electrocardiogram to rule out heart disease.”

"Then make one!" The woman on the side said immediately, "This electrocardiogram is not expensive. When we make an electrocardiogram, it is like buying peace of mind. If there is a problem, we will solve it. If there is no problem, then that is the best. !”

The man ignored the woman and said to Li Yao: "Doctor, as long as my blood pressure comes down and the electrocardiogram is fine, can I extract the tooth?"

"Yes." Li Yao nodded, "The blood pressure is stable and the heart is fine, then the tooth can be extracted!"

"Okay, then I'll do an electrocardiogram!"

Seeing the patient's consent, Lu Chen immediately typed out an electrocardiogram application form and a prescription for antihypertensive drugs.

"Then go quickly." Li Yao said, "The electrocardiogram room is in the next building."

The patient in front of him nodded with his family members, and then left the clinic together.

…

After the patient left, Li Yao looked at Lu Chen appreciatively.

"Yes, ask for medical history more carefully. For patients with toothache like this, be sure to ask about the history of heart disease. Many patients with heart disease may not necessarily have chest pain, but may have toothache, sore throat, shoulder pain, or even worse, It’s a headache!”

The heart itself has no pain-sensing nerves.

Once the myocardium is ischemic due to coronary heart disease, many metabolic products, such as lactic acid and other substances, will accumulate.

These metabolites stimulate the autonomic nerves of the heart, and the stimulation signals are transmitted to the spinal cord center through the autonomic nerves.

Different people have slightly different spinal cord segments, so the pain symptoms of coronary heart disease also vary.

Since the afferent segments of cardiac autonomic nerves are usually the afferent segments of sensory nerves in the left chest and left upper limb, most patients with coronary heart disease present with left chest or left upper limb pain.

However, if the afferent segment of the cardiac autonomic nerve is too high, it may manifest as toothache or jaw pain.

In the same way, if the afferent segment is low, it may manifest as upper abdominal pain and be mistaken for a symptom of a digestive tract disease.

Some people may also experience shoulder and back pain.

Lu Chen nodded, "Yes, I understand, teacher."

Although his clinical career was short, he encountered many heart disease patients.

All kinds of strange complaints may be myocardial infarction!

It is impossible for every patient to fall ill according to the typical symptoms in the textbook, so some rare diseases and symptoms must not be ruled out.

…

Finish handling this patient.

This is Li Yao's last patient this morning.

It is now eleven o'clock, Li Yao's clinic has been closed, and no one else can call her outpatient number.

"We'll sit down for another half an hour before getting off work. We won't see new patients now, but some patients need to see their test results in the morning." Li Yao said, "We'll wait for them."

Lu Chen nodded slightly and sat next to Li Yao like a good student.

"How have you been in Corey during this time?" Li Yao suddenly asked.

"Fortunately, although I am a little busy, I can learn a lot of knowledge." Lu Chen said.

"I heard that you also taught yourself cardiac ultrasound?" Li Yao smiled, "Isn't this easy? It's not easy to still have time to learn ultrasound technology when you are so busy in clinical practice."

Lu Chen smiled and said: "I only know a little bit about it, and I don't know how to read many heart sections."

"Well, it's better to be humble." Li Yao said, "When you go to CCU for rotation, you will have professional ultrasound equipment and you can train at any time."

The current portable ultrasound in the eight regions of the heart is a small, castrated version of the ultrasound machine.

Professional cardiac ultrasound machines can more accurately determine the patient's condition.

"Teacher, it will be a long time before I go to CCU." Lu Chen said.

Li Yao said: "Well, where will you go to the next department?"

"In a month and a half, you should go to the emergency department." Lu Chen thought for a while and said.

"You went to the emergency room so soon?" Li Yao was stunned, "I thought you were going to breathe or digest! But it's okay to go to the emergency room and exercise. It will have a lot of benefits for you in the future."

While the two were talking, the toothache patient just now also came back.

In addition to his wife, there was also a young doctor in a white coat who walked into the clinic with him.

"Director Li, is this your patient?" The young doctor stepped forward anxiously, holding an electrocardiogram in his hand.

"He is my patient." Looking at his expression, Li Yao's face darkened.

Could it really be a heart attack?

"Director Li, please take a look at the electrocardiogram quickly." The young doctor handed the electrocardiogram to Director Li.

Li Yao looked down, and Lu Chen also leaned his head over.

"The anterior leads are all elevated!"

Both of them were shocked.

You won’t know if you don’t check, but you’ll be shocked if you check!

The patient's electrocardiogram showed extensive short ST elevation in the precordial leads.

No wonder doctors in the EKG room have to bring patients in person.

There is now a possibility of acute anterior wall myocardial infarction!

Li Yao immediately said to the patient: "There is something wrong with the electrocardiogram. We are considering the possibility of acute myocardial infarction!"

The man became anxious upon hearing this, "Are you kidding me? I...I have a heart attack?"

The patient's wife was also a little overwhelmed.

"Uncle, don't get excited yet." Lu Chen hurriedly stepped forward and said, "We are just suspicious now. You need to go to the hospital for further examination."

At this time, the doctor in the electrocardiogram room took out a critical value register and asked Li Yao to sign on the register.

The man hesitated for a moment, "I don't feel much pain anymore. Do I have to be hospitalized?"

Li Yao took a deep breath, held back her temper, and said slowly: "I'll just say it directly. If your current situation is diagnosed as acute myocardial infarction, it will be very dangerous."

After speaking, Li Yao also looked at the patient's wife.

"Acute myocardial infarction, the risk of sudden death is very high!"

The woman nodded quickly: "Doctor, I will take a photo of this electrocardiogram and send it to a medical student at home."

"There is no rush to take photos. The most important thing now is to get hospitalized as soon as possible and further improve the relevant examinations. If there is a myocardial infarction, emergency surgery is required!" Li Yao said solemnly.

Lu Chen also continued to emphasize the dangers of myocardial infarction to patients and their families!

"Doctor, what do you think we should do now?" The woman bit her lip, with a sad look on her face.

"Now transfer to the emergency department and ask the emergency department to send nurses and doctors to accompany you to the CCU ward for hospitalization." Li Yao said.

Although the outpatient building is only a few hundred meters away from the eighth inpatient department, there is no guarantee what will happen during this period.

When encountering such emergency patients, they must be accompanied by emergency department nurses and doctors.

"Then I'll listen to you and go live!" the woman nodded.

After the patient and his family agreed, Lu Chen took them to the emergency department.

After explaining the condition to the emergency department doctor, the emergency department doctor on duty immediately became alert and gave the patient a quick troponin screening test.

Three minutes later, the results came out.

Troponin positive!

Myocardial infarction has been diagnosed!

The emergency department immediately dispatched doctors and nurses, UU Reading www.uukanshu． net brought rescue supplies and sent the patient to the CCU!

…

This side of the outpatient clinic building.

Lu Chen and Li Yao breathed a sigh of relief after receiving this information.

I can finally get off work with peace of mind.

"It's almost time to get off work."

Li Yao smiled. She suddenly took out an envelope from her carry-on bag and handed it to Lu Chen.

Lu Chen subconsciously took the envelope and paused before reacting.

Boy, what a thick envelope!

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