I Can See Health

On the second floor of the emergency room, please stay in the observation room.

Although the hiccupping uncle was sent to CCU, Cheng Peng still couldn't figure it out.

Why does myocardial infarction lead to intractable hiccups without the patient having obvious chest pain symptoms?

"I don't quite understand either." Although Wang Xiaodong is a superior doctor, he has only just started working. He has not seen many rare cases like this, so naturally he doesn't know the reasons.

Cheng Peng thought for a while and sent Lu Chen a WeChat message to ask about the rationale.

Lu Chen received the WeChat message and quickly replied.

"I suspect that hiccups caused by myocardial infarction may be due to the fact that most elderly patients have varying degrees of cerebral arteriosclerosis and hypoautonomia (reduced sensitivity to pain)."

"Especially when patients have diabetes, pain and sensory nerves will be damaged, causing necrotic myocardium to stimulate the vagus nerve, causing only hiccups without chest pain."

"In other words, it's not that there is no chest pain, but that the patient's pain sensation has subsided and he can't feel the pain."

Cheng Peng finally understood something after reading Lu Chen's explanation.

"Myocardial infarction manifested as hiccup is really rare!" Cheng Peng sighed.

Lu Chen added, "Actually, in addition to hiccups, there are other uncommon symptoms that may also be manifestations of myocardial infarction. For example, toothache, headache, neck pain, frozen shoulder, and even worse. , it was a headache in my toes, and it was finally found to be myocardial infarction.”

"In short, no matter what the chief complaint is, a detailed physical examination and medical history are very important. In addition, there is also an electrocardiogram on admission. All these things are brought together, and finally we can peel off the cocoons and make an accurate diagnosis."

…

After experiencing this somewhat rare patient, the emergency internal medicine outpatient clinic ushered in a short window period.

It's already ten o'clock in the evening.

In the night sky, the stars nodded.

There are fewer and fewer people on the streets.

Except for the hospital not far away, which was still brightly lit, it was dark all around.

Lu Chen was sitting in the emergency clinic.

Although the emergency department is very busy, he feels that he is just a tool.

As long as you listen to the superior doctor, there is no need to use your brain at all.

This is not in line with Lu Chen's style at all.

He came to the emergency department, but he came to exercise.

If you don’t treat patients in person, you can’t get thank you points!

I have been working as a tool, but I have wasted so many resources.

"Mr. Wang, why don't you let me do the patient's physical examination and consultation later?"

Lu Chen volunteered.

"Huh?" Wang Xueyang raised his eyebrows.

This was the first time she heard such a request from a student!

Wang Xueyang hopes that students can help take her place.

But the reality is that most students are not very reliable!

Let the students have a physical examination, and auscultation of the heart and lungs is a problem.

It's not as fast as coming by yourself!

You know, the emergency department has a heavy flow of patients.

If you delay for a few minutes, the patient and family may start shouting and quarreling!

However, Wang Xueyang thought about it.

Lu Chen could make such a request on his own, and considering his previous performance, he should not be an unreliable student.

"Okay, for the next two patients, you will ask about their medical history and conduct physical examinations." Wang Xueyang said, "I'll take a look first."

Students who have this kind of thinking should of course be encouraged.

Besides, if Lu Chen could really take her place, she would be much more relaxed that night!

"Okay." Lu Chen smiled.

Finally got a chance to meet patients.

It's only ten o'clock in the evening, if the next patients are all treated by him.

Then his efficiency in earning gratitude points and improving system upgrades will definitely reach a higher level!

…

As soon as the two of them finished talking, a patient with abdominal pain walked into the emergency room.

Abdominal pain is one of the most common types of emergency room visits.

This time, it was Lu Chen's turn to receive the treatment.

The patient is a middle-aged man in his thirties.

His face was red and he smelled of alcohol.

However, the man is now covering his head with a painful expression on his face.

Lu Chen quickly helped the family members move the patient to the bed.

"Why do you feel uncomfortable?"

The middle-aged man pointed to his stomach, "It hurts... it hurts..."

Lu Chen asked about the medical history and started a physical examination.

From the origin, inducement, location and nature of abdominal pain, whether there is transfer pain, radiating pain, and ways to relieve it, everything is detailed.

At the same time, Lu Chen was also checking the patient's abdominal signs, including tenderness, rebound tenderness, etc.

Wang Xueyang on the side looked at Lu Chen's actions and nodded with a smile.

This kid is really good!

Whether it was a consultation or a physical examination, everything was performed perfectly.

This professional skill is not like a first-year graduate student at all.

For example, consultation is the simplest clinical skill.

However, many medical students don't pay much attention to it. They just ask whatever they want, or they don't have any rules, so they can easily miss a lot of things.

But Lu Chen was different. He could ask questions clearly from the main symptoms to accompanying symptoms, as well as the negative and positive differential diagnoses.

The most important thing is that there is no unnecessary nonsense.

In the shortest possible time, he was able to gain first-hand information about the patients.

"Teacher, the patient has tenderness under the xiphoid process and no rebound tenderness. The rest of the physical examination is normal."

“What about auscultation of the heart and lungs?”

"It's all normal."

…

After seeing two patients in a row, Wang Xueyang felt relieved.

Lu Chen could really do the physical examination on her behalf.

This is what Wang Xueyang dreams of.

With a student to help her, her night would be much easier.

"Lu Chen, next, you continue to see patients, I will be by your side, and I will give you hints when you encounter areas that you don't know how to do."

"Okay, thank you, Teacher Wang." Lu Chen smiled.

Through his own efforts, he was finally able to see patients in person.

However, the next patient made Lu Chen's expression change.

…

This is a woman wearing a black headscarf.

She was supported by a young man and slowly walked into the consulting room.

Her face was pale, the expression on her face was extremely painful, and she moaned in pain from time to time.

"Doctor, I keep complaining that my stomach hurts!" the young man shouted as he walked into the consulting room.

The middle-aged woman next to him was holding her stomach while reading a book.

"I have a stomachache, please give me pain relief!"

Lu Chen's pupils narrowed.

If he remembered correctly, this woman wearing a black headscarf seemed to be the "vampire" he met when he went to the temple to pray!

Wang Xueyang saw that this female patient was in a hurry and did not intend to let Lu Chen come to treat her. She wanted to come and treat her in person.

She quickly walked to the female patient.

But the first time she saw the patient, she was frightened.

This woman's whiteness is not the delicate whiteness of her skin, but a sickly whiteness!

There were large scars on her ears and nose, which looked like they had been corroded.

And her teeth are those kind of fangs!