I Can See Health

Remember [new] in one second! Lu Chen easily took the electrocardiogram.

There are five electrocardiograms in total, which were completed before and after the patient became ill.

At this time, Sun Guoguo's voice came from beside his ears.

"Junior brother, this is the patient who came yesterday."

"Young female, 22 years old, suffered from recurrent heart palpitations for 1 month, which worsened for 2 days and was hospitalized."

"She gave birth to a boy one month ago and denies family genetic history."

…

The patient's medical history was brief, containing only a few sentences.

Lu Chen stared at the electrocardiogram with all his concentration.

"Currently, the patient has recurrent ventricular tachycardia and ventricular fibrillation. He has been given rescue treatments such as amiodarone, lidocaine and electrical cardioversion, but his condition still has not improved significantly."

After saying that, Sun Guoguo sighed and said, "She just gave birth to a baby. I don't know if she can survive it. It's so pitiful."

Lu Chen sighed slightly in his heart, but said nothing and continued to study the electrocardiogram in front of him.

The patient's electrocardiogram before onset was in normal sinus rhythm, with occasional premature ventricular contractions.

But the electrocardiogram at the time of onset was all ventricular fibrillation or ventricular tachycardia.

"Senior sister, what did you think about this electrocardiogram?" Lu Chen put down the electrocardiogram and looked up at Sun Guoguo.

"Well, the patient's electrolyte after admission showed low potassium of 3.02umol/l, which may be ventricular tachycardia and ventricular fibrillation caused by low potassium." Sun Guoguo said, "But the strange thing is that we actively supplemented potassium and the potassium ions returned to normal. , the patient’s symptoms have not improved significantly, and ventricular fibrillation and ventricular tachycardia still occur frequently.”

Ventricular fibrillation is an extremely malignant arrhythmia. Sustained episodes are likely to cause hemodynamics in the human body and even sudden death.

"Senior sister, what medicine did you use?" Lu Chen paused and asked.

"Amiodarone, lidocaine, these anti-arrhythmic drugs were all used." Sun Guoguo said, "In addition, electric defibrillation was also used many times."

Amiodarone is a broad-spectrum antiarrhythmic drug that is very common in cardiology.

In other words, more than 95% of clinical arrhythmias, whether ventricular or atrial, can be treated with amiodarone.

The drug has a wide range of indications and is quite effective, so amiodarone is a panacea drug in clinical practice.

So much so that in medical examination questions, if there is an option for amiodarone, you can basically choose it, and the accuracy rate is extremely high.

However, Lu Chen pondered for a moment, frowned and said, "Senior sister, you may have used the wrong medicine!"

"Ah?" Sun Guoguo was slightly startled, "Which medicine was used wrong?"

"Amiodarone!" Lu Chen's words made Sun Guoguo suddenly stunned.

Amiodarone used incorrectly?

Is it wrong to use amiodarone for patients with ventricular fibrillation and ventricular tachycardia?

Sun Guoguo picked up the electrocardiogram and compared it carefully, but still found nothing abnormal.

At this time, Lu Chen's voice came again: "Senior sister, look at the patient's QT interval in this electrocardiogram. Is there anything abnormal?"

"Qt interval..." Sun Guoguo muttered silently and shifted his gaze to the Qt interval on the electrocardiogram, "This Qt interval seems a bit long?"

Seeing this, Sun Guoguo was suddenly stunned.

Could it be ventricular tachycardia caused by prolonged qt interval?

That is tdp (torsade de pointes)!

Lu Chen saw Sun Guoguo's expression and knew that she had thought of this.

"Sister, this electrocardiogram, I feel it is probably tdp caused by long qt interval!"

There are many types of ventricular tachycardia.

Most types of ventricular tachycardia and ventricular fibrillation can be treated with amiodarone.

Only ventricular tachycardia caused by long QT interval is a contraindication to the use of amiodarone!

In this case, amiodarone should not be used.

Amiodarone can cause further prolongation of the QT interval and aggravate the patient's condition.

Thinking of this, a trace of cold sweat broke out on Sun Guoguo's forehead.

She didn't consider this at first, but after Lu Chen mentioned it, she immediately figured it out.

They previously defaulted to conventional ventricular tachycardia and ventricular fibrillation, but ignored the situation of long Qt interval leading to ventricular tachycardia!

I took the wrong medicine for a day!

Not only is there no therapeutic effect, but it may worsen the condition.

"Xiao Fang, go and ask the nurse to stop the amiodarone pumped into bed 31! Then use magnesium sulfate!" Sun Guoguo quickly said to the intern on the side, "Forget it, I'll go there myself!"

TDP not only requires potassium supplementation, but also polarizing solution magnesium sulfate to fight arrhythmia!

After saying that, Sun Guoguo left the office angrily.

Lu Chen put down the electrocardiogram in his hand and followed closely.

…

In the ward.

Sun Guoguo is instructing the nurse in the ward to stop amiodarone and use magnesium sulfate while supplementing potassium.

"Doctor, why do you need to stop this medicine?" the patient's husband asked nervously.

"Because of his condition, I will explain to you later." Sun Guoguo said.

At the same time, Lu Chen also came to the ward.

In his eyes, the health value on the patient's head is 38 (---)!

Medication treatment has been continued, but the patient's health trend is still three minus signs.

This means that the current medications may not have any effect.

After the nurse changed the patient's dressing, the patient's husband followed Sun Guoguo and left the ward.

…

In the ward corridor.

Sun Guoguo patiently explained the condition to the patient's husband.

"Doctor, are you saying that my wife's arrhythmia is a relatively rare one?" the man said.

Sun Guoguo nodded and said, "Well, amiodarone can be used for routine ventricular tachycardia and ventricular fibrillation, but your wife's arrhythmia is relatively rare, so amiodarone cannot be used, and the risk of sudden death is extremely high!"

As soon as he finished speaking, the patient's husband "plopped" and knelt down.

His eyes were already red, and he tightly pulled the cuffs of Sun Guoguo's white coat. His hoarse voice had a hint of crying: "Doctor, please, save my wife! I will repay you even if I am a cow or a horse. "

Sun Guoguo quickly stepped forward and grabbed the patient, "Don't do this, we will do our best!"

Lu Chen also turned away, feeling slightly uncomfortable.

Even though he was used to seeing separation between life and death in the hospital, seeing this scene still made him feel a little uncomfortable.

"It's my fault!" The patient's husband was still unable to kneel down, holding his hair tightly with one hand. "It's my fault! She is usually not in good health, but I still insist on giving her the child. I'm not good!"

The man's emotions seemed to erupt like a flood, and a feeling of regret and grief spread in his heart.

Sun Guoguo was at a loss for a moment.

Seeing this, Lu Chen stepped forward, grabbed the man's arms, pulled him up, and said sternly: "Now is not the time for you to be sad! You need to stay with the patient 24 hours a day. If there is any illness, If there are any changes, you should inform the medical staff at any time.”

Although nurses will make frequent ward rounds, they cannot be at the bedside 24 hours a day.

The man silently wiped away his tears and finally stopped kneeling.

He nodded hard and looked at Lu Chen and Sun Guoguo, "Thank you doctor!"

Then with heavy steps, he turned and walked towards the ward.

…

Back to the doctor's office.

Sun Guoguo breathed a sigh of relief and looked at Lu Chen with grateful eyes, "Junior brother, thank you."

At the same time, her eyes were a little sad.

Lu Chen said: "Sister, don't think too much. This patient is young, I think there should be hope."

"I hope so." Sun Guoguo said softly.

The prolongation of the qt interval on this electrocardiogram is very subtle.

Many doctors in the department have looked at it, but no one can find it.

There is nothing wrong with following conventional treatment methods.

But no one could have imagined that behind the ventricular tachycardia, there was a bigger trap hidden.