I Can See Health

Remember [new] in one second! Everyone in the ward stared at Lu Chen closely, as if they wanted to see the answer from Lu Chen's face.

Fan Zhiping frowned deeply, guessing that the diagnosis must be wrong.

However, from another perspective, everyone has almost guessed the diagnosis, why is it still not correct?

At this moment, Lu Chen smiled slightly and pulled out the patient's electrocardiogram from the medical records.

"Brother Fan, look at this electrocardiogram, what's so special about it?" Lu Chen smiled.

Fan Zhiping frowned and took the electrocardiogram.

He watched and studied the patient's electrocardiogram many times.

"Severe poor R-wave progression in precordial leads v1-v3." Fan Zhiping glanced at Lu Chen.

Lu Chen nodded slightly, "Yes, what about other characteristics?"

"Other characteristics..." Fan Zhiping paused, "The electrocardiogram qrs wave complex has severe low voltage."

He studied it carefully and could no longer see any other problems.

Is there something else hidden in this electrocardiogram?

Unexpectedly, Lu Chen smiled and said, "Yes, these are the two characteristic performances."

Fan Zhiping was stunned, and everyone else in the department was also stunned.

Everyone can see these two characteristic performances, but...then what?

No one could tell a different diagnosis.

Lu Chen also noticed everyone's doubtful glances, thought for a moment, and said in a deep voice: "There is also the patient's heart ultrasound. You can ignore the report written by the sonographer for the time being."

Fan Zhiping was stunned and asked them to ignore the report written by the sonographer?

The diagnosis written by the sonographer was hypertensive heart disease.

As the name suggests, long-term hypertension and poor blood pressure control lead to heart disease.

…

Lu Chen asked everyone to ignore this diagnosis?

Fan Zhiping pulled out the patient's cardiac ultrasound report.

To be honest, most clinicians trust the diagnosis of sonographers.

Especially ultrasound images, CT and MRI images.

Suddenly, everyone was really uncomfortable with having everyone ignore the sonographer's report.

Looking at the ultrasound report in front of him, Fan Zhiping began to read it word for word.

The doctors around me didn’t quite understand.

Lu Chen is very powerful, but he is just a student after all!

However, Director Fan seemed to believe what Dr. Lu Chen said!

At this time, Fan Zhiping looked at Lu Chen and had long lost the idea that he still wanted to teach students.

Instead, he vaguely regarded Lu Chen as a professor and his "mentor".

Therefore, it was natural for him to obey Lu Chen's words.

…

Fan Zhiping continued to look at the patient's ultrasound report, which showed that the end-diastolic diameter of the left ventricle was 40 mm, and the end-diastolic diameter of the right ventricle was 1.5 mm.

"Both the left and right chambers have become enlarged!" Fan Zhiping murmured to himself.

The reason why the heart becomes enlarged is because the heart function becomes worse and compensatory increase is made to maintain the heart's work.

"In addition to the double room getting bigger...what else..."

Fan Zhiping was suddenly startled, "This patient's left ventricle and right ventricle seem to be smaller than normal!"

This is abnormal!

Generally speaking, the atria and ventricles both enlarge simultaneously.

But in this patient, only the two chambers were enlarged, and the two ventricles became smaller!

Fan Zhiping said to Lu Chen: "Dr. Lu, is this patient's double chamber enlarged and the double chambers smaller instead of larger?!"

As soon as he finished speaking, everyone else in the department was also stunned.

Many people gathered around, holding the ultrasound report sheets for comparison.

"Director Fan is right! This patient is really strange!"

"The double room is enlarged and the double room is reduced. This is the first time I have seen it!"

"Do you think the ultrasound doctor's drawings are inaccurate?"

…

A smile appeared on Lu Chen's mouth, and he nodded slowly: "That's right, huge double atria, but the double ventricles are not big but small. Coupled with the characteristics of the patient's electrocardiogram, what disease did you think of, Brother Fan?"

The diagnosis at this time was already imminent.

A flash of light flashed in Fan Zhiping's mind, and he immediately said: "Senior amyloidosis heart disease?"

Amyloid heart disease, also known as amyloid heart disease, is a very rare restrictive cardiomyopathy.

People suffering from this disease are also called starchy people.

“Yes, it’s amyloid heart disease!”

Upon hearing Lu Chen's affirmative answer, whispers immediately broke out in the department.

Because this disease is relatively rare, most people have never seen it or even understand its diagnostic criteria.

Fan Zhiping also had the opportunity to see such a patient after he went to Beijing Second Hospital for further study.

…

At this moment, a doctor in the department asked a question.

"Dr. Lu, can you diagnose amyloidosis heart disease with just an electrocardiogram and heart ultrasound?"

The criteria for diagnosing cardiomyopathy are very strict, and the most accurate method is "myocardial biopsy."

This involves taking a small piece of myocardial tissue and testing it; followed by cardiac magnetic resonance imaging and other imaging tests, but the accuracy is much lower than myocardial biopsy.

However, myocardial biopsy is a traumatic surgery after all, and few people do this kind of examination.

Therefore, it is relatively difficult to diagnose "cardiomyopathy".

Lu Chen, for what reason was he so sure that the patient had amyloidosis and heart disease?

…

Everyone saw Lu Chen stand up, look around, and slowly said: "There are four key points that kill this case instantly."

Everyone in the department held their breath and listened carefully to Lu Chen's words.

"There is a mismatch between electricity and structure, poor R-wave increment of v1-v3, huge left and right chambers, and double chambers that are not big but are small!"

After hearing this, everyone in the cardiology department in Feng M County lowered their heads and thought hard.

The only one, Fan Zhiping, had a glimmer of light in his eyes, as if he had caught something.

Lu Chen continued: "Amyloid is deposited between the myocardial cells, surrounding the myocardium, isolating the myocardium one by one, like an insulator, affecting the electrical conduction between myocardial cells, so we have amyloidosis in the myocardium. An important feature of the patient's electrocardiogram is severe low voltage of qrs wave, which is caused by amyloid! "

"The severe poor R-wave increment in the electrocardiogram v1-v3, which represents the interval vector, is also due to the large amount of amyloid deposition that causes the ventricular wall to thicken."

As soon as he finished speaking, everyone suddenly realized.

The seemingly inconspicuous electrocardiogram performance had a deeper meaning when placed in Lu Chen's case!

At this time, a young doctor in the department wondered: "Dr. Lu, why did you just say that double rooms are big and double rooms are small? UU Reading www.uukanshu.net Why?"

Lu Chen smiled and said: "Actually, this is easy to understand. Amyloid deposits between myocardial cells. The ventricles become very stiff, filling is restricted, and diastolic function is seriously damaged. The ventricular cavity is not big enough, and the left and right atria are Blood cannot flow back to the ventricles, and the left and right atriums gradually become enlarged over time! "

"In fact, this case perfectly matches all the electrocardiogram, cardiac color Doppler ultrasound, and clinical manifestations of amyloid cardiomyopathy."

"The perfect match gives you no reason to reject the diagnosis of amyloid cardiomyopathy!"

With the easy-to-understand explanation, everyone present understood what Lu Chen meant.

"Amyloid cardiomyopathy", this rare diagnosis, immediately became popular among people.

While everyone lamented the rarity of this disease, an idea came to everyone's mind.

How good is the young doctor Lu Chen who can diagnose this disease?

How much of a shock did he bring to everyone?

Without solid basic skills, rich clinical thinking, and no superstition in auxiliary examination reports, it is absolutely impossible to diagnose this disease!