I Can See Health

Remember [new] in one second! Kyoto University First Affiliated Hospital, cafeteria.

"You guys eat first, I have something else to do!"

Lu Chen suddenly stood up suddenly, a glimmer of light flashing in his eyes.

Suddenly, he thought of a potential possibility for that woman's condition!

He didn't even bother to eat, so he was about to leave the canteen.

"Lu Chen, where are you going?" Wang Zihao asked immediately.

"Go back to the department!" Lu Chen waved his hand, turned around and said, "Ke Yue, thank you for reminding me just now, I'm leaving first!"

After that, Lu Chen left the canteen in a flash, leaving only the three of them looking at each other.

…

Return to the department.

Lu Chen immediately came to the "well-connected" ward. .

At this time, the woman was eating lunch brought by her family.

Seeing Lu Chen rushing to the ward in a hurry, the woman was slightly startled, "Doctor Lu, what are you doing?"

Lu Chen calmed down a little and said, "I'm sorry to disturb you for lunch. I have new ideas about your condition."

After hearing Lu Chen's words, the woman immediately put down the chopsticks in her hands, and she didn't care about eating anymore.

This migraine tortured her terribly.

Especially this time, the hemianopsia and limb sensory impairment scared her to death!

She will now try her best to seize every opportunity to solve her "migraine"!

"Doctor Lu, please speak slowly. I am not in a hurry to eat." The woman looked at Lu Chen and raised her ears, not daring to miss a word.

"You may want to do a foaming test!" Lu Chen said slowly.

"Foaming test?" The woman was stunned. She looked up many treatments for her condition.

She has dabbled in a lot of knowledge about migraines, brain tumors, etc. She doesn't dare to say that she has the medical expertise, but at least she can understand the relevant terms. But this time, she was the fundamental person in the foaming test proposed by Lu Chen. Never heard of it.

"Because I suspect that there is not something wrong with your head..." Lu Chen pressed against the woman in front of him tightly, "but there is something wrong with your heart!"

This sentence made the woman even more confused.

How can there be symptoms in the brain if there is a problem with the heart?

"Listen to my explanation first." Lu Chen continued.

He had never thought of this situation at first, and always thought it was a disease of the nervous system, but after Ke Yue's reminder just now, he suddenly thought of a disease.

"You said it, I'm listening." The woman was also attentive at the moment.

Just listen to Lu Chen slowly say: "Many adults, probably 1/4, have patent foramen ovale, but most of them are very mild and do not affect their lives. A small number of people will have symptoms."

"The foramen ovale is a physiological channel in the interatrial septum of the heart. It is formed during the embryonic period. The foramen ovale will close soon after birth, but some people do not close. If it is serious, the blood from the right atrium will flow in. to the left atrium, and then you have migraines and neurological symptoms."

The woman looked at Lu Chen confused.

She couldn't understand Lu Chen's explanation because she didn't know the anatomy of the heart at all!

"Let me explain it this way." Lu Chen found a pen and paper and started drawing. He simply drew the four chambers of the heart on the paper. "The heart has four chambers. The left atrium and the right atrium are next to each other but not connected. , because there is a interatrial wall that separates them, and the foramen ovale is a secret passage between the two rooms. This secret passage is open during the embryonic period, but it will close soon after birth, and the two rooms will no longer be connected. Connected."

"Oh, if you draw the picture like this, I can understand it better." The woman was also an intellectual and immediately understood what Lu Chen meant. "But the hole you mentioned is not closed, so why does it cause me a headache?"

Lu Chen continued to explain: "Because the foramen ovale is patent, part of the blood will directly cross the foramen and enter the right atrium. This part of the blood will not pass through the lungs, but directly enter the systemic circulation and enter the brain."

"Because this part of the blood does not pass through the lungs, there are often small emboli or small bubbles, which can directly enter the brain and cause blockage, causing symptoms similar to a stroke. This is the reason why you suddenly developed hemianopia and physical impairment last night!"

The woman was stunned. She roughly understood what Lu Chen said, "In other words, there is a hole in my heart?"

"It can be understood that way." Lu Chen said, "In fact, the patent foramen ovale is very common, and many people have it. It's just that they are not serious, there are no problems, and they are not discovered."

"Then how can we discover the existence of the breach?"

The woman somewhat believed what Lu Chen said, it sounded like the same thing.

In fact, no matter whether Lu Chen could justify himself or not, she would try to believe him.

Because I have never suffered from her disease, I don’t understand her pain!

Now, as long as there is a glimmer of hope, she will grab it!

Lu Chen thought for a while and said: "Some people can see it through cardiac color ultrasound, but if the patent foramen ovale is relatively small, cardiac color ultrasound may not be able to see it, because the color ultrasound probe is placed on the chest and is still too far away from the heart. , it’s hard to tell.”

"What should we do?" the woman asked.

Lu Chen smiled and said, "Then do a transesophageal cardiac color ultrasound. That is to put the probe into the mouth and go all the way into the esophagus. Do a color ultrasound in the esophagus, because the esophagus is close to the heart, so you can see it more clearly."

"Wouldn't it be uncomfortable to do it through the esophagus?" The woman was a little worried.

"Yes, it's just like an ordinary gastroscopy. If something goes deep into your esophagus, it will definitely be uncomfortable." Lu Chen nodded slightly, "In addition, in addition to cardiac color ultrasound, the foaming test I just mentioned can also find problems."

The so-called foaming test is to use a tube of liquid mixed with physiological saline, air, and blood, shake it thoroughly (inject two syringes back and forth) to generate bubbles, and then quickly inject it from the vein of the human arm.

Theoretically, after these bubble-filled fluids enter the veins, they will immediately enter the superior vena cava → right atrium → right ventricle → pulmonary artery → pulmonary capillaries → pulmonary veins → left atrium → left ventricle → systemic circulation (various arteries, such as middle cerebral artery) .

If the patient does not have a patent foramen ovale, then the bubble-filled fluid will enter the pulmonary capillaries according to the above path. The bubbles will be absorbed by the capillaries and will not enter the systemic circulation. Therefore, we perform transcranial Doppler ultrasound on the patient to monitor the brain. When the artery is in the middle, there will be no traces of air bubbles.

However, if the patient has a patent foramen ovale, and if the patient inhales and holds his breath during the operation (valsalva maneuver), the pressure in the right atrium can be increased, then the bubble-filled liquid will flow directly from the superior vena cava. → Right atrium → Foramen ovale → Left atrium → Left ventricle → Systemic circulation (including middle cerebral artery).

Some of the bubbles will directly pass through the foramen ovale, reach the left heart, and immediately enter the cerebral artery. At this time, a transcranial Doppler ultrasound can detect the bubble signal, thus inferring that there is a patent foramen ovale.

…

Lu Chen immediately took the woman to the examination room to conduct a foaming experiment.

Sure enough, it was just as Lu Chen expected.

After examination, bubble signals in the woman's brain!

This means that it is not necessarily true that a woman’s heart may have a foramen ovale.

After hearing the result, the "well-connected" woman was surprised and happy.

To his surprise, there was something wrong with his heart, and from what Lu Chen said, it seemed like he had congenital heart disease.

Fortunately, the cause of "migraine" has finally been found!