I Can See Health

The second zone of the heart.

In the ward.

"Dr. Lu, are you...are you sure you want to use amiodarone?" the nurse asked.

Lu Chen frowned. The nurse in this magical city is too verbose!

How many times have I asked this question?

"I'm sure!" Lu Chen said solemnly.

"Oh, that's good." The nurse curled her lips and put amiodarone in the infusion pump, preparing to inject it into the patient.

The nurse had the responsibility to help the doctor check the correctness of the medical order, but if Lu Chen insisted, she would not continue to ask.

At this time, Yu Bin and Yan Shuming quickly walked into the ward together.

"Lu Chen, how is the patient?" Yu Bin opened his mouth and asked.

The nurse who was dispensing medicine on the side saw this situation and immediately stopped what she was doing.

Lu Chen explained: "Brother, the patient is having a panic attack. This is her electrocardiogram. I am going to use amiodarone for cardioversion."

Yu Bin was slightly startled, but did not say anything immediately, but reached out to take the electrocardiogram.

"Isn't this ventricular tachycardia? Why amiodarone? Is there any special purpose?"

Yu Bin's words were very reserved and did not directly refute Lu Chen.

Beyond his words, why not use electrical cardioversion?

The primary measure for ventricular tachycardia is electrical cardioversion.

On the side, nurse Yan Shuming's lips curved up.

She wanted to see how this new young doctor would handle this matter.

"This Lu Chen didn't listen to my advice. Fortunately, he found Yu Bin. What if the doctor's orders were wrong? Wouldn't the patient be harmed?"

Clinically, many nurses are even more experienced than young doctors.

Yan Shuming secretly thought to himself that he would have to give advice to the director in the future. These new doctors had poor clinical experience and they still needed to study in the department for a period of time before they could become independent.

Otherwise, the risk is too high!

Lu Chen's expression did not change at all. He glanced at Yu Bin, and then said slowly: "Because... this is not ventricular tachycardia!"

The words just fell.

The entire ward, both doctors and nurses, stared at Lu Chen in disbelief.

Yu Bin felt a little unhappy.

How could he believe what Lu Chen said!

He lowered his head and looked at the electrocardiogram in his hand. He saw wide QRS wave tachycardia. This was ventricular tachycardia!

Moreover, the patient had suffered many seizures in the past, and each time he was diagnosed with ventricular tachycardia and required electrical cardioversion.

Lu Chen's three students also opened their mouths.

Especially female graduate student Ji Yingying, she had always emphasized to Lu Chen that this patient had supraventricular tachycardia.

At this time, Lu Chen smiled and said slowly: "Brother Yu, let me ask you a question, why does the blood pressure of patients who frequently suffer from ventricular tachycardia not drop?"

Blood pressure, this is also one of the "suspicious points" that Lu Chen noticed!

Normally, malignant arrhythmias such as ventricular tachycardia and ventricular fibrillation will basically cause a drop in blood pressure.

Yu Bin was also stunned. In his subconscious, the patient was suffering from ventricular tachycardia and needed electrical cardioversion, and he didn't pay attention to the blood pressure issue at all.

"The patient's blood pressure is very low?"

"Yeah." Lu Chen nodded majestically.

He flipped through the patient's past medical records.

The patient's cardiac ultrasound and coronary angiography showed no structural heart disease.

There are no symptoms such as long QT or Brugada syndrome on the electrocardiogram.

The patient's electrocardiogram during the attack was also not consistent with the electrocardiographic characteristics of left posterior or left anterior branch VT (ventricular tachycardia).

The most critical thing is that the patient's health value is 72 (-)!

If it is really a ventricular tachycardia attack, a severe arrhythmia, the change in life value will definitely be more than a minus sign. Valley is gone

The diagnosis of ventricular tachycardia seems not very scientific!

"this……"

Yu Bin frowned, and for a moment he was a little undecided.

What Lu Chen said seemed to make sense!

If the patient is really suffering from ventricular tachycardia, why is the hemodynamics so stable?

Why is there just some palpitations and discomfort, but no other symptoms at all?

Yu Bin picked up the patient's electrocardiogram and read it carefully.

He didn't want to let go of any clues.

"Is it true that the patient is not suffering from ventricular tachycardia?"

…

Seeing Yu Bin dazed, Lu Chen quickly urged the nurse: "Hurry up and use the amiodarone."

Yan Shuming glanced at Yu Bin and saw that he had no reaction. He gritted his teeth and gave the patient amiodarone.

"Okay, pay attention to the amiodarone pump speed and monitor heart rate changes."

Lu Chen breathed a sigh of relief when he saw that the nurse had used the medicine.

Yu Bin, who was on the side, swallowed, glanced at Lu Chen, and asked in a low voice: "Lu Chen, if the patient is not ventricular tachycardia, then what could it be?"

Lu Chen smiled slightly, "Speed ​​speed?"

"Ah?" Yu Bin took the electrocardiogram and looked at it repeatedly, frowning all the time, and murmured, "I really don't see where the supraventricular tachycardia is..."

The differential diagnosis of wide qrs complex tachycardia is an everlasting topic in cardiology.

Ventricular tachycardia and supraventricular tachycardia are often difficult to distinguish.

Ventricular tachycardia is a malignant arrhythmia that often indicates a more dangerous condition and requires more aggressive management strategies.

Supraventricular tachycardia is an arrhythmia with a relatively good prognosis.

Especially in some emergency situations, if we can quickly distinguish between ventricular tachycardia and supraventricular tachycardia, we can buy a lot of rescue time.

…

"Lu... Doctor Lu, are you sure you really don't need electric shock?"

The man stood at the door of the ward, looking inside.

He was very excited when he saw the nurse giving his wife medicine instead of using "electric shock".

At this time, his attitude towards Lu Chen was no longer as arrogant and domineering as before.

In the past, every time his wife had a panic attack, she would be given electroshock cardioversion when she came to the hospital.

As a result, the two of them had a deep fear of this "electric shock".

"No need for electric shock." Lu Chen said slowly, "We have temporarily given the patient an anti-arrhythmic drug. Now we can just monitor the changes in heart rate at any time."

"But..." the man frowned, "When will my wife's heart rate come down?"

"It depends on the specific condition and the patient's sensitivity to the drug." Lu Chen said, "Some people take half an hour, some take three hours, and some may take a day or two."

"Will this medicine be... useless?" the man said worriedly.

Although electric shock is scary, it is real and effective!

After each electric shock, UU read a book www. uukanshu.net His wife's heart rate returned to normal.

If this medication doesn't work, wouldn't it delay the treatment time?

Lu Chen could see the man's worry at a glance.

"Uncle, don't worry, we will evaluate the patient's condition at any time. No electrical cardioversion, no need for electrical cardioversion for the time being!"

What else did the man want to say? The patient on the bed immediately said: "I listen to Dr. Lu and don't need electric shock for the time being. I want to try it with drugs. Even if it takes a day or two, I am willing to try it!"

The man seems to have underestimated his wife's determination not to "shock" her.

After experiencing the torture of "electric shock", the patient suddenly heard that there was no need for electric shock, and he was extremely excited.

"Okay, Doctor Lu, we will follow your arrangements." The man said.

Lu Chen nodded slightly, told the nurse to pay attention to the patient's heart rate changes, and then left the ward.

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