I Can See Health

It took Lu Chen about twenty minutes to walk back to the bachelor's apartment.

He is now the deputy chief physician and does not need to stay in the department all the time.

The time for commuting to and from get off work is also relatively free.

If this was placed during his previous Ph.D. studies, if it would take him twenty minutes to get home at noon, then there would be no need for him to go back.

Come and go, you may not rest for more than ten minutes before you have to go to the hospital again.

Now Lu Chen could boldly go back to the apartment and even enjoy the scenery on the way.

When I returned to the community, it was peaceful. Most of the people didn't come back and were taking a lunch break at work.

The apartment Lu Chen returned to alone seemed very leisurely.

It was quiet across the street and upstairs. They probably didn't come back.

Lu Chen made a cup of tea, found the latest papers and documents, and began to read through them.

Maintaining a certain amount of reading every day is a habit that Lu Chen has developed over time.

And, whether he was a cardiologist or not, he would take a look.

It wasn't until he was tired of watching that he lay down in the bedroom, ready to take a half-hour lunch break before going to work.

Lu Chen smiled slightly, was he living the life of a retired director ahead of schedule?

…

afternoon.

Lu Chen stepped into the second area of ​​​​the heart.

This surprised Jin Miao, because none of the senior doctors from other groups were here at this time.

Senior doctors in other groups will not be so punctual. They may stay in the department for a while and then leave.

Lu Chen was the one who came earlier.

After returning to the lounge and putting on his white coat, he sat steadily in front of the computer and continued to familiarize himself with the hospital's medical records and doctor's order system.

He was going out to the clinic tomorrow, and Lu Chen had to get acquainted with it as soon as possible.

Jin Miao didn't pay much attention to Qingchen. He had a lot to do!

Not only do we have to treat new patients, but we also have to adjust the treatment plans for old patients, which is no ordinary busy job.

However, Jin Miao has many students, including regular trainees, graduate students, and interns. With these free labor forces, he can also cope with it.

In addition, Jin Miao also made an appointment for a cardiac MRI examination for the patient whose "cardiac enzyme" was elevated.

Once the results are reported, it will be possible to determine whether the patient has myocarditis.

Lu Chen can occasionally mentor Jin Miao and earn a small amount of gratitude points.

However, in the system mall now, the gratitude points required to redeem skill cards can easily reach tens of thousands or hundreds of thousands.

The value of gratitude obtained from students is already negligible.

On the other hand, Lu Chen is now the deputy chief physician. When most medical students encounter problems they don't understand, the first thing they consider is to ask the attending doctors.

Therefore, except for Jin Miao who occasionally came to Lu Chen to discuss a few issues, there were very few students who came to ask Lu Chen questions.

This channel for obtaining gratitude points is blocked!

This made Lu Chen quite melancholy!

…

However, Lu Chen couldn't take any time off after all.

At three o'clock in the afternoon, Lu Chen was familiar with the medical record system and was about to take a rest when Jin Miao ran into the doctor's office.

He came to Lu Chen: "Director Lu, a patient who came this morning has a heart attack!"

He took an electrocardiogram in his hand and handed it to Lu Chen.

Lu Chen looked down.

There is something really wrong with this electrocardiogram.

St-segment elevation in the anteroseptal leads indicates myocardial infarction.

Ordinary patients, Jin Miao would not take the initiative to see Lu Chen.

Unless the illness is serious or complicated, he will take the initiative to find a superior doctor.

The patient in front of him falls into the category of seriously ill.

Even if he treats patients, he still has to fulfill his obligation to inform.

"What are the patient's symptoms?" Lu Chen asked.

"The main thing is chest tightness, no obvious chest pain." Jin Miao thought for a while and briefly described the patient's condition.

The patient is a 60-year-old woman. She has had chest tightness for four days. She feels uncomfortable when she walks. She just sits down and rests for a few minutes.

The kids at home were busy, so I didn’t take it seriously at first, but I didn’t expect it to get worse.

Now when I lie down, I feel stuffy and suffocated. I also cough and don't like to eat.

Only then did she let her wife take her to the hospital for a checkup.

"The patient said that he had gastritis, bile reflux, and cold legs in the past. He usually just takes some painkillers and gets better, but he has never had a heart disease."

Lu Chen nodded slightly, "What about other risk factors for coronary heart disease?"

Jin Miao answered fluently: "Except for her age, she has nothing to do with hypertension, diabetes, dyslipidemia, obesity, smoking, drinking, or family history. Her heart examination is generally normal, and there are a few rales on lung auscultation."

Lu Chen listened to the narrative while looking through the patient's examination and laboratory results.

Routine blood count: white blood cells 11.13×109/l, neutrophil percentage 86.5%, absolute neutrophil count 9.63×109/l, and hemoglobin 131g/l.

Myocardial injury marker: troponin t (t) 42.2ng/l (0-14ng/l).

Brain natriuretic peptide (bnp): 12723pg/ml (\u0026amp;amp;lt;100pg/ml).

There were no obvious abnormalities in biochemistry, coagulation function, and thyroid function.

Jin Miao continued: "The increase in troponin T is not as high as expected, but the increase in bnp is particularly obvious."

Lu Chen thought for a while and then said: "Severe heart failure can also cause a slight increase in troponin. It may be ischemic cardiomyopathy. We should first provide basic treatment for coronary heart disease to improve cardiac function, and then arrange for a cardiac color ultrasound. Elective coronary angiography.”

Even if acute myocardial infarction is considered, the patient missed the best time for surgery - within 12 hours of the onset of the disease, the patient's heart is now extremely fragile, like a ball of tofu.

If you perform coronary intervention surgery now, your heart will easily be punctured.

Therefore, we can only wait for the patient's cardiac function to recover and make the heart stronger before performing coronary intervention surgery.

Jin Miao agreed with Lu Chen, "I will communicate with the patient's family."

…

Just when Lu Chen thought everything was fine, the patient's condition suddenly took a turn for the worse.

The patient suddenly developed nausea and vomiting around 4 p.m., and the vomitus was like coffee grounds, and the vomitus occult blood test was positive.

Lu Chen immediately ordered Jin Miao to review the blood routine.

The patient's hemoglobin dropped from 125g/l to 100g/l.

Could it be upper gastrointestinal bleeding?

"We're in big trouble now!" Jin Miao ran up to Lu Chen.

Lu Chen frowned deeply. UU reading www.uukanshu.net

To put rats in a rat-proof device, it is necessary not only to fast and rehydrate, but also to take into account the heart function, and to stop taking antiplatelet drugs.

Coronary heart disease is caused by blood clots, which is contradictory to the treatment of gastrointestinal bleeding!

Coronary angiography has become far away!

Lu Chen recalled that he had seen cases of gastrointestinal bleeding after taking aspirin before, but most of them were caused by gastrointestinal tumors and gastrointestinal ulcers.

"He had gastritis, bile reflux, and cold legs before..."

In Lu Chen's mind, he suddenly remembered what Jin Miao had just said when he explained the medical history.

The foundation of the digestive system is indeed not good, and then there is "old cold legs", which is another "folk diagnosis".

However, no detail, no matter how small, can be missed.

Lu Chen looked at Jin Miao and said, "I'll go with you to see the patient again." 16377/10479391