I Can See Health

   Chapter 195 Myocardial Infarction Without Risk Factors

   Back to Jinghua Second Hospital.

   The entire team was honored by the champion.

  Luo Binghe, the dean of the Graduate School, met everyone in the school hall and reiterated the award that the school had promised before.

   Won the first place in the country in the skill competition and won all scholarships unconditionally. And in all selection activities, there is priority to choose. At the same time, they have the opportunity to study abroad at Jinghua Medical University.

   Scholarships, including grants and state scholarships.

  The annual first-class bursary is 10,000 yuan, and the national scholarship is also 10,000 yuan.

   This is a huge amount of money for students who have just not had a job.

   In addition, the priority of staying in school after graduation is high, and there are opportunities to go out and communicate.

  Lu Chen and other five people have gained a lot in this national skills test.

   Not only has economic incentives, but it is of great benefit to their future development.

  …

After the    skill test was over, they returned to Jinghua Second Hospital. Lu Chen and others returned to the clinical department.

   According to the latest rotation plan, Lu Chen still needs to stay in the Cardiology Department for two months before being rotated to other departments.

   The day after returning to the Jinghua Second Hospital, Lu Chen returned to the ward in the eighth district of his heart and started the clinical rotation.

   "Junior Brother Lu, the schedule for your graduate students is out. Take a look at your class and don't forget it."

   In the early morning, as soon as Lu Chen arrived at the ward, he received a shift schedule handed over by Sun Guoguo.

   He just remembered that after the official rotation started, the hospital began to arrange shifts for them.

   Shifts are mainly divided into two types.

   One is the class in your own professional department, and the other is the class in the rotating department.

   For example, Lu Chen is working in the cardiology department, so he only needs to be on duty in the cardiology department.

   But when Lu Chen was transferred to other departments, such as endocrinology, he would need to be on duty in both the cardiology department and the endocrinology department at the same time.

  In each department, there are about three shifts per month.

   That is to say, each graduate student will be on duty for six classes per month.

   The subsidy for each duty varies from 60 to 100 yuan depending on the department.

  Lu Chen looked at the schedule in his hand.

   "There is a night shift this week. The day after tomorrow, the superior doctor is Yin Xinhua."

   Physicians and postgraduates on duty are randomly arranged.

  Lu Chen's first night shift was the attending doctor Yin Xinhua, who was in the team with Mr. Lin Cui.

  …

  After finishing work in the morning.

  Lu Chen took back the four hospital beds he had previously managed.

   However, these patients were all ready to be discharged from the hospital, and Lu Chen directly completed the record of the disease course without much thought.

   Following Sun Guoguo's room inspection and returning to the doctor's office, Lu Chen saw a group of people gathered around.

   There are interns, as well as regular trainees and graduate students, as if they are discussing something.

  Lu Chen glanced at it and saw Director Lin Cui sitting in it. He probably knew what was going on.

  Recalling that when he first came to the eight districts in his heart, Director Lin Cui liked to give lectures in Keli and ask questions to everyone.

   Ke Yue was severely criticized by Lin Cui for not recognizing the electrocardiogram of atrial fibrillation.

   It seems that Director Lin Cui has started to teach again and is almost finished.

   "Do you have any questions about the electrocardiogram? You can bring it up and discuss it together." Director Lin Cui smiled.

   A group of students chatted and started to ask questions one after another, including the meaning of the P wave QRS complex, the identification of premature beats and so on.

   Director Lin Cui held his temper and explained to them one by one.

"Director Lin, I'm very interested in a question. The ECG can judge the condition of our heart, whether there is myocardial damage, whether there is cardiac hypertrophy, etc. Since the ECG is so amazing, I would like to ask, through the ECG, can we identify the gender?"

   At this time, a question from an intern caught Lu Chen's attention.

  Lin Cui was taken aback by this sudden question.

   "Looking at a person's gender?"

   "Yes, Director Lin, can't you see it?" the intern asked in confusion.

  Lin Cui's face darkened, "You little children, ask more practical questions, all of them are some of them, can you determine the gender, can you cure the disease?"

   The intern blushed when he heard the words, said "Oh", and stopped asking.

  Although Lin Cui did not answer, everyone was interested in this question.

   "Senior brother, can the ECG determine the gender of the patient?"

   Junior Sister Yao Jie suddenly came over.

   "Do you think you can?" Lu Chen asked back with a smile.

   "No, can't you?" Junior Sister Yao Jie shook her head slightly.

   "That's it." Lu Chen smiled, "Junior sister, go get some ECGs, don't let me see the patient's information."

   "Okay." Yao Jie hurried to the side of the medical record car and found five electrocardiograms.

   handed the electrocardiogram to Lu Chen, Yao Jie blinked.

   "Senior brother, can you really tell the gender?"

  Lu Chen smiled and picked up the electrocardiogram that Yao Jie gave him.

   "First EKG, male."

   "Second EKG, female."

  …

   "Fifth ECG, male."

   When Lu Chen finished speaking, Yao Jie was shocked by the patient's information.

   "Senior brother, you, how did you know?"

   These five medical records were randomly selected by her.

  Lu Chen completely judged the gender of the patient correctly.

  Is it really possible to determine the gender of the patient?

  Lu Chen smiled and said, "Sister, the electrocardiogram is a very wonderful thing. Although it cannot be 100% accurate, it can reflect a lot of things."

   Yao Jie didn't quite believe it, so she immediately found ten electrocardiograms for Lu Chen to identify.

  Lu Chen did not refuse, "Male, male, female, male..."

   Very electrocardiogram, Lu Chen made one mistake, and all the others were successfully identified.

  Although there is a mistake, the correct rate is already quite high.

   "Senior brother, you can identify both men and women, but what about transgender people?"

  Lu Chen's face darkened, what was he thinking about all day long in his little sister's little head?

  Lu Chen was about to explain the reason to Yao Jie, but the nurse on duty walked into the office.

   "The doctor of the chief team, a new patient is here!"

   "Okay, come right away." Lu Chen stood up immediately, and then said to Yao Jie, "I'll explain to you when I'm free. It's true that gender can be judged by electrocardiogram, and even transgender people can tell."

   Yao Jie's eyes widened, the electrocardiogram is so amazing?

  …

  The newly admitted patient is in 11 beds.

  Lu Chen came to the bed, Yao Jie followed behind him pushing the electrocardiograph.

   On the hospital bed was a man of about twenty-five years old.

   He was lying on the hospital bed with his eyes closed.

   "I'm your bed doctor, what's wrong with me?"

   This is Lu Chen's most typical opening remarks.

   The man's complexion was a little pale, he slowly opened his eyes, and said softly, "I feel a little uncomfortable in my chest."

   "Chest pain or chest tightness?" Lu Chen continued

   "It hurts a little bit, but after the pain, it's still a little stuffy."

   "When did the chest pain start?"

   "I woke up in pain at about four o'clock tonight."

  Lu Chen looked at the ECG performed by the patient in the outpatient clinic, and it showed that the T wave was slightly high and sharp, and there was nothing abnormal.

   "Junior sister, review another electrocardiogram." Lu Chen ordered.

   ECG is the most accessible and cheapest cardiology examination.

  Many heart disease patients will have ECG changes when their condition changes, so many times, doctors need to constantly review the ECG.

   "Okay, Senior Brother." Yao Jie nodded lightly.

  …

  After the ECG is done.

   As soon as Lu Chen got it, his heart sank.

   ECG prompt, compared with admission ECG, ST segment elevation in leads II, III, aVF!

   "There is a possibility of acute myocardial infarction, and it is a myocardial infarction in the lower wall." Lu Chen said solemnly, "Junior sister, you go to inform Senior Sister Guoguo, let her take a look at this patient, and then notify the catheterization laboratory to prepare."

   "Okay." Yao Jie nodded immediately and walked out of the ward quickly.

   Leads II, III, and aVF correspond to the inferior wall of the heart. If these leads are abnormal, it often indicates that the inferior wall of the heart may be avascular and necrotic.

   "Just an electrocardiogram to know that I have a heart problem?" The man on the bed said lightly, "The electrocardiogram can see the changes in my body through my skin?"

Lu Chen paused and explained: "When we put the electrodes of the electrocardiogram on the chest wall, we can feel the electrical conduction, and then record it on the electrocardiogram. If there is ischemic necrosis of the myocardium, their discharge must be poor. It can be faithfully reflected on the ECG chart.”

   "Now, based on your symptoms and the results of the electrocardiogram, we can determine that the disease you are suffering from is likely to be myocardial infarction."

   However, what Lu Chen has a little doubt about now is the life value on the patient's head.

   His health is 68.

  According to the previous rules, the life value of acute myocardial infarction is below 60.

   Could it be that this patient's condition is still in the process of progress?

   "What about your family?" Lu Chen continued to ask.

  Acute myocardial infarction is a kind of acute and critical illness, and there is a risk of sudden death at any time.

   Therefore, the immediate family members of the patient should be informed as soon as possible.

   "No." The man's face darkened.

   "Not married?" Lu Chen asked, "What about the wife and children?"

   "I left a few days ago, no children."

   "Where are the parents?"

   "I'm not in Jinghua, I'm the only one in Jinghua."

  Lu Chen's heart sank, this matter is even more difficult to do!

   Acute myocardial infarction requires emergency coronary intervention.

  This invasive surgical treatment must require the signature of the patient's family.

   At this time, Sun Guoguo also came.

   She quickly asked the patient's medical history and checked the electrocardiogram.

   "It is indeed an acute myocardial infarction, which is still within the intervention time window and requires emergency surgery."

  Sun Guoguo's opinion was completely consistent with Lu Chen's.

   "Senior sister, the patient has no family members in Jinghua." Lu Chen whispered aside.

   "Are there none?" Sun Guoguo looked at the man on the hospital bed.

   "No." The man shook his head.

  Sun Guoguo also felt that this matter was very difficult.

   In such a special situation, if the patient died on the operating table, it would be troublesome.

   Not to mention who is responsible, even who will claim the corpse and who will pay for the cost.

   "Junior Brother, you take care of the patient first." Sun Guoguo took out her phone, "I'll tell Teacher Li about the patient's condition."

  Li Yao is the director of the department. Any situation involving potential disputes must be reported to her in time.

  Sun Guoguo got out of the hospital bed and called Li Yao.

  Lu Chen stayed and asked the nurse to monitor the patient's ECG.

   On the bedside ECG monitoring, the patient's heart rate was 120 beats/min and blood pressure was 98/50mmHg, which is low for a young adult in his twenties.

   Looking at the heart rate on the ECG monitor, Lu Chen frowned.

   Something seems wrong.

   Inferior myocardial infarction, the heart rate is generally slow.

   This patient is a bit abnormal, with a heart rate of 120 beats/min.

   However, Lu Chen didn't think of any other anomalies for a while.

   At this time, the patient on the hospital bed asked again: "Doctor, you have always said that I have a myocardial infarction, is this serious illness?"

   When Lu Chen heard the words, he suppressed his doubts about the heart rate and began to organize language to explain the patient's condition.

   Explaining the condition is extremely important, which is related to whether the patient can receive the next treatment.

   "Have you heard of coronary heart disease?" Lu Chen asked.

   The man frowned and nodded.

   "Acute myocardial infarction is the most serious type of coronary heart disease, and people may die at any time!"

   "Acute myocardial infarction is because the blood vessels of the heart are blocked by thrombus, and the blood flow cannot flow through. The myocardial cells at the far end are naturally ischemia and hypoxia, and will soon die."

   "Cardiomyocytes are not ordinary cells. Cardiomyocytes are innate. If one dies, there will be one less, and if a batch of dies, the entire heart may fail."

   "Once the heart fails and heart failure occurs, the patient may die."

"Therefore, opening the blocked heart blood vessels (coronary arteries) as soon as possible is the only effective treatment. In more advanced hospitals, coronary intervention is the preferred method, such as the placement of cardiac vascular stents to open the narrowed blood vessels and remove them. Thrombus blocking the way."

   After Lu Chen's explanation, the patient also understood his condition.

   "In other words, I must do this interventional surgery?" the patient said.

   "Yes!" Lu Chen nodded without doubt.

   "Okay, then I'll listen to you."

   "The problem now is that you don't have family members, and you must have family members' signatures for the operation."

   "Can't I sign it myself?"

   "We need to contact the superior doctor about this issue."

  …

  Sun Guoguo quickly returned to the ward.

   "Mr. Li said that we are only responsible for saving lives. I can't manage so many miscellaneous matters. She contacted the medical department, filed a record in the medical department, and signed the matter for them to solve. They did this thing in the first place."

  Lu Chen nodded, the best way now is to file a record with the medical department and tell the medical department that there is such a thing.

   They can't just sit back and watch their patients.

  Everything was ready and the patient was quickly taken to the cath lab.

  …

   The rescue in the intervention room competed for points, and Lu Chen and others returned to the doctor's office.

   Doctors from other groups also knew about this patient, and everyone sighed.

   Such a young myocardial infarction is really frightening!

  Lu Chen was sitting in front of the computer and began to write his medical records when he realized another problem.

   The patient has no history of hypertension or hyperglycemia, only one history of hyperlipidemia, neither smoking nor drinking.

  To be honest, there are not many high-risk factors.

   This patient is about the same age as him, and he has such a heart attack. Who would have thought? !

   Twenty minutes later, there was a piece of news that no one expected from the intervention room.

   (end of this chapter)