I Can See Health

,

"Chest tightness, still out of breath?" Yin Xinhua paused, "This may also be related to high blood pressure."

"Can high blood pressure cause chest tightness?" The patient's family members looked puzzled, "Doctor, you... you'd better go see my dad."

Yin Xinhua glanced at Lu Chen, who understood and immediately nodded to the patient's family: "I'll go right away."

It is easy to understand that high blood pressure can cause chest tightness.

Just imagine, with blood pressure so high, it would be much more difficult for the heart to pump blood out.

Just like when there is a typhoon outside and you have to carry an umbrella to move forward, it would be good if you don't get blown backwards.

But the heart cannot stop pumping blood, so even if the blood pressure is high, the heart still has to work hard to pump blood out. The higher the blood pressure, the harder it takes to pump blood out.

As a result, the heart itself becomes much more tired, and the heart itself is prone to ischemia and hypoxia, so you will feel chest tightness and even chest pain.

…

Come to the ward.

Lu Chen measured the patient's blood pressure again.

The blood pressure in both upper limbs is symmetrical, around 140/70mmhg.

The patient's blood pressure dropped, but what surprised Lu Chen was that his chest tightness still persisted and seemed to be getting worse!

"Let's do another electrocardiogram."

With a rigorous attitude, Lu Chen brought over the electrocardiogram machine and gave the patient another electrocardiogram.

What also surprised Lu Chen was that the patient's electrocardiogram had changed!

The electrocardiogram showed that the st-t segment seemed to be slightly elevated.

Lu Chen frowned. This change may mean that the patient's heart is ischemic!

…

Take the EKG and go back to the doctor's office.

Lu Chen handed the electrocardiogram to Yin Xinhua.

Yin Xinhua compared the two electrocardiograms before and after.

Fan Zhiping on the side said solemnly: "I wonder if it is myocardial infarction!"

Yin Xinhua nodded in agreement: "Although the patient does not have the typical chest squeezing pain for the time being, not everyone has typical symptoms, and the disease is not static."

The most typical symptom of myocardial infarction is chest pain.

But there are exceptions. Some people have toothache, sore throat, or even shoulder pain as their first symptoms, and it is finally found to be myocardial infarction.

Yin Xinhua returned to the ward, listened to the medical history report of the patient and his family again, and called the patient's family out for a private conversation.

"Currently, a head CT has been performed to rule out cerebral hemorrhage for the time being. However, based on the patient's chest tightness symptoms and electrocardiogram, we suspect the possibility of myocardial infarction..."

Yin Xinhua is communicating with the patient’s family about the condition.

Lu Chen and Fan Zhiping stayed in the ward.

Lu Chen thought more. In addition to acute myocardial infarction, he also considered whether the patient would have aortic dissection.

With such high blood pressure and chest tightness, aortic dissection cannot be easily ruled out.

…

Lu Chen brought the blood pressure monitor and wanted to continue measuring the patient's blood pressure.

Walking to the bedside, Lu Chen looked at the patient. Just as he was about to speak, he noticed that the patient rolled his eyes and foam was coming out of the corner of his mouth.

"Dududu..."

On the side of the heart monitor, the alarm suddenly sounded in the ward!

Fan Zhiping shouted: "Ventricular fibrillation!"

Lu Chen was shocked, threw the blood pressure monitor aside, immediately threw himself beside the hospital bed, and started to perform chest compressions.

At the same time, he shouted: "Brother Fan, go call the nurse and Dr. Yin!"

Fan Zhiping was stunned. In the past, he would do this kind of rescue, while others would do the errands.

Today the roles are reversed.

All I can say is that Lu Chen’s rescue response was so fast!

He immediately ran out of the ward and shouted to the nurse and Yin Xinhua on duty.

In fact, as soon as something happened in the ward, the nurse on duty discovered it. She had already pushed the rescue vehicle and rushed to the ward, calling Yin Xinhua all the way.

…

On Lu Chen's side, he was performing emergency cardiopulmonary resuscitation.

Half a year ago, he was just a novice in cardiopulmonary resuscitation.

Now, he is already familiar with cardiopulmonary resuscitation!

Yin Xinhua heard the sound and rushed over. Lu Chen had already received the defibrillator handed over by the nurse.

"Lu Chen, what's going on!"

"Sister Yin, the patient has sudden ventricular fibrillation!" Lu Chen said.

Yin Xinhua's heart sank, "Ventricular fibrillation?"

Is it really a malignant arrhythmia after myocardial infarction?

"Prepare for defibrillation!"

The defibrillator was ready, and Lu Chen had already applied conductive paste.

Charge and discharge!

The first cardioversion was not successful.

Continue CPR!

Second defibrillation.

"Success!"

After the second defibrillation.

The patient's sinus rhythm finally returned, but the patient still did not wake up.

"Oops! The patient's blood oxygen is dropping!"

Just when Lu Chen took a breath, Fan Zhiping's voice made his spirit tense again.

The patient's blood oxygen saturation dropped from 97% to 92%, and then the value on the monitor jumped.

It became 90% again!

"This, what is going on!"

Whether it is myocardial infarction or aortic dissection, the patient's blood oxygen saturation generally does not drop!

Yin Xinhua immediately ordered the nurse: "Change to a mask to inhale oxygen and increase the oxygen concentration!"

"Got it!" The nurse immediately changed the oxygen inhalation through the nasal cannula to the oxygen inhalation through a mask.

After putting on a mask to inhale oxygen, the patient's blood oxygen saturation fluctuated around 90%!

"Although the blood oxygen is stable, emergency intubation may be necessary at any time!" Lu Chen said solemnly.

By this time, the nurse had opened three intravenous lines.

Yin Xinhua also knew the seriousness of the matter.

"Urgently check the blood routine, biochemistry, ions, cardiac enzymes, and D-dimer. Please ask the anesthesiology department for emergency consultation. Be prepared for emergency intubation at any time, and then call the cardiac hospital chief." Yin Xinhua said to another nurse.

"Okay, Dr. Yin."

…

The patient has now returned to sinus rhythm. The most important thing at the moment is cardiopulmonary resuscitation and contacting the anesthesiology department to help with tracheal intubation.

"Doctor, my dad, he, he is..." The expressions of the patient's family members were extremely nervous. He swallowed and looked at his father who was rescuing him on the bed.

"Family members, you come out first, and I'll talk to you later."

Yin Xinhua immediately called the patient's family to the corridor and began to communicate about the condition.

…

Lu Chen and Fan Zhiping stayed by the hospital bed, ready to deal with changes in the patient's condition.

Staring closely at the ECG monitor next to the bed, Lu Chen noticed that the patient's blood oxygen could no longer be maintained!

It started to pulsate around 90%, but now it has dropped to around 85%!

"No! We need to be intubated soon. We can't wait for the anesthesiology department to come." Lu Chen said immediately, "It will be too late by the time they come!"

Fan Zhiping on the side was stunned, "Yes, but I can't do it either."

Fan Zhiping subconsciously thought that Lu Chen wanted him to intubate.

Bronchial intubation is rarely performed by doctors in other departments except for doctors in critical care, emergency, and anesthesia departments.

Although Fan Zhiping is a senior deputy chief physician, he has not touched bronchial intubation for many years.

But the next moment, he was stunned.

Lu Chen had already picked up the laryngoscope.

Is he preparing to intubate the patient himself?

Just when Fan Zhiping was still thinking about whether Lu Chen would do it, he saw that he had found the right position and inserted the tracheal tube into the patient's mouth.