I Can See Health

Fengm County People's Hospital, Department of Cardiology.

Attending doctor Wang Zhi took five electrocardiograms of patients with "cardiac arrest" and started to figure it out again.

For patients with cardiac arrest, after excluding organic heart diseases such as myocardial infarction and cardiomyopathy, arrhythmia is a common cause.

However, he has read these five electrocardiograms of the patient many times and has not found any abnormalities so far.

At this time, his WeChat on his mobile phone suddenly rang.

Wang Zhi picked up the phone and saw that it was a WeChat message from Fan Zhiping, the deputy director of the department.

"Has Professor Li Yao come to our department?"

Wang Zhi was a little confused, but he immediately replied.

"Director Fan, Professor Li Yao has come to the department."

"Oh, is there a doctor named Lu Chen with her?"

"Yes, Director Fan, how did you know this?" Wang Zhi was a little confused.

"Because I am currently studying in Professor Li Yao's group! If you have any difficult cases this time, you may not bother Professor Li. You can directly ask Dr. Lu Chen, especially about electrocardiograms."

Fan Zhiping is far away in Beijing, but he still worries about the department.

He knows very well that electrocardiograms and electrophysiology are very weak areas in county-level hospitals.

Because this requires not only hard work, but also someone to teach.

Wang Zhi was immediately puzzled, "Isn't he just a graduate student? Director Fan, is it useful for me to ask him?"

"Haha, you don't know this, I'll tell you this, Dr. Lu Chen has entered the third round of this Huaxia electrocardiogram competition!"

"What?" Wang Zhi's expression was somewhat unbelievable.

As a doctor in the Department of Cardiology, he is very clear about this electrocardiogram competition.

He also participated in this competition, and he didn't even qualify for the ranking of the department.

Those who can enter the third round are ranked in the top ten in the province!

These people are all very powerful doctors in the field of electrocardiograms in the province.

Wang Zhi looked up at Lu Chen and swallowed silently.

It was hard to imagine that a first-year graduate student could be so awesome.

No wonder he saw the problem immediately after just one look at the five electrocardiograms!

…

At this moment, Lu Chen also began to interpret the five electrocardiograms.

Wang Zhi, who had been a little indifferent, pricked up his ears to listen.

"Compared with the ECG at admission, the patient's ECG after admission showed sinus rhythm, right axis deviation, and J point elevation in the inferior wall leads, up to 2.5mm, accompanied by QRS wave notches."

"In the later follow-up ECG, from the V1 and V2 leads, the QRS wave ended with a broken QRS wave group! From the inferior wall IL, LII, and Avf leads, it looked like a J wave! It needs to be differentiated from Brugada syndrome, ARVC, and old myocardial infarction."

"And the patient's cardiac ultrasound and cardiac angiography did not find any abnormalities, so these diseases can be temporarily ruled out."

Lu Chen's explanation was very organized, and the abnormalities were marked on the ECG.

This time, not only did Wang Zhi listen carefully without saying a word, but even other deputy chief doctors came over to listen carefully to Lu Chen's explanation.

Lu Chen continued: "But whether it is a broken QRS wave or a J wave, in this specific situation, it is a high-risk warning signal for ventricular fibrillation and sudden cardiac death! Studies have confirmed that early repolarization is a sign of cardiac arrest, and the risk of ventricular fibrillation is twice that of the normal population!" "Doctor Lu, can you explain this broken QRS wave in more detail? I don't quite understand it." Wang Zhi scratched his head. His question represented the voice of the cardiologists in Fengm County People's Hospital. "Hey, it seems that I still don't understand it..." Lu Chen was very patient. He took out a blank A4 paper again and started writing on it while explaining. "Broken QRS waves represent conduction delays in myocardial scarring and fibrosis, leading to anisotropy in myocardial conduction, which can be used as a predictor of sudden death risk in patients with coronary heart disease, heart failure, hypertrophic cardiomyopathy, ARVC, dilated cardiomyopathy, and congenital heart disease!"

"This electrocardiogram represents the appearance of QRS waves in right ventricle V1 and V2, and the end of the QRS wave is a broken QRS wave group, which is also called epsilon wave in ARVC..."

...

This teaching ward round has completely become Lu Chen's chapel.

Although some of them did not quite understand Lu Chen's explanation, in general, they all understood the cause of the patient's cardiac arrest.

That is early repolarization syndrome (ion channel disease)!

"Congratulations, the system upgrade completion rate has increased!"

"Congratulations, received a thank you value +1 from Wang Zhi!"

"Congratulations, received a thank you value +1 from Ke Shuwen!"

"Congratulations, received a thank you value +1 from Cheng Lin!"

"..."

Lu Chen did not expect that he could get so many benefits from participating in a teaching ward round.

It was really worth the trip!

Director Yin Chao looked at Lu Chen who was talking eloquently and couldn't help but sigh. It was really like the Yangtze River where the waves behind pushed the waves in front, and the waves in front were beaten to death on the beach!

He looked at Lu Chen and felt itchy. It would be great if there was such a young man in his department!

Comparing Dr. Xiao Lin and Lu Chen, the gap is huge!

"Director Yin, are you satisfied with Dr. Lu's explanation?" Li Yao looked at Yin Chao.

"What a great talk!" Yin Chao smiled, "I finally know why Professor Li brought Dr. Lu here. He is much better than all the old guys like us."

Lu Chen said quickly: "Director Yin, you are very grateful. I came to this result based on your early examination results. Without your early efforts in diagnosis and treatment, I would not have been able to diagnose it all at once."

Lu Chen's modesty also made Yin Chao feel better.

"Congratulations, I received a +5 thank you from Yin Chao!"

Lu Chen was slightly startled when he saw the system prompt.

Give 5 points of gratitude at once?

Director Yin Chao didn't even award him any banners!

Lu Chen frowned. Could it be because of Yin Chao's status as department director?

Most of the gratitude points he had received before came from patients or their families, and then from his junior brothers and junior sisters.

Today is the first time for Lu Chen to read a book www. uukanshu.net The amount of gratitude gained from a department director!

…

After Lu Chen finished his explanation, Li Yao also made a summary of the teaching rounds.

Based on Lu Chen's advice, Li Yao gave his own diagnostic opinion, including J-wave syndrome and other possibilities.

Doctors including Wang Zhi were quite satisfied with this teaching round.

In this kind of county-level hospital, everyone has different levels of skills. It is extremely rare to have a doctor to teach step by step.

At this moment, Dr. Kobayashi returned to the doctor's office.

He was holding a color Doppler ultrasound report in his hand, and his face looked a little unsightly.

"Director, Professor Li, the gynecological ultrasound results of patient 31 are out."

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