I Can See Health

   Chapter 572 Bubble signals in the brain! (Ask for a monthly pass! Fight for 2000!)

  The First Affiliated Hospital of Kyoto University, cafeteria.

   "You eat first, I still have something to do!"

  Lu Chen suddenly stood up, a glint of light flashed in his eyes.

   Suddenly, he thought of a potential possibility for the woman's condition!

   He didn't even bother to eat, so he was about to leave the cafeteria.

   "Lu Chen, where are you going?" Wang Zihao said immediately.

   "Go back to the department!" Lu Chen waved his hand, turned his head and said, "Ke Yue, thank you for reminding me just now, I'll go first!"

   After that, Lu Chen left the cafeteria in a hurry, leaving only the three people who looked at each other in dismay.

  …

   Back to the department.

  Lu Chen immediately came to the ward of the "big relationship".

   At this time, the woman was eating lunch brought by her family.

   Seeing Lu Chen who rushed to the ward, the woman was slightly taken aback, "Doctor Lu, who are you?"

  Lu Chen calmed down a little and said, "I'm sorry to disturb you for lunch. I have a new idea about your condition."

   Hearing Lu Chen's words, the woman immediately put down the chopsticks in her hand, and she didn't care about eating anymore.

   This migraine tormented her hard.

   Especially the hemianopia and limb sensory impairment this time, scared her to death!

   She will now try her best to seize every opportunity to solve the "migraine"!

   "Doctor Lu, speak slowly, I'm in no hurry to eat." The woman looked at Lu Chen and pricked up her ears, not daring to miss a word.

   "You may do a foaming test!" Lu Chen said slowly.

   "Foam test?" The woman was taken aback, she looked up a lot of treatments for her condition.

Migraine, craniocerebral tumors, etc., she has a lot of knowledge, and she dare not say that she has a doctor's specialty, but at least she can understand the relevant terms, but this time Lu Chen proposed the foaming test, she is fundamental Never heard of it.

   "Because I suspect it's not your head that has a problem..." Lu Chen held the woman in front of him tightly, "It's a heart problem!"

   This sentence made the woman even more confused.

   If there is a problem with the heart, how can the brain behave?

   "You listen to my explanation first." Lu Chen continued.

   He didn't expect this kind of situation at first, he always thought it was a disease of the nervous system, but after Ke Yue's reminder just now, he suddenly thought of a disease.

   "You said, I'm listening." The woman was also attentively at the moment.

   Just listen to Lu Chen slowly: "Many adults, about a quarter of them, will have a patent foramen ovale, but most of them are very mild and do not affect their lives. A small number of people will have symptoms."

"The foramen ovale is a physiological channel in the heart's atrial septum, which is formed during the embryonic period. This foramen ovale closes soon after birth, but some people do not close it. If it is severe, the blood in the right atrium will flow into the to the left atrium, and then you have your migraine, neurological symptoms."

   The woman looked at Lu Chen with a bewildered expression.

   She couldn't understand Lu Chen's explanation, because she didn't know the anatomy of the heart at all!

"Let me explain it this way." Lu Chen found a pen and paper and began to draw a diagram, simply drawing the four chambers of the heart on the paper, "The heart has four chambers, and the left atrium and right atrium are adjacent but not connected. , because the interatrial septum wall separates them, and the foramen ovale is a secret passage between the two rooms. This secret passage is open during the embryonic period, but it closes shortly after birth, and the two rooms are not connected since then. Connected."

   "Oh, you draw the picture like this, I can understand a little bit." The woman is also a intellectual, and immediately understood what Lu Chen meant, "However, the hole you said is not closed, why does it cause me a headache?"

  Lu Chen continued to explain: "Because the foramen ovale is not closed, part of the blood will directly cross this foramen and enter the right atrium. This part of the blood does not pass through the lungs, but directly enters the systemic circulation and enters the brain."

   "Because this part of the blood does not pass through the lungs, there are often small emboli or small air bubbles, which can directly enter the brain and cause blockage, causing a stroke-like performance. You suddenly had hemianopia and limb disorders last night, and this is the reason!"

  The woman was stunned for a while, she roughly understood what Lu Chen said, "In other words, there is a hole in my heart?"

   "That's understandable." Lu Chen said, "In fact, this patent foramen ovale is very common, many people have it, but they are not serious, there is no problem, and they are not found."

   "Then how can we discover the existence of the breach?"

  The woman believed Lu Chen's statement a little, it sounded like the same thing.

   Actually, no matter if Lu Chen can justify it or not, she will try to believe him.

  Because I have never had her disease, I don't understand her pain!

   Now, if there is any hope, she will seize it!

Lu Chen thought for a while, and said, "Some people can see it on echocardiography, but if the patent foramen ovale is relatively small, the echocardiography may not be able to see it, because the probe is placed on the chest, and the distance from the heart is still too far. , difficult to distinguish."

   "What should we do then?" the woman asked.

  Lu Chen smiled and said, "Then do a transesophageal echocardiography, which is to insert the probe through the mouth, all the way deep into the esophagus, and do an ultrasound in the esophagus. Because the esophagus is close to the heart, it will be clearer."

   "Isn't it uncomfortable to do it through the esophagus?" The woman was a little worried.

   "That's right, just like doing a normal gastroscope, if something goes deep into your esophagus, it will definitely be uncomfortable." Lu Chen nodded slightly, "In addition, in addition to the echocardiography, the foaming test I just mentioned can also find problems."

  The so-called foaming test is to use a tube of physiological saline, air, and blood mixed liquid, fully vibrate (two syringes back and forth) to generate air bubbles, and then quickly inject it from the human arm vein.

Theoretically, after these bubble-filled fluids enter the veins, they will immediately enter the superior vena cava → right atrium → right ventricle → pulmonary artery → pulmonary capillaries → pulmonary veins → left atrium → left ventricle → systemic circulation (various arteries, such as the middle cerebral artery) .

If the patient does not have a patent foramen ovale, the liquid filled with bubbles will enter the pulmonary capillaries according to the above path, and the bubbles will be absorbed by the capillaries and will not enter the systemic circulation, so we perform transcranial Doppler color Doppler ultrasound on the patient to monitor the brain In the middle artery, there will be no traces of air bubbles.

However, if the patient has a patent foramen ovale, and the right atrial pressure can be increased by inhaling and holding the breath (Valsalva maneuver) during the operation, the bubble-filled fluid will directly flow from the superior vena cava → right atrium → foramen ovale → Left atrium → left ventricle → systemic circulation (including middle cerebral artery).

   Some of the bubbles will directly pass through the foramen ovale to the left heart, and then enter the cerebral artery immediately. At this time, a transcranial Doppler ultrasound can detect the bubble signal, so it is inferred that there is a patent foramen ovale.

  …

  Lu Chen immediately brought the woman to the ultrasound examination room to conduct the foaming experiment.

   Sure enough, it was not what Lu Chen expected.

   After examination, a bubble signal was found in the woman's brain!

  This means that a woman's heart may indeed have a patent foramen ovale.

   Hearing the result, the "big relationship" woman was surprised and delighted.

   Surprisingly, there was something wrong with his heart, and from what Lu Chen said, it seemed to be a congenital heart disease.

  Happily, we finally found the cause of "migraine"!

   Ask for a monthly pass!

   (end of this chapter)