I Can See Health

   Chapter 577 The Sense of Dying

  The first step for treating patients is to ask for medical history and physical examination.

  Lu Chen gave all the work to the female intern Su Rui.

   She deserves to be a student of Kyoto University's medical school. She is well-mannered in the consultation and physical examination, so Lu Chen can't pick out any faults at all.

   Patient Li Wenqian, 28 years old this year.

   A few months ago, I started feeling flustered occasionally.

   "It means that the heart will jump suddenly, accompanied by a feeling of pressure in the chest." Li Wenqian added.

  Lu Chen nodded slightly, "In our medical terminology, it's called palpitations and chest tightness."

   The patient initially thought that it was a bad heart.

   "I'm not yet thirty years old! My heart is not good!" Li Wenqian was scared to pee just thinking about it.

   After all, heart disease is no trivial matter, and even the smallest heart disease can make people miserable.

  Severe heart disease and even sudden death, can you not worry?

   "I went to the hospital at that time!" Li Wenqian recalled, "The cardiologist at the hospital below us auscultated my heart and did an electrocardiogram. No problem was found, except that my heart rate was a little too fast."

   Lu Chen wondered, the heart rate was too fast, which didn't mean anything.

  Some people have a fast heart rate when they see a doctor, which is caused by physiological stress.

   The patient's HP is 74 (-), and it seems that there shouldn't be too many problems.

   "Did you take any medication afterwards?" Lu Chen asked.

   "I did." Li Wenqian nodded, "I still remember that the doctor prescribed metoprolol tartrate."

  Metoprolol tartrate, this medicine is a beta-blocker. There are many beta-receptors in the heart. Once blocked, the cardiac activity will be inhibited, so it can be used to treat tachycardia and heart failure.

  Many patients with arrhythmia and high blood pressure will take this medicine. It is a very common and widely used medicine.

   "Is your heart feeling better?"

"It got better. Later, I was busy with work, so I didn't take it to heart." Li Wenqian said, "But two months later, the symptoms came back! The familiar heart is uncomfortable, and it suddenly comes on. It's like being taken aback, and then the heart is pounding for a few minutes, 5-6 times a day, and it's even worse than before."

   "Will taking metoprolol tartrate work?" Lu Chen wondered, listening to the patient's description, it really looked like some kind of paroxysmal arrhythmia.

"It doesn't work." Li Wenqian sighed, "The symptoms of this uncomfortable heart have seriously affected my daily life and work. Later, I went to the hospital again and chose to do it when I was most uncomfortable. Echocardiogram and EKG, but still no problems."

Su Rui, a female intern beside   , said: "It may be that the arrhythmia occurred for a short time and suddenly stopped. Although you still feel uncomfortable, the arrhythmia has already passed, so the electrocardiogram did not find any problems."

  Many arrhythmias are sudden and sudden, and it is impossible for ordinary ECGs to step on that point, so there is no way to find abnormalities.

   "Hey, that feeling is really uncomfortable, it's really like dying again." Li Wenqian said helplessly.

  Clinically, there is a professional medical term called near-death feeling.

   "The doctor at the local hospital gave me a different medicine." Li Wenqian took out another box of medicines, metoprolol succinate tablets from her bag.

  Metoprolol Succinate Tablets and Metoprolol Tartrate Tablets, are one-ingredient medicines.

   However, the latter is a short-acting drug, and one pill can only be used for a few hours; the former is a long-acting drug, and one pill can be used for about a day.

   "By the way, there is another medicine..." Li Wenqian pulled out another porcelain bottle of medicine from her bag, Suxiao Jiuxin Pills.

   Suxiao Jiuxin Pill is used for coronary heart disease, not arrhythmia, but people will curse mother when they are in a hurry, so bring it with you just in case.

   "Have the symptoms eased?"

   "No..." Li Wenqian showed a wry smile on her face, "All the medicines combined have no effect, not at all, and you will still feel uncomfortable and have that sense of near-death."

  Lu Chen frowned deeply.

   Described by the patient's symptoms, it looks like some kind of arrhythmia.

   And through the health value of 74 (-) on her head, there should be no fatal disease, otherwise the change trend cannot be a minus sign.

   "Have you done a 24-hour Holter?" Lu Chen asked.

  24-hour dynamic electrocardiogram, as the name suggests, is to carry the ECG box for 24 hours.

   As long as there is an arrhythmia attack within 24 hours, it can catch it.

   "I have done it, more than once, but to no avail."

   said, Li Wenqian took out a few more checklists from her bag.

  Lu Chen took it and took a look.

  There are a total of three dynamic electrocardiogram examination results, except for the occasional rapid heart rate, no abnormal problems were found.

   "I have been to many hospitals, but now I really have no choice." Li Wenqian sighed helplessly, "I can only come to your hospital."

   If the Cardiology Department of the First Affiliated Hospital of Kyoto University can't solve it, then she is really desperate!

  Lu Chen had a basic understanding of the condition, so he conducted a more careful physical examination on the patient.

   Heart and lung auscultation did not find any problems.

   "Senior Brother Lu, do you think it might be an autonomic disorder?" Su Rui suddenly said.

  Lu Chen nodded slightly, Su Rui's suspicion was fine.

   Autonomic dysfunction can also cause symptoms such as palpitations.

   The so-called autonomic nerves may not be well understood by everyone.

   In simple terms, it is the autonomic nerves that control the internal organs, including the sympathetic and parasympathetic nerves.

  If something goes wrong with them, the visceral sensation and movement will be unpleasant, so it is possible to suspect that the autonomic nerve disorder causes heart palpitations.

   However, Li Wenqian interrupted: "I checked the information on the Internet, and some people said that it was an autonomic disorder, so I was asked to take some B vitamins, oryzanol, etc., but it was useless for me."

  Lu Chen found that these people who came to see a doctor at the Kyoto Hospital had a thorough understanding of their condition and would often check information on the Internet.

  Su Rui frowned slightly, if it wasn't autonomic disorder, what else could it be? She pondered other possibilities in her mind.

   At this moment, Lu Chen said: "If there is really no way to detect arrhythmia, we can do electrophysiological examination."

  Arrhythmia is like a thief. The thief always waits until the night is dark and windy and the lights are dark before committing crimes.

After    succeeded, he quickly hid, and the police couldn't do anything about him (similar to an ordinary electrocardiogram).

  Okay, then step up the patrol, and the patrol will be guarded 24 hours a day (24-hour dynamic electrocardiogram).

   But even so, the thief still has a way to evade the patrol of the police and attack behind the scenes.

   What can we do in the end?

   There is only one way. If you want to catch the thief, you can only go from house to house to register and visit.

   This is called active attack, which is like an electrophysiological examination of the heart. It is directly near the heart to stimulate the heart (knock on the door to register), and if there is a problem, it will be induced.

   "What should I do with this electrophysiological examination?" Li Wenqian asked immediately.

"A minimally invasive surgery," Lu Chen explained, "directly use electrodes to penetrate deep into the esophagus, stimulate the heart near the esophagus, and see if it can induce arrhythmia. If it can, then find a way to perform radiofrequency ablation to burn off the lesions. "

  Lu Chen's description is straightforward.

   Li Wenqian was a little scared when she heard it.

   It's scary to move a knife on the heart!

   "I, I..." Li Wenqian swallowed and spit, "This... I'll think about it first. Doctor, let the director come to see me first..."

  Lu Chen shrugged his shoulders, there was nothing he could do. These patients didn't trust him, so he had to let Deputy Director Xiao Shikang come to the room for rounds.

   (end of this chapter)