I Can See Health

   Chapter 636 Where is Director Zhang?

   Patient's surgery is scheduled for next week.

  Because of the use of amiodarone for cardioversion, the effect of the drug is long-lasting and the effect is very good. In order to avoid the inability to induce supraventricular tachycardia during the operation, the operation is scheduled for the next week, and the amiodarone is metabolized out of the body as much as possible.

   After this patient, Yu Bin's attitude towards Lu Chen was very different.

   It turns out that Lu Chen is not only good at publishing papers, but also very proficient in various clinical skills.

   Judging from Lu Chen's ECG interpretation skills and his ability to communicate with patients, he is not a rookie!

   On the contrary, Yu Bin could faintly feel that Lu Chen's clinical thinking had even surpassed his.

   When facing Lu Chen, it was like asking him to face Director Zhang Shuqing.

   This feeling was the strongest when Yuhama was doing ward rounds every morning.

   "Lu Chen, please help me see a patient."

   "It's the patient with chest pain who took the medicine for coronary heart disease and still has pain!"

   "Yes, that's 28 beds!"

  Lu Chen is like a superior doctor who is omnipotent and answers every question.

   "Okay, then I'll go look at the 28 beds later."

   Then other people in the second district in their hearts will see a strange scene.

  Lu Chen took Yu Bin and other students to round the room together.

   This combination is quite weird!

   Logically speaking, Yu Bin has been clinically managing the bed independently for many years.

  Lu Chen has just graduated and has never managed a bed independently.

  Why do the roles of the two seem to be reversed!

   "This old lady's chest pain, I don't feel like coronary heart disease." Lu Chen read 28 patients.

   "Isn't it chest pain?" Yu Xin wrinkled, "But after coronary CTA, the blood vessels are narrowed."

   "There must be coronary heart disease." Lu Chen said, "But her chest pain is not necessarily caused by coronary heart disease or angina pectoris."

  Lu Chen opened the chest CT image of the patient.

   "You look at this picture first."

   "This...I've seen it." Yu Bin whispered.

   "Take a closer look."

   "Oh." Yu Bin nodded slightly, trying to find a different location.

   But he read it three or four times and found no abnormality in the CT scan of the patient's chest.

   "Are you sure there is nothing abnormal?" Lu Chen asked again.

   "Really... Really no..." At this time, Yu Bin had already flinched a little.

  Lu Chen smiled and put the patient's CT image results in front of Yu Bin's eyes again.

   "Senior brother, look at this place of the patient..."

  Lu Chen pointed to a part in the CT.

   "This is... the spine?" Yu Bin was stunned.

  He is a cardiologist, so what is he doing to see the spine when he has nothing to do?

   Suddenly, when he looked at the CT image magnified by Lu Chen again, he was stunned.

   "Spine deformity?" Yu Bin asked in surprise.

   "Yes!" A smile appeared on the corner of Lu Chen's mouth, "The patient is an elderly woman with osteoporosis, and is prone to fractures or spinal deformities."

   This slight spinal deformity is invisible on the surface and is easily ignored by everyone.

   Even the patients themselves do not know it, they may feel heart pain or stomach pain.

   This point, Yu Bin really never thought of it.

   "Spine deformity, will it also cause chest pain?" Yu Bin wondered.

   "That's for sure!" Lu Chen nodded, "I have managed several patients, all of which are caused by spinal deformities..."

   Yu Bin's expression changed, and he immediately prescribed the corresponding treatment medicine to the patient.

  …

  Similar patients are not rare.

  Yu Bin slowly discovered that many difficult or undiagnosed medical records had been solved in Lu Chen's hands, miraculously!

   This made everyone in the second district in their hearts realize the clinical power of Lu Chen.

   Such a new doctoral student completely attracted everyone's attention.

   "Lu Chen, when is the surgery?"

   "No accident, it should be tomorrow." Lu Chen said.

   The operation they were talking about was supraventricular tachycardia, which was previously misdiagnosed as ventricular tachycardia.

   "Okay, then I'll go with you to be an assistant." Yu Bin said with a smile, "Can you do that?"

   "Of course, as long as the senior brother has time to go to the catheterization room, you can!" Lu Chen did not refuse.

  These electrophysiological surgeries are still relatively rudimentary, and there is not much technical content in them.

   "Well, Lu Chen, thank you!"

   The next day.

  Lu Chen checked the room in the morning. After finishing the work, he pushed the patient downstairs.

   The quality of life of the patient in the past week has been better than that of the previous three or four years!

  No more panic symptoms!

   "Doctor Lu, do I have to have surgery?"

   At this point, the patient begins to waver again.

   "Do it!"

   Lu Chen didn't understand what the patient was thinking, and immediately said.

   "Well, that's fine." The patient could only accept it silently.

  …

   Catheter lab.

   The patient's husband was waiting outside, and Lu Chen pushed the patient into it.

   Not long after, Yu Bin also came down.

   He has changed into his surgical gown and looks ready to take the stage as an assistant.

   "Lu Chen, where is Director Zhang?"

   Yu Bin asked curiously.

  The surgery is about to start, why can't you see the surgeon?

   "What is Teacher Zhang doing here?" Lu Chen wondered.

   This kind of ablation operation is the most basic operation, so there is no need for Director Zhang to come?

   "Director Zhang won't come? Is he okay?" Yu Bin was startled, "Then, who will perform the surgery?"

   He looked around to see if teachers from other groups came to help with the operation.

   However, he did not see other groups of surgeons.

   "I do!" Lu Chen smiled slightly.

   "What? What did you say?"

   Yu Bin was stunned.

   "You, aren't you an assistant?"

   "Who said I was an assistant?" Lu Chen shrugged, "I'm a magician!"

   Yu Bin swallowed, "Lu Chen, this joke isn't very fun, it's not a practice!"

  Lu Chen did not explain much, and went directly into the catheterization room.

   "Ah, you..."

  Yu Bin stared blankly at Lu Chen walking into the catheterization room, his mind was still in chaos.

   He was going to be an assistant, but now...

  Yu Bin stayed outside the catheter room, watching Lu Chen's next steps in shock!

  …

   The patient went to the console with mixed emotions of anticipation and fear.

  Due to the shadow caused by electrical cardioversion, when Lu Chen put in the lead, the patient instinctively shouted "don't electrocute me".

   However, after Lu Chen's explanation, the patient's mood calmed down.

   After that, the surgery went very smoothly.

  Electrophysiological examination showed a dual AV nodal pathway, and it was very easy to induce a typical slow-fast AV nodal reentrant tachycardia.

  When Lu Chen stimulated the atrium rapidly, the atrioventricular 1:1 conduction and the QRS complex appeared widened (differential conduction). The widened shape was consistent with the clinical tachycardia.

   It is inferred that the patient's wide QRS tachycardia should be atrioventricular nodal reentrant tachycardia with differential conduction.

   The next ablation process is very simple.

   After the slow path of the atrioventricular node was modified, the tachycardia was no longer induced.

   The whole process lasted 40 minutes.

   After 4 years, the patient can be said to have cleared away the clouds and mists, and the willows are bright.

   (end of this chapter)