I Can See Health

  Chapter 638 ECG at 37 minutes

  CCU shows the classroom.

   Many doctors came to participate in the discussion.

   Most of them are senior attending physicians, and there are also some deputy chief physicians and chief physicians.

   There are very few doctors like Lu Chen who just came to the hospital.

   Lu Chen knew almost no one except his mentor, chief director Liu Jun, and the doctor in the second district of his heart.

  When he was in the Jinghua Second Hospital, he participated in many case discussions.

   However, they are all participating as students, and they are rarely able to express their own ideas.

   This time is different. He represents Mr. Zhang Shuqing's medical team and has the opportunity to express his opinions.

   "Lu Chen, come here!"

   In the noisy environment, Lu Chen suddenly heard a voice, he looked for it, it was Jiao Jingqiu, the attending doctor in the second district of his heart.

   There was a young doctor sitting next to her. Lu Chen looked at him, and he probably wasn't someone in the second area of ​​his heart.

  Lu Chen stepped forward and sat beside Jiao Jingqiu.

   "Lu Chen, are you here to study too?" Jiao Jing Qiu Yingying smiled.

  Lu Chen was taken aback for a moment, then nodded and smiled, "Mr. Zhang asked me to come and see. What is the condition of this patient, why are so many people here?"

   "I'm not too sure." Jiao Jingqiu shook his head and whispered, "But I heard that the patient seems to be a family member of a leader in the city..."

  Lu Chen frowned slightly, the anticipation that had just risen in his heart disappeared in an instant.

   He thought it was some difficult patient!

At this time, the male doctor beside Jiao Jingqiu said, "I heard from my colleague in CCU that it is a patient with sinus bradycardia, and the patient's eldest brother is the leader of a certain unit in the city. What is the purpose of this discussion? , is to see whether to put the pacemaker."

   "That's all? Do you want to have a big discussion in the subject?"

  Jiao Jingqiu blinked her eyes in disbelief.

   "Tell me that you are young, you have no consciousness at all!" The male doctor grinned, "The leadership is a big deal! Even if the illness is not serious, it must be shown to the leadership!"

   "But our clinicians are very busy!" Jiao Jingqiu pouted, "Who has the time to mess with them here..."

  Lu Chen pursed his lips, but did not speak.

  He agreed with Jiao Jingqiu's words in his heart.

   But everyone is in this environment, and many things cannot go as they wish.

   Only when you become stronger can you have a choice.

  …

   At this moment, Liu Jun on the podium spoke.

   "Everyone returned to their seats, and the case discussion began immediately."

As soon as the    voice fell, the noisy sound in the classroom slowly disappeared, everyone sat down, and those who did not find a seat stood at the back.

   At this time, on the projector in front of the podium, the medical records of the patients in this discussion appeared.

   Zhang Shuqing also walked slowly to the stage.

   "The case discussion this time, I invite everyone to come here, mainly about the issue of pacemaker implantation..."

   With the PPT screening, Zhang Shuqing introduced the patient's condition and auxiliary examination materials to everyone one by one.

   Condition introduction is complete.

   Liu Jun, Director of Cardiology University, stepped onto the podium again, looked around the crowd, and said slowly:

   "The topic of this discussion, do patients need to have a pacemaker implanted? After the pacemaker is implanted, what treatment problems do they need to face?"

   "I won't name names. Let's brainstorm and speak up."

   After Liu Jun finished speaking, there was a murmur of discussion under the podium.

  Lu Chen saw a middle-aged doctor raise his hand in the front row, Zhang Shuqing immediately handed over the microphone.

   "Okay, the first person to speak is Director Qin from the first district in the heart." Liu Jun nodded slightly.

  Qin Feng is the deputy chief physician who has just been promoted this year. He has made good achievements in the field of electrophysiology.

   He stood up, took the microphone, and said slowly, "I just heard Director Zhang's introduction, and I have a certain understanding of this patient."

   "The main symptom of the patient is fatigue, the electrocardiogram is sinus bradycardia, the heart rate is only about 37 beats/min, and it may be slower to fall asleep at night!"

   "Other tests, including routine blood tests, liver and kidney function, thyroid function, and echocardiography were normal."

   "The initial diagnosis is sinus bradycardia. If the patient has severe symptoms of fatigue, a pacemaker needs to be implanted!"

  Liu Jun nodded slightly when he heard the words.

  Lu Chen kept frowning, staring at the ppt screen.

   The interface where the PPT is parked on the podium is the patient's electrocardiogram.

  …

   "Who will speak next?" Liu Jun continued to ask.

"Let me do it!"

   There is a middle-aged female doctor next to Director Qin. She wears glasses and has a serious face. It seems that she should also be a director-level figure.

   "Director Zhang, here it is."

   Director Qin immediately handed the microphone to her.

   Liu Jun on the stage smiled, "Okay, then Director Zhang from the fourth district in his heart will express his views."

Director Zhang stood up, her voice was a little cold, she did not directly pervert whether a pacemaker was implanted, but asked: "Has the patient ever taken heart rate-lowering drugs, such as Betaloc, drugs such as digitalis, etc. What was the previous heart rate of any patient? Is it a manual worker, or an athlete?"

   Director Zhang has many questions.

   basically revolves around the slowdown in heart rate.

   Long-term oral heart rate-lowering drugs, as well as manual workers and athletes, will have a slow heart rate.

  If it is physiological and there is no symptoms of severe dizziness or syncope, then no special treatment is required.

  If it is because of certain drugs, then stop the drug, after removing these factors, the patient's heart rate should be able to increase.

   On the stage, Zhang Shuqing explained one by one: "The patient has not taken any heart rate-lowering drugs, nor has he been a manual worker, nor an athlete."

   Director Zhang nodded, "I think it's better to be cautious. After perfecting the dynamic electrocardiogram, we will further evaluate whether to implant a pacemaker."

   "Okay, Director Zhang's opinion is good." Liu Jun nodded with a smile.

   Next, several directors and senior attending physicians spoke.

   However, the opinions of these people are similar to those of Director Qin and Director Zhang at the beginning.

   It is necessary to place a pacemaker, or after improving the dynamic electrocardiogram, and then assess whether to implant a pacemaker.

  …

  Lu Chen didn't speak.

   He found a copy of the patient's electrocardiogram and read it repeatedly.

  Jiao Jingqiu also came over and took a few glances.

   "Lu Chen, what else is so good about this electrocardiogram?" Jiao Jingqiu wondered, "Isn't it a sinus bradycardia, no matter how you look at it, you can't see anything?"

  Lu Chen smiled and shook his head, "I'll just take a look."

   The electrocardiogram shown on the ppt just now cannot be seen clearly.

  Lu Chen will never "follow what others say".

   It is only after one's own thinking that the final diagnosis can be made.

   His ECG skills are already advanced, and his proficiency in ECG interpretation has reached 93%.

   Most of the electrocardiograms with problems have no clue in his eyes!

  …

at this time.

  The male doctor sitting next to Jiao Jingqiu whispered, "Jingqiu, what's the use of discussing this? Isn't it the same result?"

   Jiao Jingqiu nodded helplessly, "No way, we still have to discuss it! How about... I'll speak too?"

   "Ah? You, you want to speak?" The male doctor said in surprise, "What can you say?"

   At this moment, Liu Jun was asking if anyone else was speaking from the podium.

   Jiao Jingqiu immediately raised his hand.

   "Oh, let's talk about the doctor at the back."

The    microphone was successfully handed to Jiao Jingqiu.

   "Cough cough." Jiao Jingqiu cleared her throat, stood up and said, "Isn't this a simple sinus bradycardia?"

   "Severe sinus bradycardia just explains the patient's symptoms of fatigue, especially after exercise. Sinus bradycardia is also one of the manifestations of sick sinus syndrome."

   "Severe sinus bradycardia with symptoms, just implanting a pacemaker, from symptoms to ECG and treatment... Isn't this perfect?"

   "This is a very straightforward question..."

   Jiao Jingqiu pouted.

   It is such a simple question, and it takes so many people to sit together and discuss it for so long?

   The family members of this leader are really big names!

  The male doctor sitting next to Jiao Jingqiu was in a hurry at this time, and quickly lowered his voice, "Jingqiu, don't say a few words! What are you talking about?!"

   On the podium, Liu Jun's expression changed slightly, and then returned to normal.

   He could hear Jiao Jingqiu complaining inside and out.

   This kind of thing is not something a little doctor can complain about.

   There are so many directors in front of you who have no opinion, why did one of your attending doctors jump out?

   "Okay, I remember Dr. Jiao's opinion."

   Liu Jun nodded towards Jiao Jingqiu, his eyes burning like torches.

   "Okay, this discussion is over, we finally summarize our opinions..."

   Just when Zhang Shuqing was about to announce the end of the discussion, he suddenly caught a glimpse of Lu Chen raising his hand.

   He was slightly startled.

   He was still thinking about why his student Lu Chen didn't speak up, and showed his face in front of everyone, making a wave of presence.

  Lu Chen really raised his hand.

   However, the discussion is coming to an end now.

   Now raise your hand to speak, is it necessary?

   It seems that there will be no other different opinions, right?

   "Oh? There is also a young doctor speaking." Liu Jun also saw Lu Chen raising his hand, "Then you can make the last speech."

  Lu Chen stood up slowly and took the microphone from Jiao Jingqiu's hand.

   Jiao Jingqiu's face brightened, thinking that Lu Chen was really interesting.

   must have come to help him complain!

The male doctor beside    sighed slightly, thinking, next time, he must stay away from these two goods...

   However, Lu Chen's first sentence stunned everyone present.

   "Teachers, I want to ask a question, is this patient's ECG a bradyarrhythmia or a tachyarrhythmia?"

   There were still people whispering in the entire showroom just now, but at this moment there was no sound.

   Everyone looked at Lu Chen with puzzled eyes, even with a hint of mockery.

   Beside him, Jiao Jingqiu opened his mouth so wide that he could even put a fist in.

  Lu Chen is too exaggerated!

  On the electrocardiogram, the patient's heart rate was clearly written as 37 beats/min!

   Normal heart rate is 60-100 beats/min.

   Less than 60 beats/min, that is bradycardia.

  > 100 beats/min, it is called tachycardia.

   "Lu Chen, are you alright? Are you out of your mind?" Jiao Jingqiu said in surprise, "The heart rate of this electrocardiogram is 37 beats per minute!"

   (end of this chapter)