I Can See Health

   Chapter 728 Shall I come? (third more)

  As the inpatient general of the Cardiology Department, Lu Chen also undertakes all emergency consultations and rescue work in the Cardiology Department.

   Therefore, the medical team from the island country came to discuss this matter. Although he knew about it, he did not go to join in the fun.

   However, the island medical team did not bother him.

   The emergency consultation in the emergency department came to him again!

   Magic City No. 1 Hospital, CCU lounge.

   At this time, Lu Chen was in a dream.

   A rush of cell phone alarms woke him up directly.

   "Mr. Lu, emergency consultation in the emergency department!"

   Wu Si no longer made the special phone number of the hospital chief, and directly called Lu Chen's private phone.

   "Okay, I'll be there soon!"

  Lu Chen was busy wearing a white coat while holding his mobile phone in one hand.

   opened the door, and there were bursts of noise outside the catheter room. He didn't pay much attention to it, and hurriedly walked towards the emergency department.

  …

   About five minutes later, Lu Chen arrived at the emergency department.

   On the hospital bed, an old man who was sweating profusely and short of breath was sitting on the hospital bed.

   The head of the bed was shaken at a right angle of 90 degrees to the ground.

  Wu Si, the attending physician of the emergency department. Nurses are being organized to rescue patients.

   Seeing that Lu Chen had arrived, he felt a little more at ease.

   "Mr. Lu, this should be a patient with acute heart failure."

  Lu Chen nodded, without the slightest trace of ink, picked up the stethoscope and began to perform a simple physical examination on the patient.

   Wu Si started to introduce Lu Chen's condition.

  The patient developed dyspnea without obvious incentive more than one month ago, accompanied by chest tightness and shortness of breath, which was aggravated in the supine position, and relieved after sitting up. He went to the local hospital for diuresis and improved circulation, and the symptoms improved.

   One day ago, the above symptoms worsened, and he coughed up pink foamy sputum. He went to the local hospital again.

   Diagnosed as "heart failure", he was given nitroglycerin and sodium nitroprusside, but the curative effect was not good. After that, 7 vials of "recombinant human brain natriuretic peptide for injection" were pumped for 5 days, and the patient's condition still did not improve significantly.

   An hour ago, the patient was transferred to the emergency department of Modu No. 1 Hospital and continued treatment.

   "At present, heart failure is certain!" Lu Chen agreed with Wu Si's diagnosis.

   Through physical examination, the patient was orthopnea, full of wet rales in the lungs, and edema of both lower extremities, which was obviously a symptom of acute heart failure.

   And his HP is 47 (---), in a critical condition, the risk of sudden death is extremely high!

   "Use furosemide first." Lu Chen said, "After stabilizing the patient's vital signs, transfer to CCU."

   "Okay." Wu Si nodded. At this time, he took out another case.

   It seems that it should be the patient's case data in the local hospital.

   "Mr. Lu, look at this, the patient had an echocardiogram at the local hospital and it showed severe aortic valve stenosis - mild regurgitation!"

  Lu Chen raised his brows slightly, and immediately accepted the report in his hand.

   From this heart ultrasound report, the patient's condition can be completely determined.

  Chronic heart failure caused by heart valve disease, and acute attack!

   Moreover, patients with severe aortic stenosis are absolutely suitable for TAVR surgery!

   After flipping through it for a while, Lu Chen asked Wu Si to bring over the emergency ultrasound machine for the sake of safety.

   He needs to review the patient with echocardiography.

   Ultrasound is related to the operator's technique.

  Small tricks are very likely to cause huge errors!

  …

   Wus soon had the nurse push the ultrasound machine.

   After performing a cardiac ultrasound examination on the patient, Lu Chen was again diagnosed with "severe aortic stenosis".

   Moreover, he also measured the patient's cardiac ejection fraction, which was only 38%!

  Other data showed severe calcification of the aorta.

   Aortic valve: Vmax: 3.5m/s, Pgmean: 26mmHg, valve area: 0.6cm.

   The left atrium and left ventricle were enlarged, and the ascending aorta was widened. The basal segment of the interventricular septum is thickened and the ventricular wall beat is diffusely weakened.

   "What was the result?" Wu Si asked curiously.

  Heart ultrasound, unlike abdominal ultrasound, is difficult to understand if the anatomy is not clear.

   "The local hospital has done a good job." Lu Chen said solemnly, "There is indeed severe aortic stenosis, so it is best to do emergency TAVR surgery immediately!"

   Wu Si had no doubts about Lu Chen, "I'm going to communicate with the patient's family?"

  Lu Chen nodded, "If the family agrees to the operation, send it to the CCU immediately, and I will help contact the surgeon."

   "Okay!" Wu Si heard the words and quickly called the patient's family aside and started talking about the emergency surgery.

   Lu Chen stayed in the emergency room and continued to watch the patient's condition.

  …

   Five minutes later, Wu Si's communication ended.

   "The patient's family agreed!" Wu Si walked into the emergency room with a hospital certificate in his hand, "Mr. Lu, are you going to the CCU now?"

   In fact, he almost guessed the result. The patient's family members went to many hospitals and sent the patient to the First Hospital of Magic Capital, and he would definitely not give up easily.

   "Wait a minute, I'll call CCU first." Lu Chen said.

   He wants to ask the CCU doctor to prepare, and also to confirm that the CCU catheter has a free operating room.

  The call was connected immediately.

   "CCU in my heart? I'm Lu Chen."

   "Mr. Lu, what's wrong?" It was CCU doctor Zhang Lulu who answered the phone.

Lu Chen heard it all at once, and quickly said: "Sister Lulu, there is a patient with severe aortic valve stenosis in the emergency department. He has acute heart failure and may need emergency TAVR surgery. I heard that the medical exchange group from the island country came to the catheter. Room, can surgery be done over there now?"

   "There is a free operating room now, and emergency surgery can be done!" Zhang Lulu said immediately, "But Professor Zhang Shuqing and Professor Zhu Qingshan are both on stage. If you want to perform TAVR emergency surgery, there may be no one."

  Lu Chen frowned slightly, "Is there anyone?"

   At present, there are many people who can perform TAVR surgery in the First Hospital of the Magic City, but only Zhang Shuqing and Zhu Qingshan are the only doctors who can perform this kind of emergency surgery!

  Lu Chen hesitated for a moment, then said slowly, "Why don't I do it!"

   Zhang Lulu was stunned for a moment. She knew that Lu Chen could independently lead the TAVR operation, and he had done a lot.

   "But you are the hospital chief now..." Zhang Lulu whispered.

   "Sister Lulu, I'm a cardiologist first, and then I'm the chief inpatient." Lu Chen said, "The patient needs emergency surgery, and I'm definitely responsible for it. As for the chief inpatient work, Ms. Lulu, are you busy now?"

  Zhang Lulu smiled helplessly, "You kid actually came to fight my sister's idea! I happen to be not the main class today, so I can help you with the general work in the hospital for a while."

   Seeing Zhang Lulu say this, Lu Chen's face showed a hint of joy.

   "That's great! Thank you, Lulu! I'll ask the emergency department to bring the patient to the CCU right away."

   hung up the phone, and Lu Chen immediately told Wu Si to pack up and prepare to transfer the patient to the CCU ward.

   Lu Chen took a step ahead and returned to the CCU ward to start preoperative preparations.

   (end of this chapter)