This Doctor is Great

After a ppt report, Zhou Mo made a small appearance in Zhou Da's rounds.

It left an impression on many doctors.

This kid is so terrifying, he must not stay... Oh no, it should be—this pretty boy!

but,

Zhou Mo is extremely eager to stay in the hospital, so he naturally wants to continue to express himself and make people continue to admire him.

Therefore, in the following ppt reports of other doctors, Zhou Mo has been listening carefully, looking for an opportunity to express himself.

6th...

8th...

10th...

finally,

On the 11th, the doctor in charge of the ccu reported a case, and Zhou Mo found an opportunity!

…………

The bed management doctor of ccu reported a special case of his bed management to the professors using PPT.

Patient A, a 33-year-old male, was sent to the emergency department because of chest pain. The blood pressure was very low, 98/50mmHg, and the electrocardiogram was diagnosed as myocardial infarction.

The so-called myocardial infarction is myocardial necrosis caused by acute and persistent coronary ischemia and hypoxia.

Most of the cases are caused by thrombus leading to blockage of coronary arteries, or too severe atherosclerosis leading to too narrow coronary arteries with different blood flow, or a sharp increase in myocardial oxygen consumption or coronary artery spasm...

Responding to this patient A, because he is young, does not usually have high blood pressure, does not have coronary heart disease, and does not have strenuous exercise, so it is basically suspected that a thrombus blocks the coronary artery, causing myocardial infarction.

then,

Yesterday, I was urgently sent to the Department of Cardiology for coronary angiography + intervention to eliminate thrombus.

but! !

A problem occurred!

After coronary angiography was performed in the Department of Cardiology, it was found that there was no thrombus in the coronary artery and no narrowing of the passage.

In other words, not a heart attack!

However, the electrocardiogram showed that it was a myocardial infarction.

Electrocardiogram: Normally, the heart continues to discharge. When the electrodes of the electrocardiogram are placed on the chest wall, you can feel the electrical conduction, and then record it on the electrocardiogram. If there is ischemic and necrotic myocardium, their discharge must be poor , can faithfully respond to the ECG chart, thereby capturing useful information.

Moreover, after the blood test, the patient's troponin was significantly increased, and the diagnosis of myocardial infarction was basically confirmed.

Troponin is a protein that almost only exists in the heart muscle cells. Once the troponin rises, it can be inferred that the heart muscle cells are necrotic and ruptured, and the troponin is released into the blood, so the troponin can be detected. Elevated protein.

Now the electrocardiogram + troponin all prompt: myocardial infarction!

But coronary angiography denied myocardial infarction!

Contradiction!

then,

The inexperienced doctor who managed the bed was stumped by this patient A.

Then I made a ppt, and made a big rounds report this morning, hoping to get the teachings of the professors.

Patient A case report finished...

Many doctors began to think.

Maybe it's because I'm tired, maybe I want to test my subordinates,

At this time, Professor Qi, the chief director, no longer commented, but leaned on the back of the chair, smiled and encouraged and said: "This case is interesting, everyone can speak freely..."

In the Department of Cardiology of the Provincial Second Hospital, because it is a large department, there are many doctors, and the leadership style, the internal competition atmosphere of the Department of Cardiology is relatively strong.

Every big ward round is an opportunity for junior doctors to perform, and it depends on whether there are junior doctors who can seize it.

Other professors and associate professors sat upright and did not grab the opportunity of their subordinates to speak and perform.

Zhou Mo wanted to raise his hand, but someone was faster.

A resident doctor raised his hand and said, "I think myocarditis can be considered. Myocarditis can lead to the destruction and necrosis of myocardial cells, which can naturally cause the increase of troponin..."

As soon as the words fell, Zhou Mo was about to speak, and another resident raised his hand and said quickly:

"I think that in addition to myocarditis, aortic dissection and pulmonary embolism can also be considered... because pulmonary embolism and aortic dissection can also show symptoms similar to acute myocardial infarction, especially chest pain. The heart and lungs are not separated, and sometimes the lungs The problem will affect the heart sideways, and all changes in the electrocardiogram are also possible..."

Zhou Mo was surprised.

I go,

In the fifth group, why are all the doctors like salted fish? During the ward rounds, it may not be so fierce to rush to answer.

Why didn't he even get a chance to interrupt during the rounds.

Too fierce! !

Huang Yiming tugged at Zhou Mo's sleeve: "What? You want to speak too?"

Zhou Mo whispered: "I don't have a hospital yet, I want to behave better, so that the leader can remember me and stay in the hospital in the future."

"Ah?" Huang Yiming only realized it at this time. That's right, Zhou Mo is different from himself. He has already signed an employee contract with the Second Provincial People's Court. But Zhou Mo is a free man.

"Come on!!" Huang Yiming encouraged Zhou Mo.

Zhou Mo nodded.

Subsequently,

Zhou Mo raised his hand many times, but he didn't grab others.

A doctor from Guipei said that it may be heart failure, shock...

Some resident doctors also said that it may be a serious arrhythmia...

You can say anything.

After about 6 doctors delivered their speeches, the rhythm of the competition finally slowed down.

At this moment, Zhou Mo finally got his chance.

"I think there's another possibility—broken heart syndrome."

"???"

"Broken Heart Syndrome?"

"TTC? Acute stress cardiomyopathy?"

As soon as Zhou Mo's words came out, many doctors suddenly became refreshed.

A fresh and refined disease appeared!

Fresh!

It is no longer the old-fashioned arterial dissection, pulmonary embolism, myocarditis, etc...

"It seems possible..."

"Broken Heart Syndrome, it really fits well..."

Professor Qi's gaze couldn't help but look at Zhou Mo a few more times at this moment.

Let’s not talk about whether it is accurate or not, but the broken heart syndrome proposed by Zhou Mo has greatly broadened the horizons of doctors.

Broken Heart Syndrome, this is also a special heart disease that Zhou Mo has been working hard to make up for various diseases in the Department of Cardiology in the past two days, and then came across it.

Its origin is that a research team led by Dr. Champion treated 19 emergency patients between 1999 and 2003. These patients had symptoms such as chest pain and suffocation, which were similar to the symptoms of a heart attack.

Moreover, after the 119 incident in the United States, the researchers interviewed relatives of 100 victims. It turned out that these grieving people experienced physical pain for a certain period of time, feeling that the throat was tight and dry, breathing was difficult, the need to sigh, the abdomen felt empty, muscle weakness, and a feeling of heartache and tension.

Finally, the "New England Journal of Medicine" published Dr. Champion's article, the disease described as - broken heart syndrome.

It is rare in China, but it is estimated that most cardiologists know it, but it is easy to ignore it.

When Zhou Mo read about this case,

Bald Whimsy:

Could Lin Daiyu's illness be this disease?

Zhou Mo continued: "Broken heart syndrome, the symptoms of this disease look similar to acute myocardial infarction on the surface, but after the heart is tested, it is found that there is no coronary artery blockage. On the contrary, the appearance of the heart looks like Like a balloon, it is caused by the improper contraction of the bottom of the heart...So the patient can use this method to identify whether it is a broken heart syndrome...In addition, you can ask him if he has been too sad recently..."

Thanks: "Humble Gentleman and Humble Self-Shepherd" for the reward... the first one, thank you! !

In addition, I will read the book review area and this chapter, looking forward to...