I Can See Health

   Chapter 209 Ventricular Fibrillation After Headache

   "Chest tightness and breathlessness?" Yin Xinhua paused, "This may also be related to high blood pressure."

   "Can high blood pressure also cause chest tightness?" The patient's family looked puzzled, "Doctor, you...you should go see my dad."

  Yin Xinhua glanced at Lu Chen, Lu Chen understood, and immediately nodded to the patient's family: "Go right away."

  High blood pressure can cause chest tightness, which is easy to understand.

  Imagine that blood pressure is so high that it is much harder for the heart to pump blood out.

   It’s like when a typhoon blows outside and you have to carry an umbrella forward, it’s not bad to not be blown backwards.

   But the heart can't help pumping blood, so even if the blood pressure is high, the heart still has to try desperately to pump the blood out. The higher the blood pressure, the more effort it takes to pump it out.

   In this way, the heart itself is tired, and the heart itself is prone to ischemia and hypoxia, so you will feel chest tightness and even chest pain.

  …

   came to the ward.

  Lu Chen took the patient's blood pressure again.

   The blood pressure of both upper extremities is symmetrical, around 140/70mmHg.

   The patient's blood pressure has dropped, but what's strange to Lu Chen is that his chest tightness still persists, and it seems to be getting worse!

   "Let's do an ECG again."

   In a rigorous manner, Lu Chen brought in an electrocardiograph and performed another electrocardiogram on the patient.

   Another surprise to Lu Chen was that the patient's electrocardiogram had changed!

   The ECG showed that the ST-T segment appeared to be slightly elevated.

  Lu Chen frowned, this change may mean that the patient's heart is ischemia!

  …

   Take the ECG and go back to the doctor's office.

  Lu Chen handed the electrocardiogram to Yin Xinhua.

  Yin Xinhua compared the two electrocardiograms before and after.

   Fan Zhiping said solemnly: "I think, could it be a myocardial infarction!"

  Yin Xinhua nodded in agreement: "Although the patient has no typical chest squeezing pain for the time being, not everyone has typical symptoms, and the disease is not static."

  Myocardial infarction, the most typical symptom is chest pain.

   But there are exceptions. Some people have toothache, sore throat, and even shoulder pain as the first symptoms, and they are finally found to be myocardial infarction.

  Yin Xinhua returned to the ward, listened to the medical history report of the patient and his family again, and called the patient's family out for a private conversation.

   "At present, a head CT has been performed to temporarily rule out cerebral hemorrhage. However, based on the patient's symptoms of chest tightness and electrocardiogram, we suspect the possibility of myocardial infarction..."

  Yin Xinhua is communicating with the patient's family.

  Lu Chen and Fan Zhiping stayed in the ward.

  Lu Chen thought more, in addition to considering acute myocardial infarction, he also considered whether the patient would have aortic dissection.

   With such high blood pressure and chest tightness, aortic dissection cannot be easily ruled out.

  …

  Lu Chen brought the blood pressure monitor and wanted to continue taking a blood pressure monitor for the patient.

   Walking to the bedside, Lu Chen looked at the patient. Just as he was about to speak, he found that the patient rolled his eyes and foamed at the corners of his mouth.

   "Dududu..."

   On the side of the ECG monitor, the alarm sound suddenly exploded in the ward!

   Fan Zhiping shouted: "Ventricular fibrillation!"

  Lu Chen was startled, he threw the blood pressure monitor aside, immediately threw himself beside the hospital bed, and started chest compressions.

   At the same time, he roared: "Brother Fan, go and call the nurse and Doctor Yin!"

  Fan Zhiping was taken aback for a moment. In the past, this kind of rescue was done by him, and others went to run errands.

   Today the role is reversed.

   It can only be said that Lu Chen's rescue response is really fast!

   He immediately ran out of the ward and called to the nurse on duty and Yin Xinhua.

   In fact, there was an accident in the ward, and the nurse on duty found out that she had already pushed the rescue car and rushed to the ward, calling Yin Xinhua all the way.

  …

   On Lu Chen's side, he was undergoing emergency cardiopulmonary resuscitation.

   Six months ago, he was only a novice in CPR.

   And now, he is very familiar with CPR!

  Yin Xinhua came over after hearing the news, Lu Chen had already got the defibrillator handed over by the nurse.

   "Lu Chen, what's the situation!"

   "Sister Yin, the patient suddenly suffered from ventricular fibrillation!" Lu Chen said.

   Yin Xinhua's heart sank, "Ventricular fibrillation?"

   Is it really a malignant arrhythmia after myocardial infarction?

   "Prepare for defibrillation!"

  The defibrillator is ready, and Lu Chen has already applied the conductive paste.

  Charge, Discharge!

   The first cardioversion was unsuccessful.

   Continue CPR!

  Second defibrillation.

   "Success!"

   After the second defibrillation.

   The patient finally recovered sinus rhythm, but the patient still did not wake up.

   "Oops! The patient's blood oxygen is dropping!"

   Just when Lu Chen breathed a sigh of relief, Fan Zhiping's voice made him tense again.

   The patient's blood oxygen saturation dropped from 97% to 92%, and then the value on the monitor jumped.

   has become 90% again!

   "This, what's the situation!"

   Whether it is myocardial infarction or aortic dissection, the patient's blood oxygen saturation generally does not drop!

   Yin Xinhua immediately instructed the nurse: "Change to a mask to inhale oxygen and increase the concentration of oxygen inhalation!"

   "Received!" The nurse immediately replaced the nasal cannula for oxygen inhalation with a mask.

   Put on a mask to inhale oxygen, and the patient's blood oxygen saturation fluctuated around 90%!

   "Although the blood oxygen is stable, emergency intubation may be required at any time!" Lu Chen said solemnly.

   At this time, the nurse has opened three venous accesses.

  Yin Xinhua also knew the seriousness of the matter.

   "Urgently check blood routine, biochemistry, ions, myocardial enzymes, D-dimer, please consult the anesthesiology department for emergency consultation, be ready for emergency intubation at any time, and then call the general hospital in the heart." Yin Xinhua said to another nurse.

   "Okay, Doctor Yin."

  …

  The patient has now returned to sinus rhythm, and the most important thing at present is cardiopulmonary resuscitation and contacting the anesthesiology department to help with endotracheal intubation.

   "Doctor, my dad, he, he is..." The patient's family members were extremely nervous. He swallowed and looked at the bed who was rescuing his father.

   "Family, you come out first and I'll talk to you later."

  Yin Xinhua immediately called the patient's family to the side of the corridor and began to communicate about the condition.

  …

  Lu Chen and Fan Zhiping stayed at the bedside, ready to deal with the patient's condition changes.

   Staring closely at the ECG monitor beside the bed, Lu Chen noticed that the patient's blood oxygen could no longer be maintained!

   It started pulsing up and down 90%, and now it's down to around 85%!

   "No way! I'm going to be intubated soon, so I can't wait for the anesthesiology department to come." Lu Chen immediately said, "It's too late when they come!"

   Fan Zhiping was stunned for a while, "Yes, but neither do I."

  Fan Zhiping subconsciously thought that Lu Chen wanted him to be intubated.

  Broncho intubation, except for doctors in critical care, emergency, anesthesia and other departments, doctors in other departments rarely do this operation.

   Although Fan Zhiping is the deputy chief physician of the elderly, he has not touched bronchial intubation for many years.

   But the next moment, he was stunned.

  Lu Chen had already picked up the laryngoscope.

  He is preparing to intubate the patient himself?

   Just when Fan Zhiping was still thinking about whether Lu Chen would be able to do it, he saw that he had already pinpointed the position and stuffed the tracheal tube into the patient's mouth.

   (end of this chapter)