I Can See Health

   Chapter 238 Shall I try it? (first update)

  Sun Guoguo has a relatively stable personality. When the dissection cannot be completely ruled out, she will not easily allow the patient to undergo interventional surgery.

   "Let's do it at the same time!"

   After thinking about it for a few minutes, Sun Guoguo decided to contact the catheterization lab to prepare for the intervention.

   The other side is to contact the CT room, saying that patients with chest pain should undergo an enhanced CT scan of the chest to rule out the possibility of aortic dissection.

   "Lu Chen, please push the patient for enhanced CT in a while. If the results are ok, then don't go back to the ward, just push the patient to the catheterization room."

   "Okay, Senior Sister." Lu Chen nodded.

   This is by far the safest way.

   However, it was an enhanced CT and an interventional operation. The patients and their families were a little scared by the situation.

  Sun Guoguo directly communicated with the patients and their families about the condition, obtained informed consent for all operations, and signed his name.

   Then, Lu Chen pushed the patient to the CT room.

  …

   On the way, the patient's brows were not loosened, and they were tightly wrinkled.

   At the door of the CT room, the patient's chest pain got worse!

   "Just push a morphine." Lu Chen said to the accompanying patient.

   "Okay." The nurse nodded.

   A morphine injection was prepared in the first aid box in advance, and the nurse directly gave 4mg morphine to intravenous push and analgesia.

  Morphine injection is a strictly controlled narcotic drug.

   Whether the patient has myocardial infarction or aortic dissection, excessive pain is not conducive to the recovery of the disease.

   In particular, it may increase the oxygen consumption of the heart, so Lu Chen decided to push the morphine needle.

  Because I had communicated with CT in advance, as soon as I arrived in the CT room, the needle for angiography was inserted, and the examination was arranged immediately.

   The enhanced CT scan was completed soon.

  Lu Chen took a general look and found that there was no obvious dissection of the thoracic and abdominal aorta, so it should not be chest pain caused by aortic dissection.

  The rest is acute myocardial infarction!

   On the ward side, after the enhanced CT is completed, the image results are directly uploaded to the medical record system.

   In the ward, Sun Guoguo has also seen CT images.

   "If you don't see the dissection, then push it directly into the catheterization room. I contacted the doctor in the catheterization room." Sun Guoguo also called Lu Chen and asked him to directly send the patient to the catheterization room for emergency interventional surgery.

   Now, Lu Chen was completely relieved, and stepped up to push the patient directly to the catheterization room.

  …

   Less than 10 minutes before and after.

  Lu Chen handed the patient over to the doctor in the cardiac catheterization room.

   The catheter lab sent a doctor again to communicate with the family.

   There is not too much communication about surgery. Only with proper communication can we avoid doctor-patient disputes after surgery as much as possible.

   The doctor in the catheterization room spoke very fast, and regardless of whether the family understood it or not, he put the consent form in front of her directly.

   "Sign it."

   The patient's wife also listened to the general idea. The overall meaning is that this stent is effective, but expensive.

   And there may be problems, but if you don't do it, you will die.

   "That's nothing to say, I'll sign." The patient's wife picked up the pen, gritted her teeth, and her fingers were shaking.

   After signing the operation communication, the operation began.

but……

  The accident came as expected.

  …

   Cardiac catheterization room.

   Interventional Cardiologist Ren Feng, he stared at the screen and repeatedly irradiated with X-rays, but he didn't see any obvious narrowed or blocked coronary arteries.

   A few large blood vessels are still very smooth!

  What's going on here?

   Ren Feng on the stage was sweating on his forehead and began to swear, "tmd, I didn't see anything abnormal on the chest CTA."

After    stepped down, Ren Feng transferred the CT film he just made.

   After checking it repeatedly, there is indeed no aortic dissection!

   Combined with the current coronary angiography, there is no myocardial infarction.

nothing!

   The patient has severe chest pain, which is obviously a problem!

   But no problem was found, this is no joke.

  Fortunately, the patient's chest pain seems to have improved at this time, and the brows are slightly stretched.

  Otherwise, the interventionists in the cath lab would have to be rushed to death.

   "End the operation." Ren Feng said to the assistant and nurse beside him, "Tell the family that the patient is not acute myocardial infarction, nor is it coronary heart disease, and there is no coronary heart disease at all."

  Although the coronary artery is a little narrow, it is far from the level that causes myocardial ischemia and hypoxia and frequent angina pectoris.

   The patient was quickly pushed back to the eighth area of ​​the heart.

  …

   Eight areas in the heart at this time.

  Lu Chen, Sun Guoguo and others have seen the results of coronary angiography.

   Everyone was a little stunned.

   Not aortic dissection, nor acute myocardial infarction!

   At this time, the patient's wife walked into the doctor's office.

"Dr. Sun, what is the cause of chest pain, isn't it coronary heart disease? It has always been treated according to coronary heart disease. Before, nitroglycerin can also relieve chest pain. Isn't it said that nitroglycerin is a special medicine for coronary heart disease. "

   The patient's wife insisted on "coronary heart disease" this time.

   She has no choice but to worry.

   This is not, that is not, there is an explanation for what is sick!

   "The chest pain just now is really scary, it feels like a person can't die all of a sudden."

  Sun Guoguo was also very depressed, but depression could not solve the problem.

   However, she immediately thought of a remedy.

   Judging from the severity of the patient’s chest pain, it must be related to the condition of the heart or lungs or large blood vessels.

  Since no obvious problems were found in coronary angiography and chest CTA, it is very necessary to do a cardiac ultrasound!

  The heart of the human body is like a house, with walls, pipes, and circuits.

   ECG is to look at the circuit (cardiac conduction system), coronary angiography is to look at the water pipe (coronary artery), and echocardiography is to look at the walls and doors and windows.

  A problem with the electrical circuit and water pipe in the house can cause chest pain.

  Broken walls (myocardium), doors and windows (valves) can also cause chest pain. So this echocardiography is a must.

   Originally, coronary heart disease patients routinely have echocardiography.

   But it was too urgent just now, and I was racing against time to get on stage.

  Sun Guoguo also thought that the echocardiography might be a superfluous examination.

   But in retrospect, echocardiography is still a must.

   Of course, the family agreed to do it. As long as she found the cause, she couldn't be so confused.

   Besides, she has done all the dangerous and expensive coronary angiography, not less than a heart ultrasound.

  …

  Sun Guoguo returned to the ward and auscultated the patient's heart again. It seemed that there was a murmur, but it was not too obvious.

   "Junior Brother Wei, please give the patient a bedside echocardiography." Sun Guoguo said.

   "Okay!" Wei Wenzhong nodded.

   However, in less than two minutes, he returned to the ward.

   "Senior sister, the teacher in the ultrasound room is doing an ultrasound at the CCU on the fourth floor. It may take more than ten minutes!" Wei Zhong said.

  Cardiac ultrasound is not a routine emergency examination, and some small hospitals do not even have bedside emergency ultrasound.

   "Okay, then we can only wait!" Sun Guoguo frowned.

  The patient has repeated chest pains, and it is imperative to do a cardiac ultrasound!

   At this time, Lu Chen suddenly said, "Senior sister, why don't I try an ultrasound?"

   (end of this chapter)