I Can See Health

   Chapter 240 Dwarf winter melon! (Snow a bit of Bi Wan reward plus more)

   Now the patient's diagnosis is finally clear, that is hypertrophic cardiomyopathy!

  The family members were relieved when they heard a statement.

  People are most afraid of the unknown!

   "Is this disease serious?" the patient's wife suddenly asked.

Lu Chen thought for a while, then said: "The cause of this disease is unknown, it may be related to heredity, severe heart failure or even sudden death. Many young people died suddenly, or it was reported in the news that so-and-so was playing basketball. Died, maybe this hypertrophic cardiomyopathy."

  Due to the patient's repeated chest pain attacks over the past few years, his cardiac function was not very good after the echocardiography just now.

  Sun Guoguo said to the patient on the bed: "If you don't control your blood pressure well, your heart function will get worse and worse."

  High blood pressure will increase the load on the heart, which will further cause myocardial hypertrophy.

   When severe heart failure occurs, the patient will be unable to move.

   "After my blood pressure drops, can I stop the antihypertensive drugs?" the patient whispered.

  Sun Guoguo said with a serious expression, "You can't take antihypertensive drugs if you want to take them, and you can't take them if you don't want to. Antihypertensive drugs should be taken every day, just like eating, so that blood pressure can be stabilized."

  If the blood pressure fluctuates greatly, this is more harmful than pure high blood pressure!

  Imagine that a water pipe is constantly expanding and contracting, and sooner or later it will explode.

   "Doctor, is my hypertrophic cardiomyopathy really incurable?" the patient asked with a bitter face.

   "I don't even know the cause of this disease. How can I cure it?" Sun Guoguo said, "Of course, just because it can't be cured doesn't mean it can't be cured."

   "We have drugs to control the symptoms. The metoprolol we give you now is a better drug. It can make your heart beat a little slower, relax a little bit, and relieve obstruction."

   "Besides, you can throw away your nitroglycerin. Eating nitroglycerin for hypertrophic cardiomyopathy may aggravate the condition."

   "But before chest pain, sublingual application would really help." The patient was a little puzzled.

"It may be that the blood pressure is too high. Nitroglycerin can lower blood pressure and relieve symptoms." Sun Guoguo emphasized, "But anyway, it is better to use metoprolol in the future, and use less nitroglycerin. You do not have coronary heart disease. ."

   "If I take this metoprolol, will the pain continue?"

   "If the drug doesn't work well, surgery is still possible." Sun Guoguo continued, "The left ventricular outflow tract of the heart is obstructed. If it gets worse, it can be surgically removed."

  Lu Chen and Sun Guoguo patiently explained the condition to the patients and their families.

  …

   "Congratulations, get +1 thanks to Luoping!"

   "Congratulations, get +1 thanks from Zhang Fang!"

  Lu Chen got two more points of gratitude.

   However, Lu Chen was surprised that the system upgrade completion rate did not increase!

  According to the previous practice, each time a case is diagnosed, the upgrade completion rate will increase by 1%.

   However, the diagnosis of this patient is already clear, but the system has not given any hints.

   "Is it a system delay?" Lu Chen couldn't help but think, "Or is it a system bug?"

   However, after the patient applied metoprolol, the chest pain did ease!

   So Lu Chen didn't pay much attention to this.

  …

  Because of dealing with this patient, most of the lunch break time has passed.

  Lu Chen had to go to the cafeteria to buy a meal.

After    finished eating, with only ten minutes left, he went directly to the eighth district in his heart.

   The patient with hypertrophic cardiomyopathy in the morning made Lu Chen aware of some of his own problems.

   For example, the auscultation of the heart is not careful enough!

  Heart auscultation is the housekeeping skill of a cardiologist.

   The patient has myocardial hypertrophy and left ventricular outflow tract obstruction. It stands to reason that a murmur can be heard in the cardiac auscultation area.

   But Lu Chen subconsciously felt that the patient was a patient with myocardial infarction, so he did not carefully auscultate the heart valve area!

   Without careful auscultation, such an important sign was missed all of a sudden!

   In addition, Lu Chen also realized the importance of cardiac ultrasound for clinical diagnosis.

  Especially for patients with such changes in heart structure, no matter whether it is ECG, chest CT, or coronary angiography, it is impossible to diagnose and judge.

   Only through cardiac ultrasound can we better understand the morphological characteristics of the heart structure!

   Doing a cardiac ultrasound by yourself is far more intense than having someone else do a cardiac ultrasound.

  …

   After a busy day, I went back to my bedroom at night.

  Lu Chen continued his training in cardiac ultrasound.

   After a real-world drill, he became more aware of the weaknesses of his technique.

   Based on this, Lu Chen started targeted training!

   It is precisely because of the existence of the virtual space of the system that he was able to master the entry-level technology of cardiac ultrasound in such a short period of time.

   The skill proficiency of cardiac ultrasound rose all the way to 60% before it stopped.

  Although this kind of cardiac ultrasound skill card is elementary, it still benefits Lu Chen a lot.

  …

   The next day.

   Today, Li Yao came to the ward and started the director's rounds once a week.

   Recently, because Li Yao was busy writing the national nature tender, she came to the ward less frequently.

   This further ensures the quality of ward rounds.

   Therefore, Li Yao's rounds are very slow today.

   "Mr. Li, this 10-bed patient came yesterday, and the echocardiogram showed hypertrophic cardiomyopathy." Sun Guoguo said.

  Li Yao stood at the head of the bed of the 10-bed patient, holding his medical records in his hand.

At this time, the patient's wife suddenly complained: "Director Li, the doctors told our family to lose weight, but if you look at him, he is fat on his face and stomach, and his hands and feet are not fat. If he loses weight, he will look like a winter melon. ."

   This made everyone laugh.

"Hypertensive patients must lose weight!" Li Yao read his laboratory report, "Blood lipids are high, blood sugar is also high, and the glycated hemoglobin is 7.5%, which means that he is very likely to have diabetes. But you didn't find it before. High blood pressure, high blood lipids, and high blood sugar are all there. If you don't lose weight, then wait for the hospital to be re-hospitalized in the future."

  Li Yao checked the patient while talking.

   She found that the patient is really fat on the head and face, mainly on the trunk, and the limbs are not very fat, but look a little thin.

  Li Yao pondered for a while, then sighed, as if he had noticed something strange.

   She turned to look at the crowd behind her.

   "When you see the patient's body shape, what do you think of?"

  Lu Chen had already noticed it.

   When the patient's family said about the dwarf winter melon, everyone else laughed, but he was the only one who couldn't laugh.

   The completion rate of the system upgrade has not increased for a long time. Lu Chen thinks that this may not be a system bug!

   He thought of a situation that no one else might have thought of, except for Li Yao of course.

No one else in the    group spoke.

  Lu Chen took over the words: "The patient's condition is more complicated, and I'm afraid this cardiac hypertrophy is not the main cause."

   As soon as these words came out, everyone was in an uproar.

   No more updates, everyone, go to sleep.

   (end of this chapter)