I Can See Health

  Chapter 241 Lived into a Case (First Update)

   Director Li Yao was the only one who smiled. She looked at Lu Chen and said, "Keep talking."

  Lu Chen nodded, wondering if it was because of the "clinical insight" he received last time.

   He quickly sorted out all the information of the patient in his mind, and began to integrate and analyze it.

   "From the point of view, the patient's chest pain, chest tightness, heart failure and other symptoms may be caused by hypertrophic cardiomyopathy."

   "However, the diagnosis of hypertrophic cardiomyopathy is still a bit sloppy, and other diseases may also have similar myocardial changes, not necessarily caused by the primary genetic inheritance, but may also be caused by acquired diseases. Cardiac hypertrophy."

  Lu Chen was also puzzled until he just saw the patient's body shape.

   "Look at the patient, the typical full moon face and buffalo back."

   When Lu Chen said this, everyone was even more surprised.

   "Have you seen the face of the full moon and the back of a buffalo?" Lu Chen looked at Wei Wenwen who was beside him.

  Wei Wenwen nodded, "I've seen it in books, but I haven't seen it in reality."

  Lu Chen said sternly: "If you guessed correctly, the patient in front of you has a typical full moon face and a buffalo back."

  It stands to reason that buffalo backs and full moon faces are not uncommon.

   But everyone's attention is not on this one, it's all on the heart and myocardium.

   So when Lu Chen proposed a full moon face and a buffalo back.

   Everyone was very surprised, and after looking at them carefully, many people started to nod again.

   Especially the patients have thin limbs, which is similar to some patients who have been taking hormones for a long time.

  Central obesity, thin hands and feet around, this is the result of the redistribution of protein and fat.

  Lu Chen continued: "The patient either took hormones for a long time, or the level of hormones increased due to diseases in the body."

   But the patients and their families were taken aback.

   "I've never taken hormones!" The patient said immediately.

  Lu Chen smiled and said, "That's right, that means you may have a hidden disease."

   "This disease is constantly secreting hormones, and excessive secretion of hormones will cause your blood sugar to rise, blood lipids to rise, and concentric obesity on your full moon face and buffalo back."

   "More importantly, it also causes heart damage, causing cardiac hypertrophy."

  Lu Chen finally spoke up.

   "Is the patient Cushing's syndrome?" Wei Wenwen couldn't help asking.

  Any doctor or medical student, you only need to mention the full moon face and the buffalo back to him.

   He must think of Cushing's syndrome, because this is too classic.

  The so-called Cushing's syndrome is a general term for diseases caused by various causes that cause the adrenal gland to secrete too much glucocorticoid (hormone).

   Many diseases cause the adrenal glands to overproduce hormones, so this is a syndrome, not a specific disease. The most common cause is a pituitary tumor, followed by a tumor of the adrenal gland itself.

   "Well, that's what I thought about it." After Lu Chen finished speaking, he looked at Li Yao, waiting for her to express his position.

   I saw a very bright smile on Li Yao's face.

It seems that she is very satisfied with Lu Chen's analysis, "Yes, if it wasn't for the family's reminder, I would have ignored the patient's central obesity. If you look closely, the patient's skin is also relatively thin, which indicates that It's Cushing's syndrome."

   Everyone looked at the patient's skin and gasped in amazement.

   "The patient's skin really looks thinner and more transparent."

   Everyone is convinced of Li Yao and Lu Chen's analysis.

   And it can also explain all the positive symptoms of the patient from start to finish, from hypertension, hyperlipidemia, hyperglycemia, central obesity, cardiac hypertrophy, thin skin and so on.

   Especially the patient's high blood pressure, according to the patient's own words, has not been well controlled after changing a lot of medicines. On the one hand, it is related to the irregularity of their medication, and of course it may also be related to the disease itself.

  …

   Next, Li Yao used an easy-to-understand analogy to tell the patients and their families about the disease.

  Pituitary and adrenal glands are endocrine organs of our body.

   The pituitary gland is the leader and the adrenal gland is the subordinate.

   Therefore, if the patient is really Cushing's syndrome, the next step is to find out whether the leader of the pituitary gland has a problem, or the subordinate of the adrenal gland has a problem.

   "Director Li, how should we investigate this disease next?" said the patient's wife nervously.

  Li Yao did not answer directly, but turned to look at everyone.

   "Where is the pituitary gland? The pituitary gland is in our brain. Where is the adrenal gland? As the name suggests, it is above our kidneys, almost at our waist."

   "No matter where the problem is, the top priority is to first determine whether the patient has Cushing's syndrome."

  …

   Patients and their families were mixed when they heard that they had Cushing's syndrome.

  I am delighted that Director Li Yao said that if it is a simple tumor, it can be cured by one-size-fits-all.

   Sadly, it may also be cancer that causes too much hormone secretion, which is tricky.

   On the same day, blood tests will be arranged to check related hormones, and blood hormone levels in three time periods will also be checked.

   is the blood hormone level at 16:00 pm, 0:00 am, and 8:00 am the next morning, respectively.

   The purpose of this separate examination is to see whether the hormone secretion in the patient is still regular.

  …

  Li Yao is worthy of being the director of the department. Not only this case, but every subsequent case, she has analyzed it very well.

   All the places that you don’t usually think of are called out.

  The seemingly difficult cases are analyzed step by step, and finally a correct diagnosis and the best treatment measures are obtained.

   rounds, and finally found Dong Hao.

   Dong Hao was lying on the hospital bed, and Li Yao's expression was also stunned.

  Lu Chen immediately explained: "Teacher, Brother Dong Hao had a heart attack and was diagnosed with paroxysmal supraventricular tachycardia. This time he came to the hospital for radiofrequency ablation."

  Li Yao understood.

   "You just got out of the Cardiology Department, Xiao Dong, you should be well aware of this disease, right?"

   Dong Hao gave a wry smile, "Director Li, I feel that I have lived as a typical case, and I compare every symptom of mine with the book, and it feels right!"

   "Don't worry too much." Li Yao smiled, "The technology of radiofrequency ablation is now very mature, and there are few side effects and complications."

   "Well, I know, Director Li." Dong Hao nodded slightly.

   But Li Yao frowned and said, "However, Xiao Dong. I still want to remind you that there is a risk of recurrence after surgery. Because we can't eliminate all abnormal pathways!"

   After some people have surgery, the paroxysmal appeal has recurred in a few months at a very long time!

   "Don't worry, Director Li, Junior Brother Lu Chen told me about these precautions for surgery." Dong Hao said.

   Even for the most familiar friends, none of these communication records should be missing, and they all need the signature of the patient or guardian.

  …

  Li Yao's big rounds lasted a full hour and a half.

it is finally over!

   (end of this chapter)