I Can See Health

   Chapter 277 Lu Chen's "Little Classroom"

   Feng M County People's Hospital, Department of Cardiology.

   The attending doctor Wang Zhi took the five electrocardiograms of the "cardiac arrest" patient and figured it out again.

   For patients with cardiac arrest, after excluding organic heart diseases such as myocardial infarction and cardiomyopathy, arrhythmia is a relatively common cause.

  However, he has read the patient's five electrocardiograms many times, and so far he has not found any abnormality.

   At this moment, his mobile phone WeChat suddenly rang.

  Wang Zhi picked up his mobile phone and saw that it was a WeChat message sent to him by Fan Zhiping, the deputy director of Corey.

   "Has Professor Li Yao come to our department?"

  Wang Zhi was a little unclear, but he replied immediately.

   "Director Fan, Professor Li Yao has come to the department."

   "Oh, with her, is there a doctor named Lu Chen?"

   "Yes, hey, Director Fan, how did you know this?" Wang Zhi was a little puzzled.

   "Because I'm currently studying in Professor Li Yao's group! If you have any difficult cases this time, I'm too embarrassed to trouble Professor Li. You can directly ask Dr. Lu Chen, especially the electrocardiogram."

  Fan Zhiping was far away in Jinghua, but he was still heartbroken for the department.

   He knows very well that in county hospitals, electrocardiography and electrophysiology are a very weak field.

   Because this requires not only hard study, but also someone to teach.

  Wang Zhi suddenly felt puzzled, "Isn't he a graduate student? Director Fan, is it useful for me to ask him?"

   "Hehe, you don't know, I'll tell you that, Dr. Lu Chen has been shortlisted for the third round of this Huaxia ECG competition!"

   "What?" Wang Zhi's expression was a little unbelievable.

   This electrocardiogram contest, as a cardiologist, he is very clear.

   He also participated in this competition, and he was not even qualified to rank second in the department.

   Those who can enter the third round will be ranked in the top ten in the province!

   These people are all doctors who are very good in the field of electrocardiography.

  Wang Zhi looked up at Lu Chen and swallowed silently.

  It is hard to imagine that a first-year graduate student can be so awesome.

   No wonder he just glanced at the five ECGs and immediately saw the problem!

  …

   At this moment, Lu Chen also began to answer the five electrocardiograms.

   Wang Zhi, who was still a little careless, pricked up his ears to listen.

   "Compared with the admission ECG, the patient's ECG after admission showed sinus rhythm, the electrical axis was deviated to the right, and the J-point elevation in the inferior wall leads, up to 2.5 mm, was accompanied by QRS notch."

"In the later follow-up ECG, from the perspective of leads V1 and V2, the end of the QRS complex is a broken QRS complex! From the inferior leads Il, lII, and avF, it looks like a J wave again! It needs to be related to Brugada syndrome, ARVC, Differentiation of old myocardial infarction."

   "The patient's echocardiography and cardiac angiography did not reveal any abnormalities, and these diseases can be temporarily ruled out."

  Lu Chen's explanation was very organized, and he marked the abnormal place on the electrocardiogram.

   At this moment, not only Wang Zhi listened carefully without saying a word, but even the other deputy chief doctors came over to listen carefully to Lu Chen's explanation.

Just listening to Lu Chen continued: "But whether it is a broken QRS wave or a J wave, in this specific case, it is a high-risk early warning sign of sudden cardiac death from ventricular fibrillation! Studies have confirmed that early repolarization is a sudden cardiac arrest. Signs, the risk of ventricular fibrillation is twice the normal population!"

   "Doctor Lu, can you talk more about this broken QRS wave, I don't quite understand it."

  Wang Zhi scratched his head. His question represented the voice of the cardiologists in the Fengm County People's Hospital. "Hey, I still don't seem to understand..."

  Lu Chen was extremely patient, took out the blank A4 paper again, and began to write on the paper while explaining.

"Broken QRS complexes represent myocardial scarring and fibrosis with conduction delay, leading to conduction anisotropy in the myocardium, which can be used as sudden death in patients with coronary heart disease, heart failure, hypertrophic cardiomyopathy, ARVC, dilated cardiomyopathy, and congenital heart disease. Risk Predictors!"

   "This ECG represents that the QRS complex in the right ventricle V1 and V2 appears at the end of the QRS complex, which is also called Epsilon wave in ARVC..."

  …

   This teaching round has completely become Lu Chen's chapel.

  Although some of them didn't understand Lu Chen's explanation very well, in general, they all understood the cause of the patient's cardiac arrest.

   That is early repolarization syndrome (ion channel disease)!

   "Congratulations, the completion of the system upgrade has increased!"

   "Congratulations, +1 for the thank you from Wang Zhi!"

   "Congratulations, +1 for receiving a thank you from Ke Shuwen!"

   "Congratulations, +1 for receiving thanks from Cheng Lin!"

  “…”

  Lu Chen didn't expect that he could get so many benefits by participating in a teaching ward round.

   Really worthwhile trip!

   Director Yin Chao looked at Lu Chen who was chatting, and couldn't help but sigh, it was really the back waves of the Yangtze River pushing the front waves, and the front waves were shot to death on the beach!

  Looking at Lu Chen, his heart was itching, it would be great if there was such a young man in his department!

   Comparing Dr. Xiaolin and Lu Chen, the gap is huge!

   "Director Yin, are you satisfied with Dr. Lu's explanation?" Li Yao looked at Yin Chao.

   "That's great!" Yin Chao smiled, "I finally know why Professor Li brought Dr. Lu here. He is much better than so many of us."

  Lu Chen hurriedly said: "Director Yin, you are over the top. I also came to this result based on your previous examination results. Without your early diagnosis and treatment, I would not have been able to diagnose it at once."

  Lu Chen's modesty also made Yin Chao feel better.

   "Congratulations, +5 for receiving thanks from Yin Chao!"

   Seeing the system prompt, Lu Chen was slightly taken aback.

   Give 5 points of gratitude at one time?

   Director Yin Chao didn't even give him any pennants!

  Lu Chen frowned. Could it be because of Yin Chao's status as the section director?

   Most of the gratitude points he obtained before came from patients or their family members, and then from his junior brothers and sisters.

   Today is the first time that Lu Chen has received thanks from a department director!

  …

   After Lu Chen finished his lectures, Li Yao also gave a summary of this teaching round.

   On the basis of Lu Chen, Li Yao gave her own diagnostic opinion, and there are other possibilities such as J wave syndrome.

Doctors including   Wang Zhi are quite satisfied with this teaching round.

   In such a county-level hospital, everyone has different levels, and it is extremely rare to have a doctor teach by hand.

   At this moment, Dr. Kobayashi returned to the doctor's office.

   He was holding a color Doppler report in his hand, and his face was a little unsightly.

   "Director, Professor Li, the gynecological ultrasound results of the 31-bed patient are out."

   (end of this chapter)