I Can See Health

   Chapter 741 Talented people work harder than you!

The procedures for    ward rounds are similar.

   The regulatory trainee or graduate student of the tube bed to report the medical history.

  Jin Miao explains the current diagnosis, treatment drugs, and the next treatment plan.

  Lu Chen stood beside Jin Miao, occasionally asking a few questions aloud, but more often he just listened carefully.

   When Jin Miao saw this, he thought that Lu Chen was not proficient in clinical practice, so he couldn't give any advice, and could only be silent most of the time.

   He really misunderstood Lu Chen!

  Lu Chen felt that he was new here, so he carefully observed Guanghai's ward rounds and the conditions of the patients in the group.

   Therefore, even if there is any problem, I just write it down first, and don’t ask questions on the spot.

   Instead, prepare to ask questions later.

   "Director Lu, this patient may be troublesome. After five days of admission, the diagnosis is not yet clear, so further examination may be required." Jin Miao brought Lu Chen to the bed of the last patient.

   His original intention was not to embarrass Lu Chen.

  Because if this patient asked Lu Chen about the cause, he would not explain it, and he might lose face.

   Sure enough, as soon as he said these words, the patient looked at Lu Chen strangely when he heard the words "Director".

   There is such a young director?

   However, I can't handle so much now.

   "Director, I've been living here for five days, why haven't you found the cause yet?" The patient immediately got up from the hospital bed.

  Jin Miao paused as he was about to leave, he was really afraid of what to do!

   He was about to explain to the patient, but he didn't expect that Lu Chen had already taken the patient's medical record from Ji Pearson beside him.

   "Did you transfer from the oncology department?" Lu Chen remembered reading her medical records before the ward round.

The patient was a woman in her fifties, she nodded slightly, "Yes, I'm preparing for chemotherapy. If there is a problem with the test result, I will be transferred to the Cardiology Department. You have to solve my heart problems quickly. , I want to go back to chemotherapy as soon as possible!"

   "Don't worry, I'll look at your medical records." Lu Chen comforted.

   Jin Miao smiled bitterly in her heart.

   Director Lu Chen is making a swollen face and making him fat!

  This patient, they have been studying for a long time in private, but they have no clue. Could it be that Lu Chen knew what the problem was just by looking at it?

   "Doctor Jin, first give a brief introduction to the patient's condition."

  Lu Chen put down the patient's medical record and picked up the tablet computer equipped in the department.

   Tablet PC and hospital intranet link, you can check the laboratory sheets and reports of all patients at the office.

"Okay." Jin Miao nodded, "This patient was transferred from the oncology department last Wednesday. He was diagnosed with pulmonary CA and has undergone three courses of chemotherapy. This time is the fourth course. However, before chemotherapy, it was found that myocardial enzymes increased If it is high, transfer it to our department to continue treatment, mainly to find the cause of the elevated myocardial enzymes."

   "Does the patient have any symptoms?" Lu Chen asked.

   "I don't have any discomfort."

   Before Jin Miao could reply, the patient immediately spoke up.

  Lu Chen nodded. He looked at the patient's kinase results. Tests such as troponin and other creatine kinases all increased to varying degrees.

   Elevated myocardial enzymes usually indicate myocardial damage. Common causes are acute myocardial infarction, renal failure, etc.

  Jin Miao continued: "The patient has no risk factors for myocardial infarction, and no symptoms of chest pain or chest tightness. Echocardiography, coronary CTA, and even electrocardiogram are all normal, so we don't have any clues for now."

   A normal echocardiogram can rule out cardiomyopathies, such as hypertrophic cardiomyopathy, which sometimes also cause elevated cardiac enzymes.

  Coronary CTA is normal, excluding coronary heart disease, such as acute myocardial infarction, which leads to elevated myocardial enzymes.

   The electrocardiogram was normal, excluding fast or slow arrhythmias.

   At this time, Lu Chen looked at Jin Miao and asked a seemingly unrelated question: "What chemotherapy regimen did the patient use before?"

   "This...I don't know." Jin Miao shook his head, "Then I'll go back to the office later and check the patient's previous medical records in the oncology department."

   They are only responsible for diseases in cardiology. As for the oncology drugs of patients, they did not ask or need to know.

  Lu Chen frowned.

   "Director Lu, does it matter?" Jin Miao asked in a low voice.

   "I don't know yet." Lu Chen said softly, then looked at the patient beside him, "Do you know that you are taking chemotherapy drugs in the oncology department?"

   "Uh, it's a new type of drug." The patient thought for a while, "What kind of immunosuppressant is it called, it's very expensive."

  Lu Chen's eyes narrowed, "Immune checkpoint inhibitor?"

   "Well, yes! That's the medicine." The patient nodded quickly.

   "Okay, I understand." Lu Chen handed back the medical records in his hand to the graduate student, and then said to Jin Miao, "Let's make an appointment with the patient for a cardiac MRI, and I will review the cardiac enzymes tomorrow."

   "Huh?" Jin Miao was taken aback, "Heart MRI?"

   "Yes, our hospital should be able to do it, right?" Lu Chen said.

   "It can be done, but it is less done now." Jin Miao replied, he really couldn't find the reason why Lu Chen asked the patient to have a cardiac MRI.

   "Let's arrange it as soon as possible." Lu Chen turned back to the patient and said, "After we analyzed your condition again just now, we considered the possibility of myocarditis, so we need to check a cardiac MRI to confirm the diagnosis of myocarditis."

   The patient is naturally full of promises. She just wants to make an early diagnosis and transfer back to the tumor for chemotherapy as soon as possible.

   Jin Miao was stunned when she heard the word "myocarditis".

  The diagnosis of myocarditis, in addition to myocardial biopsy, is cardiac MRI.

  Myocardial biopsy is an invasive test with high risks, and few people will do it.

  To diagnose myocarditis, the only way is to do a cardiac MRI.

   However, Jin Miao racked her brains, but still couldn't think of the cause of the patient's myocarditis!

   The patient has no symptoms of prodromal cold, nor any symptoms of chest pain or chest tightness.

   Considering myocarditis, you have to come up with an incentive, right? !

   It is impossible to get myocarditis for no reason!

   Walking out of the ward, Jin Miao mustered up the courage and asked Lu Chen in a low voice, "Director Lu, you are considering myocarditis, what is the cause?"

  Lu Chen frowned slightly, "Didn't you listen to me just now?"

   "Did you say it?" Jin Miao recalled the content of the conversation just now, and then noticed the "immune checkpoint inhibitor" that Lu Chen said.

   "Could it be the myocarditis caused by that tumor drug?" Jin Miao wondered.

   He had never heard of this kind of drug, but Lu Chen actually knew that this drug could cause myocarditis?

  Lu Chen nodded, "Go back and read the literature. Myocarditis caused by immune checkpoint inhibitors is a hot topic in the recent intersection of tumors and heart disease."

"it is good……"

  Jin Miao nodded silently.

   He really hadn't heard of this medicine, but Lu Chen was right.

   Don't be afraid of other people with good talent, just be afraid of people with good talent, you will work harder than you!

   (end of this chapter)