I Can See Health

Oncology.

Show classroom.

At this time, everyone's attention was on Lu Chen.

Those who are familiar with Lu Chen and those who are not familiar with Lu Chen are looking forward to what different opinions Lu Chen will have.

Director Tang of the Oncology Department looked at Lu Chen with burning eyes.

No one knew that he and Professor Ouyang were actually close friends in private.

During normal gatherings, Professor Ouyang Ming mentioned Lu Chen to him many times.

Director Tang was naturally very curious about this outstanding young man.

Today I raised it in public and let Lu Chen finally answer this question.

In addition to a test, it is more of a help!

Those present here are all directors or deputy directors of various departments, showing their faces in front of everyone.

There are not many opportunities like this!

Naturally, Lu Chen didn't know the hidden story behind this.

For him, no matter what the reason, he is willing to accept the challenge.

The condition of the tumor patient in front of him was just a small challenge to him.

What Lu Chen was not afraid of the most was diagnosis!

His system comes with a "diagnostic" function.

Only when the diagnosis is correct, the system will pop up a prompt.

Therefore, Lu Chen had already thought through most of the diagnostic possibilities in his mind.

As long as the patient's diagnosis exists in the current medical field, Lu Chen can diagnose it.

…

Lu Chen stood up and looked around at everyone.

"It's an honor to be able to stand here today and share my thoughts on this patient with everyone."

"Director Huang was right when he said it before. Looking at this patient's dyspnea symptoms, electrocardiogram, troponin, etc., it is true that coronary heart disease cannot be ruled out!"

Director Tang was slightly disappointed.

He originally thought that Lu Chen had some special opinions, but he didn't expect that they were all the same!

At this time, Lu Chen changed the subject, "However, my next opinion may be different from Director Huang's!"

"Huh?" Director Tang raised his eyebrows, becoming interested.

In the demonstration classroom, other doctors also turned their attention to Lu Chen again.

"The patient's coronary CTA showed that the antegrade stenosis was only 40% narrowed." Lu Chen said slowly, "From the perspective of the mechanism of coronary heart disease, this degree of stenosis will definitely not cause serious symptoms, such as myocardial infarction. , heart failure, etc.”

"In this regard, Director Huang's opinion is that it is an obstacle to coronary microcirculation, but I think that for any disease, we must first start from a monistic perspective!"

Medical monism, simply put, is to use one disease to explain all symptoms and signs!

When Huang Xiaofeng heard this, he couldn't help but interrupt: "Director Lu, what is the relationship between tumors and heart disease? I think it is very likely that the patient had coronary heart disease before, but the symptoms were not obvious. . After getting the tumor, the body suffered a trauma, which caused the coronary heart disease to worsen!”

Huang Xiaofeng's remarks are not unreasonable.

Many doctors present agreed with this view.

Lu Chen smiled, "I don't deny your idea, Director Huang. But I would like to put forward some small opinions of my own!"

"Okay, tell me, we'll all listen!"

Huang Xiaofeng looked at Lu Chen, wanting to see what other reasons could come out of this young man's mouth. !

Lu Chen no longer paid attention to Huang Xiaofeng, but walked up to the stage, came to the position of the doctor in charge of the bed, and operated the projector to show the ppt.

He first returned the ppt to the interface of three electrocardiograms.

Everyone was a little confused. Didn't they just see this picture?

Why watch it again?

Just listen to Lu Chen slowly say: "All auxiliary examinations must be fully integrated with clinical practice to be meaningful."

"Director Huang is right. These three electrocardiograms look like very typical myocardial infarction electrocardiograms. The first and second electrocardiograms have ST segment elevation in leads avr, v1-v3, and v3r-v5r, and the entire vector moves toward Right deviation, very similar to left main disease.”

"The third electrocardiogram showed extensive ST elevation in the prethoracic leads and inferior leads, which is also very similar to a myocardial infarction."

"In the above two situations, if it is myocardial infarction, it must be a very serious myocardial infarction. Then, the patient has no symptoms of progressive ischemia, no obvious chest pain, and no very dangerous clinical manifestations!"

Lu Chen paused, "In other words, the electrocardiogram is seriously inconsistent with the clinical symptoms! This means that the diagnosis of coronary heart disease is in the wrong direction!"

After Lu Chen finished speaking, the whole place was silent!

No one expected that this young Director Lu would directly overturn Director Huang Xiaofeng’s diagnosis!

The diagnosis of coronary heart disease...wrong!

This left everyone stunned.

Director Tang of the Oncology Department became more and more excited as he listened.

Although Lu Chen didn't finish speaking, he could feel the confidence in Lu Chen's words.

This kind of confidence is something that no one else present has.

The person Professor Ouyang Ming admires is indeed a master of two things!

"Have you overlooked something very important?" Lu Chen continued, "The patient is a tumor patient and is undergoing targeted therapy and immunotherapy!"

"I guess this patient may have myocarditis caused by immunotherapy!"

As soon as he finished speaking, the system popped up a prompt.

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

At the same time, everyone present was puzzled.

"Myocarditis caused by tumor immunotherapy?"

Everyone knows about myocarditis, but myocarditis caused by immunotherapy...

This is beyond their cognition!

Even oncologists have never heard of it!

"Director Lu, can you explain this disease to everyone?" Director Tang said quickly.

"Okay, no problem." Lu Chen nodded slightly, then took out his mobile phone.

Everyone was a little confused when they saw Lu Chen connect his mobile phone to the projector.

Lu Chen began to introduce: "This is a document I read last month, published in the Lancet magazine."

The paper is all in English, but since everyone is a big shot in the medical industry, it will naturally not be a problem for them.

"This paper is about studying the side effects related to immunotherapy. Immune myocarditis, as the name suggests, is a drug for tumor immunotherapy. While treating tumors, it can also damage the patient's cardiomyocytes!" Lu Chen highlighted the key points of the paper, " Among the many adverse reactions, myocarditis caused by immunotherapy is a side effect that doctors are very unwilling to see. "

The incidence rate of immune myocarditis is 0.06%-3.8%.

Although the incidence rate is relatively low, it is highly lethal.

The mortality rate of immune myocarditis is as high as 39.7%-50%! Once it happens, nearly half of them will be life-threatening.

"After reading this article, let's look at the second article!" Lu Chen switched to another article, "This paper is also published in the New England Journal, the top journal in the field of cardiovascular disease."

"Researchers warn patients who use immunotherapy to be highly vigilant about the occurrence of immune myocarditis. Because the symptoms of this adverse reaction are not very specific, it is easy to be ignored or mistaken for other underlying diseases!"

After reading the two documents, the classroom was completely silent.

What makes you awesome is not how good you are.

But after telling your reasons, you can still find the corresponding evidence!

Compared with Lu Chen, Huang Xiaofeng's diagnosis seemed pale at this time. UU read www.uukanshu.net

Director Tang smiled happily, but he felt a little more sad inside.

Fortunately, this young man Lu Chen is indeed extraordinary!

Sadly, China’s research still lags behind foreign countries!

When will this situation be reversed?

Director Tang looked at Lu Chen in front of him, feeling more hopeful for no reason.

－－－－－－Digression－－－－－

Myocarditis caused by immune check inhibitors has been mentioned in China in recent years.

The first domestic guidelines were issued last year.

The content written in the article lags behind the reality.

After all, I can’t just fabricate a new research field out of thin air.

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