I Can See Health

I can see the beginning of the misunderstanding case discussion in Chapter 837 of the HP text volume.

Lu Chen sat behind the Kebed team.

He made a visual inspection and found that there were seven cardiology teams in the entire demonstration classroom, numbering around 17 people.

On the podium, the attending doctor of this case began to introduce the basic situation of the patient to everyone.

This model is similar to that in China.

After the doctor in charge introduced the condition, he asked questions.

The various doctors will then continue the discussion and analyze the answers.

"Patient, male, 18 years old."

"I went to the hospital because the electrocardiogram was obviously abnormal during post-exercise examination. The patient did not have any uncomfortable symptoms."

"He was in good health and denied any family history of cardiomyopathy or unexplained sudden death."

The patient's medical history is simple, a few sentences.

But then, the examinations and tests ordered by the doctor in charge were not simple!

There are many copies of electrocardiograms.

Lu Chen picked out the most typical ones.

As soon as he opened the electrocardiogram, Lu Chen read the results immediately.

This is a typical result of asymmetric T waves, and the ST in the precordial leads is still depressed.

Clearly, this is the EKG of cardiomyopathy.

For example, the most common disease is hypertrophic cardiomyopathy.

Sure enough, as soon as this picture came out.

Everyone started talking and at the same time they were confused.

We are all top doctors in the world, and we can all recognize this basic electrocardiogram.

The doctor in charge smiled and asked everyone to be patient and continue checking the patient's other information.

Next.

The doctor in charge took out the patient's electrocardiogram, cardiac ultrasound, and cardiac magnetic resonance for review.

The patient's cardiac ultrasound and cardiac MRI all confirmed the diagnosis of "cardiomyopathy."

The cardiac ultrasound results showed that the apical myocardium was hypertrophic, with a maximum thickness of 24mm, the size and systolic function of the left ventricle were normal, and there was no obstruction to blood flow.

Cardiac magnetic resonance examination showed that the apical and anterior septal thicknesses were 25 mm and 13 mm respectively.

At the apex of the heart, delayed contrast enhancement can be seen.

In addition, the patient also underwent genetic testing.

Genetic examination showed that the patient had mutations in the MYH7 coding and β-MHC genes!

However, the patient's parents and siblings were all tested negative.

These results all confirmed the possibility that the patient had "hypertrophic cardiomyopathy"!

Since no sudden death risk markers were found during this examination, there is no indication for ICD implantation for the time being.

…

Seeing this, Lu Chen frowned.

At first glance, this case seems too simple.

No matter how you look at it, no matter what tricks you pull out, this is hypertrophic cardiomyopathy!

Could it be that doctors at Mayo cannot diagnose such an obvious disease?

This is absolutely impossible!

Lu Chen continued to look down.

The following medical records slowly dispelled Lu Chen's doubts.

After the patient was discharged from the hospital, he followed the doctor's advice and stopped strenuous training, but he still maintained an active lifestyle.

One year later, the patient was reviewed again.

A follow-up cardiac MRI showed that the left ventricular hypertrophy was relieved!

The maximum thickness at the apex is 10 mm.

The reexamination electrocardiogram showed that the ST segment depression was significantly improved compared to the first visit!

As soon as this result came out, everyone in the classroom became somewhat silent.

The patient’s symptoms improved miraculously without any treatment!

Kebed beside Lu Chen frowned and whispered: "It looks like hypertrophic cardiomyopathy, but the exercise stopped and the hypertrophy was relieved. This looks like physiological myocardial hypertrophy!"

Lu Chen also frowned.

Kebed is right, pathological cardiac hypertrophy is impossible to reverse.

Only physiological myocardial hypertrophy can be reversed after stopping exercise.

However, the patient had previously undergone genetic testing, and the gene for hypertrophic cardiomyopathy was indeed detected.

This seems to be contradictory!

Lu Chen's heart sank. It was indeed a case that could appear in Mayo!

There is no such thing as a disease that is easily diagnosed.

"Lu, what do you think of this case?" Kebed looked at Lu Chen standing aside.

Lu Chen shook his head, "I have no idea at the moment."

Kebed touched his chin and said slowly: "Lu, I have an idea. This patient's cardiac hypertrophy resolved spontaneously after he stopped training, and the genetic tests of family members were all negative. So I think it may be necessary to do another genetic test to rule out the problem. Possibility of false positive on initial inspection.”

Kebed's idea is simple.

He felt that the first genetic test was wrong!

His opinion was to re-do genetic testing.

After Kebed mentioned the idea, other Mayo cardiologists also raised the possibility.

This 18-year-old athlete is likely to have simple physiological cardiac hypertrophy.

Lu Chen frowned because when he considered this diagnosis.

The system did not pop up any prompts.

In other words, "physiological cardiac hypertrophy" is wrong!

For a time, everyone's opinions were not unanimous.

Some doctors say it is "physiological cardiac hypertrophy", while others say it is "genetic pathological hypertrophic cardiomyopathy"!

Everyone has their own opinions, and no one can convince anyone.

…

Lu Chen remained silent.

Because he discovered something very strange.

When he thought of "physiological cardiac hypertrophy," the system did not pop up a prompt.

When he thought of "pathological hypertrophic cardiomyopathy", the system also did not pop up a prompt.

Doesn’t this patient have “cardiomyopathy” at all?

This idea came to Lu Chen's mind.

Everyone has been arguing for a long time, but in fact it is not cardiomyopathy at all? !

This is too ridiculous...

Lu Chen reorganized the patient's examination.

Whether it is from electrocardiogram, cardiac ultrasound, cardiac magnetic resonance, or even genetic testing, it has been confirmed that the patient has cardiomyopathy!

There is no other possibility.

"Is it possible that the system is down again?"

But since Lu Chen owned the system until now, the system has always been reliable.

There has never been a system bug!

…

While Lu Chen was thinking, the entire Mayo Cardiology Classroom was mainly divided into two factions.

One party believes that it is physiological myocardial hypertrophy. The main reason is that after stopping exercise, the patient's myocardial hypertrophy has recovered compared to before.

On the other hand, they thought it was pathological hereditary cardiomyopathy because the result of the genetic test was positive!

Any other test may not be as accurate as genetic testing.

Kebed continued to say to Lu Chen: "Lu, everyone is holding different opinions now. We can only look at conducting genetic testing again and wait until the results to make a judgment."

At this moment, an idea suddenly flashed in Lu Chen's mind.

Everyone seems to have entered a misunderstanding.

Why do everyone think it is either physiological or pathological?

Can't both situations exist at the same time?

Just when Lu Chen thought of this, the system immediately popped up a long-awaited notification sound.

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

"Brother Shen!"

"Um!"

When Shen Changqing walks on the road, whenever he meets someone he knows, he will say hello or nod to each other.

But no matter who it is.

There was no unnecessary expression on everyone's face, as if they were indifferent to everything.

To this.

Shen Changqing has become accustomed to it.

Because this is the Demon Suppression Division, an organization that maintains the stability of the Qin Dynasty. Its main responsibility is to kill monsters and monsters. Of course, there are also some other side jobs.

It can be said.

Everyone in the Demon Suppression Division has a lot of blood on their hands.

When a person is used to seeing life and death, he will become indifferent to many things.

When he first came to this world, Shen Changqing was a little uncomfortable, but he got used to it over time.

The Demon-Suppressing Division is huge.

Those who can stay in the Demon Suppressing Division are all powerful masters, or those who have the potential to become masters.

Shen Changqing belongs to the latter.

Among them, the Demon Suppressor Division is divided into two professions, one is the Guardian Envoy and the other is the Demon Slayer.

Anyone who enters the Demon Suppression Department starts from the lowest level as a demon slayer.

Then he will be promoted step by step, and he is expected to eventually become a guardian envoy.

Shen Changqing's predecessor was a trainee demon slayer in the Demon Suppression Division, and he was also the lowest level among the demon slayers.

Possessing the memory of a previous life.

He is also very familiar with the environment of the Demon Suppression Division.

It didn't take long for Shen Changqing to stop in front of a loft.

Unlike other places in the Demon Suppressing Division that were full of chills, the attic here seemed to stand out from the crowd, showing a different kind of tranquility in the bloody Demon Suppressing Division.

At this time, the attic door was open, and occasionally people came in and out.

Shen Changqing only hesitated for a moment before stepping in.

Enter the attic.

The environment changes in vain.

The fragrance of ink mixed with the faint smell of blood hit his face, causing him to frown instinctively, but then relaxed it quickly.

There is almost no way to cleanse away the smell of blood on everyone in the Demon-Suppressing Division.