This Doctor is Great

Zhou Mo asked patiently in detail: "I mean, why did you go to the emergency department? Why did the emergency department send you to the cardiology department?"

Patient Chen Zhongxin: "Oh, that's what you're talking about... The thing is this, I was moving things at home this morning, and I don't know what happened. I was carrying that table, and the table was square... ( Omit a few adjectives), I was dizzy at that time, sitting on the ground to rest..."

"You don't know, doctor, my eyes were dark and I didn't have much strength..."

"I'm almost scared to shit, I think I can't do it..."

The patient Chen Zhongxin looked terrified.

It took several minutes for Zhou Mo to get a general understanding of his situation.

When the patient moved forty or fifty catties, he was short of breath, weak, his vision went dark, and he fainted to the ground.

For a big man, it would not be so serious to move forty or fifty catties.

Then I was sent to the emergency room by a friend, and woke up in the emergency room.

Then the emergency department was diagnosed and sent to the cardiology department.

Zhou Mo: "Do you have any medical history? Three highs, surgery, etc.? And family medical history..."

After a few minutes of communication, it was determined that there was nothing.

Only then did Zhou Mo take out the patient's examination report.

Emergency department and electrocardiogram.

Emergency · Blood sugar.

Why is the ECG checked?

Because the patient passed out, it is natural to suspect that there is a heart problem, so checking the electrocardiogram of more than a dozen yuan is the basic quality of emergency doctors to avoid the most dangerous situations such as myocardial infarction.

Why check blood sugar?

Because the patient expressed lack of strength, it is very likely that there is a problem with blood sugar, which is the symptom of hypoglycemia. Blood sugar results can be obtained by pricking a finger, so blood sugar also needs to be checked.

The results of the two checks are:

ECG: P wave duration widened...

Blood sugar: normal.

Obviously, there is something wrong with the heart.

So the emergency department simply sent the patient to the cardiology department.

In addition, the emergency department also performed a routine blood test on the patient Chen Zhongxin, but the results have not yet come out.

At this moment,

The electrocardiogram that the nurse was fiddling with for the patient was ready, and the electrocardiogram began to be typed out bit by bit.

"Yiming, push a B over..."

"good."

Huang Yiming left quickly.

While waiting for the B-ultrasound, part of the electrocardiogram came out.

Zhou Mo picked it up and looked at it,

ECG: P wave duration widened...

not long,

Huang Yiming brought the B-ultrasound.

Zhou Mo began to perform color ultrasound on the patient's heart. Huang Yiming looked at it enviously, but it was a pity that he couldn't learn it.

sit down,

Zhou Mo started to manipulate the machine.

At this moment,

Zhou Mo smelled a smell.

Mothballs? (here foreshadowing)

After 3 minutes, the result came out.

"Enlarged left atrium."

"And mild mitral regurgitation."

"But the good news is that the color Doppler ultrasound did not indicate valve calcification, contracture, or prolapse."

After Zhou Mo put down the B-ultrasound probe, he said to Huang Yiming.

"Regurgitation?"

"You know that the left atrium is enlarged, are there any reasons?"

Huang Yiming suddenly felt nervous about being tested by the teacher, so he quickly searched in his mind, but fortunately, his knowledge is relatively solid:

"The left atrium is enlarged, there are several possibilities..."

"First, rheumatic heart disease, especially mitral valve stenosis or insufficiency."

"The second is dilated cardiomyopathy. This kind of dilated cardiomyopathy is manifested by the expansion of each chamber of the heart. In addition to the expansion of the atrium, there can also be the expansion of the ventricle, the thinning of the ventricular wall, and the weakening of myocardial contractility."

"Third, congenital heart disease, including atrial septal defect, ventricular septal defect, and patent ductus arteriosus, these congenital heart diseases develop to a certain stage, and may also lead to the enlargement of the left atrium..."

Huang Yiming spoke fluently at once.

Patient (reader): "…………"

I don't understand! Hey!

Huang Yiming: "Why does the left atrium become enlarged?"

Zhou Mo: "I'm also curious...so I need to find the reason."

The two thought.

at this time,

Senior brother Chen Bing walked into the ward quickly from the outside, looking nervous.

Zhou Mo: "Brother, what's the matter?"

Senior Brother Chen Bing: "This patient had a routine blood test, and the results just came out. The laboratory department issued a system alarm, severe anemia!"

What?

Severe anemia? !

Both Zhou Mo and Huang Yiming were taken aback.

Senior Brother Chen Bing nodded, and then asked the patient, "Your name is Chen Zhongxin, right?"

Patient Chen Zhongxin was made nervous by senior brother Chen Bing: "Yes, it's me. Doctor, am I going to die? If I'm going to die, please tell me in advance..."

"I want to delete those contents of my phone..."

Zhou Mo: "..."

Chen Bing and Huang Yiming: "..."

What the hell did you do with your phone?

Could it be that 'A Bing's high school grades were not satisfactory'? Or is it 'Gao Yi'...

We are curious! ! ! !

Ahh~~~~ Zhou Mo's thoughts were almost interrupted.

Zhou Mo: "How much is hemoglobin?"

Brother Chen Bing said: "It's only 57g/L."

I go!

57?

Both Zhou Mo and Huang Yiming were shocked!

A normal adult man's hemoglobin should be 120-150g/L, but now the patient's hemoglobin is less than half, and if it is lower than 60g/L, it is severe anemia.

In other words, this patient has lost half of his blood!

Zhou Mo hurriedly said: "Then arrange for a nurse to give him a blood transfusion first!"

Senior Brother Chen Bing: "Already arranged...what's the patient's condition?"

Zhou Mo: "The left atrium is enlarged...Combined with such severe anemia, if the anemia is anemia for a long time, it may be anemic heart disease caused by anemia."

'Anemic heart disease': Chronic anemia with hemoglobin (HB) \u003c70g/L caused by various reasons, resulting in increased cardiac output, enlarged heart, or cardiac insufficiency.

Zhou Mo looked at the paleness of the patient's face.

This should be an anemic appearance.

Originally, Zhou Mo didn't think about it.

The patient's so-called "weakness" may be a symptom of anemia, which can be explained.

As for coma,

Such severe anemia is very likely to lead to coma.

If the blood supply is not enough for the brain to use, then the brain function will inevitably be impaired, such as dizziness, nausea, etc., and even a short-term coma in severe cases.

This is a very reasonable inference.

The issue is,

Why is he severely anemic?

Where did the lost half of the blood go?

Is the blood lost for a short time, or for a long time?

If it is lost for a short time, it is naturally not anemic heart disease, but if it is lost for a long time.

The causes of anemia are nothing more than:

Less hematopoiesis!

A lot of blood loss!

One in and one out.

Basically include:

Iron deficiency anemia...

Did you vomit blood...

Is it normal for my aunt to bleed...No, this is a man...

The stool is black or not, what disease history do you have (hemolytic anemia), whether you have hemorrhoids...

Iron deficiency or iron deficiency, this needs to wait for a blood test to do a "serum iron test".

Zhou Mo asked the patient, "Have you always felt that you have no strength? Or have you only recently felt that you have no strength?"

The patient thought for a while: "I don't know, maybe I felt it a long time ago? It seems that running is easier to get tired."

Zhou Mo: "Do you usually feel that you are bleeding? Spitting blood or something?"

The patient rolled his eyes: "Aren't you talking nonsense? Of course not...Doctor, you are so stupid..."

Zhou Mo: "..."

look left and right,

Where's my needle? I'm going to sew his mouth shut!

.