I can see health

Chapter 195 Myocardial Infarction Without High Risk Factors

Back to Jinghua Second Hospital.

The whole representative team received the courtesy of the champion.

Luo Binghe, the dean of the graduate school, met with everyone in the school auditorium, and reiterated the rewards the school had promised.

Won the first place in the country in the skill competition and won all scholarships unconditionally.And in all selection activities, they have the right to choose first.At the same time, he won the opportunity to study and exchange abroad with Jinghua Medical University.

The scholarships include bursaries and national scholarships.

The annual first-class bursary is 1 yuan, and the national scholarship is also 1 yuan.

This is a huge sum of money for students who have just had no job.

In addition, the priority is high among graduates staying in school, and there are opportunities to go out for exchanges.

Lu Chen and the other five have gained a lot in this national skill test.

Not only are there economic rewards, but they are also of great benefit to their future development.

……

After the skill test was over, Lu Chen and the others went back to the clinical departments after returning to Jinghua Second Hospital.

According to the latest rotation plan, Lu Chen still needs to stay in the cardiology department for two months before transferring to other departments.

On the second day after returning to Jinghua No. [-] Hospital, Lu Chen returned to the ward in Xinxin District [-] and started clinical rotation.

"Junior Brother Lu, your postgraduate schedule is out, take a look at your class, don't forget it."

In the early morning, as soon as Lu Chen arrived at the ward, he received the schedule from Sun Guoguo.

It was only then that he remembered that after the official rotation began, the hospital began to arrange shifts for them.

Scheduling is mainly divided into two types.

One is the class of one's own professional department, and the other is the class of rotating department.

For example, Lu Chen is rotating in the cardiology department, so he only needs to be on duty in the cardiology department.

But when Lu Chen was transferred to other departments, such as the Department of Endocrinology, he would have to be on duty in both the Department of Cardiology and the Department of Endocrinology.

Each department has about three shifts a month.

In other words, every graduate student will be on duty six classes a month.

The subsidy for each shift ranges from 60 to 100 yuan depending on the department.

Lu Chen looked at the schedule in his hand.

"There is a night shift this week, the day after tomorrow, and the superior physician is Yin Xinhua."

The senior physicians and graduate students on duty are arranged randomly.

Lu Chen's first night shift was the attending doctor Yin Xinhua who worked with Lin Cui.

……

After finishing work in the morning.

Lu Chen regained the four hospital beds he managed before.

However, these patients were all about to be discharged from the hospital, and Lu Chen directly completed the progress records without much effort.

After Sun Guoguo finished the room check and returned to the doctor's office, Lu Chen saw a group of people gathered together.

There are interns, regular trainees and graduate students, as if they are discussing something.

Lu Chen glanced at it and saw Director Lin Cui sitting in it, so he probably knew what was going on.

Recalling that when he first came to Xinxin District [-], Director Lin Cui liked to give lectures in the department and ask everyone questions.

Ke Yue was once severely criticized by Lin Cui for failing to recognize the electrocardiogram of atrial fibrillation.

It seems that Director Lin Cui started to give lectures again and almost finished her lecture.

"Do you have any questions about the electrocardiogram? You can bring it up and discuss it together." Director Lin Cui said with a smile.

A group of students chattered and began to ask questions one after another, including the meaning of P wave and QRS wave, the identification of premature beats, and so on.

Director Lin Cui restrained her temper and explained to them one by one.

"Director Lin, I am very interested in a question. The electrocardiogram can judge the condition of our heart, whether there is myocardial damage, whether there is heart hypertrophy, etc. Since the electrocardiogram is so magical, then I would like to ask, through the electrocardiogram, can we identify people's heart disease? gender?"

At this time, a question from an intern caught Lu Chen's attention.

Lin Cui was also taken aback by this sudden question.

"Look at people's gender?"

"That's right, Director Lin, can't you watch it?" the intern asked doubtfully.

Lin Cui's face darkened, "You children, ask a few more practical questions, ask all these questions, can you determine the gender, can you cure the disease?"

Hearing this, the intern blushed, said "Oh", and stopped asking.

Although Lin Cui didn't answer, everyone was interested in this question.

"Brother, can the electrocardiogram determine the patient's gender?"

Junior sister Yao Jie at the side suddenly came over.

"Do you think you can?" Lu Chen asked with a smile.

"No, can't you?" Junior sister Yao Jie shook her head slightly.

"How about this." Lu Chen smiled, "Junior Sister, go find some electrocardiograms, and don't let me see the patient's information."

"Okay." Yao Jie quickly ran to the side of the medical record car and found five ECGs.

After handing the ECG to Lu Chen, Yao Jie blinked.

"Brother, can you really tell the gender?"

Lu Chen smiled and picked up the electrocardiogram that Yao Jie gave him.

"First ECG, male."

"Second ECG, female."

……

"The fifth ECG, male."

When Lu Chen finished speaking, Yao Jie was astonished at the patient's information.

"Brother, you, how do you know?"

These five medical records were randomly selected by her from the medical records.

Lu Chen completely judged the patient's gender correctly.

Could it be possible to really determine the gender of the patient?

Lu Chen smiled and said: "Junior Sister, the electrocardiogram is a very wonderful thing. Although it is not [-]% accurate, it can reflect many things."

Yao Jie didn't quite believe it, so she found another ten ECGs and let Lu Chen identify them.

Lu Chen did not refuse, "They are male, male, female, male..."

In the electrocardiogram, Lu Chen made a mistake in one, and all the others were identified successfully.

Although there is a mistake, the correct rate is quite high.

"Brother, you can identify men and women, but what about transgender people?"

Lu Chen's face darkened, what was going on in Junior Sister's little head all day long?

Lu Chen was about to explain the reason to Yao Jie, but unexpectedly the nurse on duty walked into the office.

"Doctors in the chief group, a new patient has arrived!"

"Okay, come right away." Lu Chen immediately stood up, and then said to Yao Jie, "I will explain to you later, the electrocardiogram can indeed determine gender, even transgender people can tell."

Yao Jie's eyes widened, the electrocardiogram is so magical?
……

Newly admitted patients are in bed 11.

Lu Chen came to the bedside, and Yao Jie followed behind him pushing the EKG machine.

On the hospital bed was a man about 25 years old.

He was lying on the hospital bed with his eyes closed.

"I'm your bed doctor, what's wrong?"

This is Lu Chen's most typical opening speech.

The man's complexion looked a little pale, he slowly opened his eyes, and said softly, "I feel a little uncomfortable in my chest."

"Chest pain or tightness?" Lu Chen continued
"It hurts a bit, and after the pain is over, it's still a little stuffy."

"When did the chest pain start?"

"Around four o'clock this evening, I woke up painfully in my sleep."

Lu Chen looked at the patient's electrocardiogram taken at the outpatient clinic, which showed that the T wave was slightly high, and there was nothing abnormal about it.

"Junior Sister, check another ECG." Lu Chen ordered.

Electrocardiogram is the easiest and cheapest cardiology examination.

Many patients with heart disease will have ECG changes when their condition changes, so doctors need to constantly review the ECG.

"Okay, senior brother." Yao Jie nodded slightly.

……

After the EKG is done.

As soon as Lu Chen got it in his hand, his heart sank.

The electrocardiogram showed that compared with the admission electrocardiogram, the ST segment in leads II, III, and aVF was elevated!
"There is a possibility of acute myocardial infarction, and it's an inferior wall myocardial infarction." Lu Chen said in a deep voice, "Junior Sister, go tell Senior Sister Guoguo to come and see this patient, and then notify the cath lab to prepare."

"Okay." Yao Jie nodded immediately, and walked out of the ward quickly.

Leads II, III, and aVF correspond to the lower wall of the heart. If these leads are abnormal, it often indicates that the lower wall of the heart may be ischemic and necrotic.

"An electrocardiogram can tell that I have a heart problem?" The man on the bed said calmly, "Can the electrocardiogram clearly see the changes in my body through my skin?"

Lu Chen paused and explained: "When we put the electrodes of the electrocardiogram on the chest wall, we can feel the electrical conduction, and then record it on the electrocardiogram chart. If there is ischemic and necrotic myocardium, their discharge must be poor. It can be faithfully reflected on the ECG chart."

"Now, based on your symptoms and the results of the electrocardiogram, we can judge that the disease you are suffering from is probably myocardial infarction."

However, what Lu Chen has a little doubt about now is the life value on the patient's head.

His health is 68.

According to the previous rule, in the acute phase of myocardial infarction, the life value is below 60.

Could it be that the patient's condition is still progressing?
"Where's your family?" Lu Chen continued to ask.

Acute myocardial infarction is an emergency and critical illness, and there is a risk of sudden death at any time.

Therefore, the immediate family members of the patient should be informed as soon as possible.

"No." The man's face darkened.

"Not married?" Lu Chen said, "Where's your wife and children?"

"I left a few days ago and have no children."

"Where are the parents?"

"I'm not in Jinghua, I'm the only one in Jinghua."

Lu Chen's heart sank, and this matter became even more difficult!
Acute myocardial infarction requires emergency coronary intervention.

This invasive surgical treatment must require the signature of the patient's family members.

At this time, Sun Guoguo also rushed over.

She quickly asked about the patient's medical history and looked at the electrocardiogram.

"It is indeed an acute myocardial infarction, and it is still within the intervention time window. Emergency surgery is required."

Sun Guoguo's opinion is exactly the same as that of Lu Chen.

"Senior Sister, the patient has no family members in Jinghua." Lu Chen whispered from the side.

"Is there none?" Sun Guoguo looked at the man on the hospital bed.

"No." The man shook his head.

Sun Guoguo also felt that this matter was very difficult.

In such a special situation, if the patient dies on the operating table, it will be so troublesome.

Not to mention who is responsible, even who will claim the corpse and who will pay for the expenses are all problems.

"Junior brother, take care of the patient first." Sun Guoguo took out his mobile phone, "I'll tell Teacher Li about the patient's condition."

Li Yao is the director of the department, and any situation involving potential disputes needs to be reported to her in time.

Sun Guoguo stepped out of the hospital bed and called Li Yao.

Lu Chen stayed and asked the nurse to monitor the patient's ECG.

On the bedside ECG monitoring, the patient's heart rate was 120 beats/min, and blood pressure was 98/50mmHg, which is low for a young man in his 20s.

Looking at the heart rate on the ECG monitor, Lu Chen frowned.

Something seems wrong.

In inferior wall myocardial infarction, the heart rate is generally slow.

This patient is a little abnormal, with a heart rate of 120 beats per minute.

However, Lu Chen didn't think of any other abnormalities for a while.

At this time, the patient on the hospital bed asked again: "Doctor, you have always said that I have a heart attack. Is this serious?"

Hearing this, Lu Chen suppressed his doubts about the heart rate and began to organize his words to explain the condition to the patient.

It is extremely important to explain the condition, which is related to whether the patient can accept the next step of treatment.

"Have you heard of coronary heart disease?" Lu Chen asked.

The man frowned and nodded.

"Acute myocardial infarction is the most serious type of coronary heart disease, and death may occur at any time!"

"Acute myocardial infarction is caused by a blood vessel in the heart being blocked by a thrombus, and the blood cannot pass through. The remote myocardial cells will naturally suffer from ischemia and hypoxia, and will soon die."

"Myocardium cells are not ordinary cells. Cardiomyocytes are born with it. If one dies, one will be lost. If a group dies, the whole heart may go on strike."

"Once the heart goes on strike and heart failure occurs, the patient may die."

"Therefore, opening the blocked heart vessels (coronary arteries) as soon as possible is the only effective treatment. In relatively high-end hospitals, coronary intervention is the first choice, such as placing a heart vascular stent to open the narrowed blood vessels and remove them. Clogged blood clots."

After some explanation from Lu Chen, the patient also understood his condition.

"That is to say, I must do this interventional operation?" the patient said.

"Yes!" Lu Chen nodded without doubt.

"Okay, then I will listen to you."

"The problem now is that you don't have any family members, so you must have your family members' signatures for the surgery."

"Can't I sign it myself?"

"For this question, we need to contact the superior doctor."

……

Sun Guoguo returned to the ward soon.

"Mr. Li said that we are only responsible for saving lives. We can't handle so many miscellaneous things. She contacted the medical department, filed a record with the medical department, and asked them to settle the signing. That's what they did in the first place."

Lu Chen nodded. The best way now is to file a record with the medical department and tell the medical department that there is such a thing.

It is impossible for them to sit idly by and ignore patients.

Everything was ready and the patient was quickly sent to the cath lab.

……

The rescuers in the intervention room competed for points, and Lu Chen and others returned to the doctor's office.

Doctors in other groups also knew about this patient, and everyone sighed.

Such a young myocardial infarction is really frightening!

When Lu Chen sat in front of the computer and began to write the medical records, he realized another problem.

The patient has no history of hypertension and hyperglycemia, only a history of hyperlipidemia, and does not smoke or drink.

To be honest, there are not many high-risk factors.

This patient is about the same age as him, but who would have thought that he would have such a heart attack? !

But 10 minutes later, there was a news that no one expected from the intervention room.

(End of this chapter)