I can see health

Chapter 202 The Silent Heart

"Doctor Fan, what's the matter?"

Lu Chen looked at Fan Zhiping who was walking in front of him strangely.

Didn't he go to treat patients?
"This electrocardiogram..." Fan Zhiping took out the electrocardiogram in his hand and placed it in front of Lu Chen's desk. "It always feels strange, but I can't say why."

Lu Chen looked down at the electrocardiogram.

His first impression was that he didn't see a P wave, but there were small f waves with different shapes, so this was atrial fibrillation.

However, it doesn't look like atrial fibrillation!

Because the heart rhythm of atrial fibrillation is absolutely irregular, but the heart rhythm of this ECG is neat!
……

Ke Yue is now also very interested in electrocardiograms.

Since director Lin Cui severely criticized her, she has worked hard to learn electrocardiography.

After two months of hard work, the level of reading electrocardiogram has improved a lot.

She put her head in front of Lu Chen, and immediately showed doubts.

"This, isn't this atrial fibrillation?"

No P waves are seen, but small jagged f waves are clearly visible.

This is one of the most important ways to identify atrial fibrillation.

Atrial fibrillation is the eternal pain in Ke Yue's heart.

She was sure that the electrocardiogram in front of her was definitely atrial fibrillation!

However, such a simple electrocardiogram.

As the deputy chief doctor of the Cardiology Department, Fan Zhiping couldn't fail to see it!

Ke Yue's words also attracted other people in the group.

Sun Guoguo happened to be fine, so she came to Lu Chen's side and picked up the electrocardiogram on the table.

"This is..." Sun Guoguo frowned, "This ECG is really strange! There is no P wave, but there is a small F wave of atrial fibrillation, but the heart rhythm is usually regular."

It looks like atrial fibrillation, but after thinking about it, it doesn't look like it!
"Heart rhythm?"

Ke Yue was taken aback, and quickly looked at the electrocardiogram again.

Sure enough, the heart rhythm was regular, that is to say, the time between each heart beat was the same.

This completely contradicts the ECG characteristics of atrial fibrillation.

……

This electrocardiogram is really strange. So far, Lu Chen has no clue.

It was the first time he had seen such an electrocardiogram.

"What's the patient's condition?" Lu Chen looked up at Fan Zhiping holding the electrocardiogram.

"This is a heart transplant patient." Fan Zhiping paused and began to tell the patient's medical history.

Patient, male, 61 years old.

Diagnosed with coronary heart disease, atrial fibrillation, cardiac insufficiency, and type 2014 diabetes in 2.

In the first half of this year, the patient received a heart transplant due to end-stage heart disease.The patient received the Bicaval technique, the left atrium and great vessels of the recipient were preserved, and the right atrium and ventricle were resected.

Periodic outpatient follow-up after operation, the heart donor did not have any relevant past medical history.The patient experienced acute cellular rejection 7 months after transplantation.

"Heart transplant?" Lu Chen frowned.

Heart transplant patients are still rare.

Generally speaking, a transplanted heart can last about five years.

After learning about the patient's medical history, Lu Chen still didn't have any thoughts about this electrocardiogram.

Sun Guoguo also shook his head.

"I can't figure out what the electrocardiogram is for the time being. I can only wait for Teacher Li to make a ward round tomorrow and ask her opinion."

Lu Chen nodded, this is the only way to do it now.

But he was a little reconciled.

He has studied the electrocardiogram for so long, but he will not give up easily.

The more difficult the electrocardiogram, the more passionate and motivated Lu Chen is.

……

Two 10 minutes later.

Junior Sister Yu, who helped Fan Zhiping, returned to the doctor's office with a stack of checklists.

"Brother, here are some results from the patient's last review."

"Okay, thank you." Lu Chen nodded and began to look through the patient's previous auxiliary examinations.

Echocardiography: left ventricular ejection fraction 60%, normal right ventricular function, moderate tricuspid and mitral regurgitation, severely dilated left atrium.

According to the medical records, the patient had no symptoms of palpitations, chest pain or dyspnea in the last time he had a follow-up visit in the outpatient clinic, and the physical examination showed no positive signs.

"Where's his medication?" Lu Chen asked.

"There is a list of medications at the end."

Lu Chen turned directly to the end.

The patient's current regular medication: tacrolimus 1mg PO BID, sirolimus 4mg PO QD, prednisone 3mg PO QD, bisoprolol 1.25mg PO QD, rivaroxaban 15mg PO QD.

(Note: po is oral, QD is once a day, BID is twice a day)
Among them are immunosuppressants, hormones, anticoagulants, and drugs to improve heart function after heart transplantation.

Patients' medications are relatively routine.

"The patient came to the hospital this time without any discomfort, mainly for reexamination." Fan Zhiping added on the side.

"En." Lu Chen nodded.

He combined all the test results, as well as the patient's medical history.

But still can not see the patient's ECG diagnosis.

Fan Zhiping suddenly whispered: "How about I send this electrocardiogram to Jinghua Electrophysiology WeChat group for everyone to discuss?"

"Okay." Lu Chen said, "Depending on the wisdom of the collective, maybe we can have an idea."

Seeing that Lu Chen agreed, Fan Zhiping took a photo of the ECG and sent it to Jinghua Electrophysiology WeChat group.

……

Jinghua Electrophysiology Exchange Group.

Every day in the group, people send ECG questions.

There are simple ones and there are more difficult ones.

Before the National Skills Test, Lu Chen often spoke in the group.

However, since he was preparing for the exam, for more than a month, he hasn't been a bubble in the group.

On the contrary, Fan Zhiping, one of the most active people in the group, is usually very enthusiastic to help others answer ECG, or discuss academic issues of ECG with everyone.

After Fan Zhiping posted this strange electrocardiogram to the group, it immediately attracted the attention of most people.

"Old Fan, isn't this atrial fibrillation?"

"Yes, it's obvious atrial fibrillation! Why did you send this ECG?"

As soon as Fan Zhiping posted it in the group, someone couldn't wait to speak.

However, before Fan Zhiping could explain, someone asked a question: "Everyone, take a closer look, the heart rhythm in this ECG is neat! Are you sure it's atrial fibrillation?"

"Hey, from what you said, it seems to be true."

"Judging from the p wave, it's atrial fibrillation, but judging from the heart rhythm, it's not!"

"Think about it, if it was a picture of atrial fibrillation, Lao Fan wouldn't show it to us!"

"This should be @Professor Lu!"

"..."

Everyone in the group chattered, but they didn't say anything.

After Lu Chen looked through the chat history of WeChat, he found no useful information.

For the time being, he could only put the electrocardiogram aside, and look through the electrocardiogram again after returning to the dormitory.

……

Fan Zhiping held the electrocardiogram in his hand, but felt quite helpless in his heart.

When he first came to the eighth district of the heart, this electrocardiogram gave him a blow.

Fortunately, it was a somewhat difficult electrocardiogram.

Otherwise, this is not to make everyone underestimate their cardiology department in Feng M County.

However, just one day after coming here, Fan Zhiping could feel that the academic atmosphere in the Eighth District of Xinxin was much stronger than that of the county hospital.

The doctors in their county hospital talk about stocks and options whenever they have time, so where would they discuss academic issues?

Someone who can take the initiative to look through internal medicine books is considered a good person.

However, in the inner eighth district of Jinghua No. [-] Hospital, if everyone encounters any question that they don’t understand, they will immediately search for relevant information, even search for literature to solve the problem, and discuss together to find the answer to the question.

These are incomparable to the doctors in the county hospital!
Fan Zhiping had a feeling in his heart.

Although feeling a little helpless, he also tried to pick up books and documents to slowly enrich himself.

In the profession of doctors, one really lives and learns.

……

After get off work at noon, Lu Chen packed a meal in the cafeteria.

Back in the dormitory, he began to check the electrocardiogram data while eating.

The knowledge of electrocardiogram is vast, far more than what he has now.

However, his current electrocardiogram interpretation skills are only at the basic level.

In the system mall, intermediate skills cannot be exchanged for the time being.Only when you unlock a higher level mall, you may be able to exchange for more advanced skill cards and skill books.

Now, Lu Chen can only rely on his own efforts to slowly discover information related to this strange ECG from the data in the ECG.

After about half an hour.

Other people in the dormitory also came back after lunch one after another.

"Lu Chen, you came back so early today?"

Wang Zihao walked to Lu Chen's side and patted him on the shoulder lightly.

"Well, I need to check something." Lu Chen smiled, "I just packed the meal and brought it back."

"You are really fascinated by the electrocardiogram, and started to chew on the electrocardiogram book again."

Wang Zihao also admired Lu Chen.

Some people are not only talented, but also work harder than you!
Originally, he wanted to play two games before going to bed, but Wang Zihao thought it was better to read some literature before going to bed!

Otherwise, the gap will become bigger and bigger.

"Hey, old Wang, you don't play games anymore?" Another roommate said in surprise, "A new hero just came out, Zeiqiang! Don't you want to try?"

Wang Zihao curled his lips, "I read the skill introduction, isn't this the combination of two hero skills in another game? It's just a stitch monster, nothing interesting, you guys can play."

"Ok."

The other two roommates can only do double row.

……

But the speaker has no intention, but the listener does.

When Lu Chen heard what Wang Zihao said about the stitch monster, a sudden inspiration flashed in his mind.

"A combination of two heroes, a stitch monster..."

"Two hearts, a heart transplant..."

When he looked at this electrocardiogram that "looks like atrial fibrillation" again, he suddenly understood!

"I see!"

Behind the silent heart, there is another wonderful world.

(End of this chapter)