I can see health

Chapter 238 Shall I Try It? (first update)
Sun Guoguo has a relatively stable personality. When the dissection cannot be completely ruled out, she will not easily let the patient undergo interventional surgery.

"Let's do it at the same time!"

After thinking about it for a few minutes, Sun Guoguo still decided to contact the cath lab and prepare for the interventional operation.

On the other side, they contacted the CT room, saying that patients with chest pain should undergo enhanced chest CT scans to rule out the possibility of aortic dissection.

"Lu Chen, you can push the patient for enhanced CT later. If the results are all right, then don't go back to the ward, just push the patient to the cath lab."

"Okay, Senior Sister." Lu Chen nodded.

This is currently the safest way.

However, it was an enhanced CT and an interventional operation. The patient and his family were a little scared by this posture.

Sun Guoguo directly communicated with the patients and their families about the condition, obtained informed consent for all operations, and signed a signature.

Afterwards, Lu Chen pushed the patient to the CT room.

……

The patient's brows were never loosened along the way, and they were tightly frowned.

At the door of the CT room, the patient's chest pain worsened again!

"Just push a morphine." Lu Chen said to the accompanying patient.

"Okay." The nurse nodded.

A morphine injection was prepared in the first-aid box in advance, and the nurse directly administered 4mg of morphine intravenously for analgesic treatment.

Morphine injections are strictly controlled narcotics.

Regardless of whether the patient has myocardial infarction or aortic dissection, excessive pain is not conducive to the recovery of the disease.

In particular, it may increase the oxygen consumption of the heart, so Lu Chen decided to push the morphine injection.

Because I had communicated with the CT in advance, once I arrived at the CT room, the needles for imaging were prepared, and the examination was arranged immediately.

The enhanced CT scan was completed soon.

Lu Chen took a general look. There was no obvious dissection of the thoracoabdominal aorta, so it should not be the chest pain caused by aortic dissection.

Then the rest is acute myocardial infarction!

On the ward side, after the enhanced CT is completed, the image results are directly uploaded to the medical record system.

In the ward, Sun Guoguo had also seen the CT images.

"If you don't see the dissection, then push it directly into the cath lab. I'll contact the doctor in the cath room." Sun Guoguo also called Lu Chen and asked him to send the patient directly to the cath room for emergency interventional surgery.

Now Lu Chen was completely relieved, and stepped up to push the patient directly to the catheterization room.

……

There was less than 10 minutes before and after.

Lu Chen handed the patient over to the doctor in the catheterization room of the Cardiology Department.

The cath lab sent doctors out again to communicate with the family members.

Surgical communication is not too much, only communication in place, in order to avoid as much as possible after the doctor-patient disputes.

The doctor in the catheterization room spoke quickly, regardless of whether the family members understood it or not, and directly put the consent form in front of her.

"Sign it."

The patient's wife also listened to the general idea. The overall meaning is that this stent is effective, but expensive.

And there may be problems, but if you don't do it, you will die.

"That's nothing to say, I'll sign it." The patient's wife picked up the pen, gritted her teeth, and her fingers were trembling.

After signing the surgical communication, the surgery began.

but……

The accident came as expected.

……

Cardiology catheterization room.

Ren Feng, an interventional cardiologist, stared at the screen tightly and repeatedly irradiated with X-rays, but he didn't see any obvious narrowed or blocked coronary arteries.

Several large blood vessels are still unobstructed!

What's going on here?
Ren Feng on the stage was sweating on his forehead, and began to curse, "Tmd, I didn't see any abnormalities in the chest CTA."

After stepping down, Ren Feng called out the CT film he had just made.

After repeated inspection, there is indeed no aortic dissection!

Combined with the current coronary angiography, there is no myocardial infarction.

nothing!
The patient had severe chest pain, obviously something was wrong!
But no problem was found, this is no joke.

Fortunately, the patient's chest pain seemed to have improved at this time, and his brows stretched slightly.

Otherwise, all the interventional doctors in the catheterization room will really have to die.

"End the operation." Ren Feng said to the assistants and nurses beside him, "Tell the family members that the patient is neither acute myocardial infarction nor coronary heart disease, and there is no coronary heart disease at all."

Although the coronary artery is a little narrow, it is far from the level that causes myocardial ischemia and hypoxia and frequent attacks of angina pectoris.

The patient was quickly pushed back to the eighth area of ​​the heart.

……

At this time, there are eight areas in my heart.

Lu Chen, Sun Guoguo and others have seen the results of coronary angiography.

Everyone was a little dazed.

Not aortic dissection, not acute myocardial infarction!
At this time, the patient's wife walked into the doctor's office.

"Doctor Sun, what is the cause of the chest pain? Isn't it coronary heart disease? It has always been treated according to coronary heart disease. Before, nitroglycerin can also relieve chest pain. Isn't it said that nitroglycerin is a special medicine for coronary heart disease? "

This time, the patient's wife insisted on "coronary heart disease".

She couldn't help it, she was really worried.

This one is not, that one is not, there is an explanation for what kind of disease it is!

"The chest pain just now is really scary, it feels like people will die all of a sudden."

Sun Guoguo was also very depressed, but depression could not solve the problem.

However, she immediately thought of a remedy.

Judging from the severity of the patient's chest pain, it must be related to the condition of the heart, lungs or great blood vessels.

Since no obvious problems were found in coronary angiography and chest CTA, it is very necessary to do a color ultrasound of the heart next!

The human heart is like a house, with walls, water pipes, and circuits.

The electrocardiogram is to look at the circuit (cardiac conduction system), the coronary angiography is to look at the water pipe (coronary artery), and the color Doppler ultrasound is to look at the walls, doors and windows.

Problems with the house's electrical wiring and plumbing can cause chest pains.

Damaged walls (myocardium), doors and windows (valve) can also cause chest pain.So this color Doppler ultrasound is a must.

Originally, patients with coronary heart disease routinely undergo cardiac color Doppler ultrasound.

But it was too urgent just now, and we raced against time to get on stage.

At that time, Sun Guoguo also felt that the color ultrasound of the heart might also be a redundant examination.

But in retrospect, cardiac ultrasound is still a must.

Of course the family members agreed to do it, as long as she found the cause, she couldn't be so confused.

Besides, she did all the dangerous and expensive coronary angiography, not missing a color ultrasound of the heart.

……

Sun Guoguo returned to the ward and auscultated the patient's heart again. It seemed that there was a murmur, but it was not too obvious.

"Junior Brother Wei, ask for a bedside echocardiogram for the patient," Sun Guoguo said.

"Okay!" Wei Zhongwen nodded.

However, in less than 2 minutes, he returned to the ward.

"Senior sister, the teacher in the ultrasound room is doing an ultrasound in the CCU on the fourth floor. It may take more than ten minutes!" Wei Zhongwen said.

Cardiac ultrasound is not a routine emergency examination, and some small hospitals do not even have bedside emergency ultrasound.

"Okay, then we have to wait!" Sun Guoguo frowned.

The patient suffers from repeated chest pains, so cardiac ultrasound is imperative!

At this time, Lu Chen who was on the side suddenly said, "Senior Sister, why don't I come for an ultrasound?"

(End of this chapter)