I can see health

Chapter 241 Surviving into a Case (Part [-])
Among the people present, only director Li Yao smiled, she looked at Lu Chen: "You continue to talk."

Lu Chen nodded, wondering if it was because of the "clinical insight" he received last time.

He quickly sorted out all the patient's information in his mind, and began to integrate and analyze.

"From the indications, the patient's chest pain, chest tightness, and heart failure may all be caused by hypertrophic cardiomyopathy."

"However, the diagnosis of hypertrophic cardiomyopathy is still somewhat sloppy. Similar myocardial changes may also occur in other diseases, which may not necessarily be caused by primary genetic inheritance, but may also be caused by acquired diseases."

Lu Chen was also puzzled until he saw the patient's body shape.

"Let's look at the patient, the typical full moon face and buffalo back."

When Lu Chen said this, everyone was even more surprised.

"Have you ever seen a full moon face and a buffalo back?" Lu Chen looked at Wei Zhongwen who was beside him.

Wei Zhongwen nodded, "I've seen it in books, but I haven't seen it in reality."

Lu Chen said seriously: "If you guessed right, the patient in front of you has a typical full moon face and buffalo back."

It stands to reason that buffalo backs and full moon faces are not uncommon.

But everyone's attention is not on this, but on the heart and myocardium.

So when Lu Chen brought up the full moon face and buffalo back.

Everyone was very surprised. After looking at the crowd carefully, many people began to nod again.

In particular, the patient's limbs are thin and thin, which is similar to some patients who have been taking hormones for a long time.

Central obesity and thin hands and feet all around are the result of redistribution of protein and fat.

Lu Chen continued: "The patient either took hormones for a long time, or the hormone levels increased due to diseases in the body."

But the patients and their families were taken aback when they heard this.

"I've never taken hormones before!" the patient said immediately.

Lu Chen smiled and said, "That's right, it means you may still have a hidden disease."

"This disease is constantly secreting hormones. Excessive secretion of hormones will cause your blood sugar to rise, cause blood lipids to rise, and lead to your central obesity with a full moon face and a buffalo back."

"What's more, it can also lead to heart damage, causing cardiac muscle hypertrophy."

Lu Chen finally spoke up.

"Is the patient Cushing's syndrome?" Wei Zhongwen couldn't help asking.

Any doctor or medical student, you just need to mention the full moon face and buffalo back to him.

He must think of Cushing's Syndrome, because it is so classic.

The so-called Cushing's syndrome is a general term for diseases caused by excessive secretion of glucocorticoids (referred to as hormones) by the adrenal glands due to various causes.

Many conditions can cause the adrenals to overproduce hormones, so this is a syndrome rather than a specific disease.The most common cause is a tumor of the pituitary gland, followed by a tumor of the adrenal gland itself.

"Well, that's what I thought about it." After finishing speaking, Lu Chen looked at Li Yao, waiting for her to express her opinion.

I saw the bright smile on Li Yao's face.

It seemed that she was very satisfied with Lu Chen's analysis, "That's right, if it wasn't for the reminder from the family, I would have ignored the patient's central obesity. If you look carefully, the patient's skin is also relatively thin, which all suggests It's Cushing's syndrome."

Everyone looked at the patient's skin and wondered.

"The patient's skin really looks thinner and more transparent."

Everyone believed in the analysis of Li Yao and Lu Chen.

And it can also explain all the positive symptoms of patients from beginning to end, from high blood pressure, high blood fat, high blood sugar, central obesity, cardiac hypertrophy, thin skin and so on.

Especially the patient's high blood pressure. According to the patient himself, he has changed many medicines but failed to control it well. On the one hand, it is related to his irregular medication, and of course it may also be related to the disease itself.

……

Next, Li Yao told the patients and their families about the disease with easy-to-understand metaphors.

The pituitary and adrenal glands are endocrine organs in our body.

The pituitary gland is the leader and the adrenal gland is the subordinate.

Therefore, if the patient really has Cushing's syndrome, the next step is to find out whether the leader of the pituitary has a problem, or the subordinate of the adrenal gland has a problem.

"Director Li, how should we investigate this disease?" the patient's wife asked nervously.

Li Yao didn't answer directly, but turned to look at everyone.

"Where is the pituitary gland? The pituitary gland is in our brains. Where is the adrenal gland? As the name suggests, it's on top of our kidneys, almost at the waist."

"No matter what went wrong, the first thing to do is to determine whether the patient has Cushing's syndrome."

……

When the patient and his family members heard that they had Cushing's syndrome, they felt mixed feelings.

Fortunately, director Li Yao said that if it is a simple tumor, it can be cured with one size fits all.

Sadly, it's also possible that the cancer is causing too much hormone production, and that's tricky.

On the same day, a blood test was arranged to check the relevant hormones, and the blood hormone levels in three time periods were also checked.

They are the blood hormone levels at 16:0 in the afternoon, 8:[-] in the morning, and [-]:[-] in the morning of the next day.

The purpose of this separate investigation is to see whether the secretion of hormones in the patient's body is still regular.

……

Li Yao is worthy of being the director of the department. She analyzed not only this case, but every subsequent case very well.

Call out all the places that you don't usually think of.

Seemingly difficult cases are analyzed step by step, and finally a correct diagnosis and the best treatment measures are obtained.

After rounds, Dong Hao was finally found.

Dong Hao was lying on the hospital bed, and Li Yao was stunned.

Lu Chen immediately explained: "Teacher, Brother Dong Hao had a panic attack before and was diagnosed with paroxysmal supraventricular tachycardia. This time he came to the hospital for radiofrequency ablation."

Li Yao understood.

"Just graduated from the Department of Cardiology, Xiao Dong, you should be very clear about the disease you are appealing to, right?"

Dong Hao smiled wryly, "Director Li, I feel that I have become a typical case. I compared every symptom I have with the book, and I feel that it is right!"

"Don't worry too much." Li Yao smiled, "The technology of radiofrequency ablation is very mature now, with few side effects and complications."

"Well, I know, Director Li." Dong Hao nodded slightly.

But Li Yao frowned and said, "However, Xiao Dong. I still want to remind you that after the operation, there is a risk of recurrence. Because we can't completely eliminate all abnormal pathways!"

For some people, paroxysmal ventricle relapses in as short as a few months or as long as several years after surgery!

"Don't worry, Director Li, Junior Brother Lu Chen has told me about these surgical precautions." Dong Hao said.

Even for the most familiar friends, there must be all these necessary communication records, and all of them need to be signed by the patient himself or the guardian.

……

Li Yao's rounds lasted for a whole hour and a half.

it is finally over!
(End of this chapter)