I can see health

Chapter 261 Sudden Chest Tightness
"Isn't it just a common cold?" the patient wondered.

Lu Chen shook his head.

"Pneumonia is very different from a cold. Most colds are also viral infections, but the infection is generally limited to the nose and throat, and there may be runny nose, sneezing, sore throat and other discomfort."

"Once the infection enters the trachea, it's bronchitis. If it goes deeper and invades the alveolar lung parenchyma, it's pneumonia."

"In this respect, pneumonia is definitely much more serious than a cold."

"What's more, if it's just a common cold, you will definitely not be hospitalized, and you will be admitted to our cardiology department."

The patient nodded, expressing his understanding.

Lu Chen asked a few more questions, all of which were routine medical history, and the patient explained everything truthfully.

Such as no marriage, no children, no unclean sex life history, etc., and no infectious diseases such as hepatitis B and tuberculosis.

Although it should have been recorded in the medical records, Lu Chen asked again.

Go back to the doctor's office.

Yin Xinhua immediately looked at Lu Chen and Fan Zhiping.

"What's the patient's condition?"

Lu Chen paused and said, "The initial consideration is delayed pneumonia, and the patient's ECG has ST-T changes, so the possibility of myocarditis cannot be ruled out."

Such a young patient is generally unlikely to have myocardial infarction, but myocarditis cannot be ruled out.

Myocarditis is also easy to miss. It is like a cold, but it is much more serious than a cold. Blood tests for myocardial enzymes and troponin are required to confirm the diagnosis.

For patients with pneumonia and suspected myocarditis, the emergency department usually receives cardiology instead of respiratory.

The Department of Cardiology will definitely treat pneumonia, but the Department of Respiratory Medicine may not necessarily treat myocarditis.

Therefore, this patient was admitted to the Department of Cardiology by the emergency department.

Yin Xinhua nodded slightly, "I read the medical records just now, and the diagnosis is pulmonary infection, which does not rule out the possibility of myocarditis. The patient's myocardial enzymes are normal, and the main consideration is the lung disease. We attach great importance to the diagnosis and treatment of pneumonia, which cannot be trusted. Big, it might really kill someone.”

Pneumonia will not be cured without antibiotics.

You know, in the era without antibiotics, pneumonia would kill people.

We don't feel scared when we hear about pneumonia now, that's because we are used to the era when we have antibiotics.

"The patient's examination hasn't been done yet." Lu Chen checked the patient's medical order.

When the patient was admitted to the hospital, his body temperature was only low-grade fever, which was not as high as it is now, so the receiving doctor did not complete the chest CT examination.

"Let's do a chest CT in the emergency department, and then do an abdominal CT as well." Yin Xinhua said, "Then check the blood culture and recheck the inflammatory indicators."

Some patients who appear to have pneumonia may also have cholecystitis, appendicitis, or pancreatitis.

In this case, it is not clear, it is difficult to understand.

Inspection is the most reliable.

Your hands and eyes are not necessarily reliable, so don't rely too much on your eyes unless you really have sharp eyes.

Lu Chen returned to the ward again and explained to the patient the necessity of these examinations.

The patient cooperated very well and went out for an examination.

The results of chest and abdomen CT came out, suggesting that there was a little inflammation in both lungs.

In the follow-up blood draw and re-examination, except for the high white blood cell count, the others were basically normal. Myocardial enzymes were re-examined, and the myocardial enzymes were basically normal.

"Look, the problem should still be in the lungs, and the possibility of myocarditis is very small." Yin Xinhua pointed to the lesion on the chest CT, "The patient probably had pneumonia more than ten days ago, but he has not paid attention to it. When a cold is treated, Without antibiotics, that’s not going to work.”

Lu Chen nodded, "I'll explain the condition to the patient."

……

Lu Chen came to the ward.

"Then I will be discharged from the hospital after a few days of anti-inflammatory injections?" the patient asked doubtfully.

Lu Chen paused, and said: "It depends on the specific condition. If a pneumonia patient has chest tightness, you must be alert that it may develop into severe pneumonia, so don't worry, and take care of your illness. In addition, we still have to be vigilant about the heart. If you are sick, it is good to run less.”

"it is good."

The patient was obedient. He had no accompanying family members, so he borrowed a power bank from the patient next to him on the bed, and then gave the infusion with peace of mind.

After treating the patient, Lu Chen and Fan Zhiping returned to the doctor's office.

……

Today's night shift seems to be extraordinarily quiet.

Except for this 37-bed patient who had a fever, the other patients in the ward were in stable condition.

Ten p.m.

The lights in many wards were out.

Yin Xinhua breathed a sigh of relief.

She turned her head to look at Lu Chen and Fan Zhiping at the side.

The two were discussing the knowledge of electrophysiology in full swing.

"It seems that these two people are not on fire tonight?"

As soon as this idea flashed through his mind, Yin Xinhua heard the shout of the nurse on duty from the nurse station.

"Doctor Yin! Bed 37 is sick! It's too late!"

The nurse shouted several times in a row.

"I really can't think about this!" Yin Xinhua's slightly relaxed heartstrings immediately tensed up.

Picking up the stethoscope next to her hand, she immediately ran out of the office.

Seeing this, Lu Chen and Fan Zhiping followed closely behind.

……

Run out of the doctor's office.

While running, Lu Chen had a big question mark in his heart.

"The patient in bed 37 is dying? But didn't he have 68 HP just now?"

"Even if it was severe pneumonia, how could he suddenly get sick?"

With this question in mind, Lu Chen hurried into the ward.

in the ward.

The patient was panting heavily and sweating profusely.

My eyes are almost blurred!
"The patient suddenly became short of breath just now, and his whole face turned blue."

The nurse on duty quickly reported the situation.

After all, Yin Xinhua is a battle-tested attending doctor.

Although the situation in front of her came quickly, she responded very quickly. She immediately asked a few nurses to help the patient breathe oxygen, and at the same time ordered Lu Chen to prepare equipment such as endotracheal intubation and ventilator.

The first aid kit was also pushed over.

Yin Xinhua put the stethoscope close to the patient's chest.

But at this time, the patient's breathing sound was too chaotic, and with the sound of panting, no special changes could be heard at all.

But one thing, Yin Xinhua is clear, the breathing sounds of the patient's two lungs are basically symmetrical.

This means that the patient should have no pneumothorax or atelectasis, which is very critical.

If the patient has a tension pneumothorax, the patient will definitely die if he cannot breathe.

Seeing that the patient's lips are getting more and more purple.

"What was the patient doing just now? Why did his condition become so fast?" Yin Xinhua asked the two nurses on duty again.

The two nurses on duty shook their heads one after another, "It's nothing special, I've been here all this time, and I haven't done anything else."

It came so suddenly that everyone couldn't figure out the situation.

On the side, Lu Chen got ready for the endotracheal intubation.

There was no way, the patient was severely hypoxic at this time.

Although the cause is not well understood, pulmonary embolism, pneumothorax, atelectasis, pericardial effusion, etc. should still be considered.

Auscultation is not like pneumothorax or atelectasis.

I can't hear the pericardial effusion, and the breathing sound is too loud, which especially affects the auscultation of the heart. I can only rely on the color ultrasound of the heart, but it is obviously not possible to do color ultrasound now, and I must save my life first!
(End of this chapter)