I can see health

Chapter 277 Lu Chen's "Small Classroom"

Feng M County People's Hospital, Department of Cardiology.

The attending doctor Wang Zhi took the five ECGs of the "sudden cardiac arrest" patient and tried to figure it out again.

For patients with sudden cardiac arrest, after excluding organic heart diseases such as myocardial infarction and cardiomyopathy, arrhythmia is a relatively common cause.

However, he has read the five ECGs of the patient many times, and he has not found any abnormalities so far.

At this time, his mobile phone WeChat suddenly rang.

Wang Zhi picked up his cell phone and saw that it was a WeChat message sent to him by Fan Zhiping, the deputy director of Corey.

"Has Professor Li Yao come to our department?"

Wang Zhi was a little confused, but he replied immediately.

"Director Fan, Professor Li Yao has come to the department."

"Oh, is there a doctor named Lu Chen with her?"

"Yes, hey, Director Fan, how do you know this?" Wang Zhi was a little puzzled.

"Because I'm currently studying in Professor Li Yao's group! If you have any difficult cases this time, I'm sorry to bother Professor Li. You can directly ask Dr. Lu Chen, especially about the electrocardiogram."

Fan Zhiping was far away in Beijing, but he was still worried about the department.

He is very clear that in county-level hospitals, electrocardiography and electrophysiology are very weak areas.

Because this not only requires hard study, but also requires someone to teach.

Wang Zhi suddenly felt puzzled, "Isn't he just a graduate student? Director Fan, is it useful for me to ask him?"

"Hehe, you don't know, don't you? Let me tell you this. Dr. Lu Chen has already been shortlisted for the third round of the Huaxia ECG competition!"

"What?" Wang Zhi's expression was a little disbelieving.

As a cardiologist, he is very clear about this electrocardiogram competition.

He also participated in this competition, and he was not even qualified to rank in the department.

Those who can enter the third round are ranked in the top ten in the province!
These people are all very powerful doctors in the field of ECG.

Wang Zhi looked up at Lu Chen, and swallowed silently.

It's hard to imagine that a student in the first year of research can be so awesome.

No wonder he only glanced at the five ECGs and immediately saw the problem!
……

At this moment, Lu Chen also began to answer the five ECGs.

Wang Zhi, who didn't care about it before, pricked up his ears to listen.

"Compared with the admission electrocardiogram, the patient's electrocardiogram showed sinus rhythm, the electric axis was deviated to the right, and the J point was elevated in the inferior wall leads, up to 2.5mm, with QRS notch."

"In the late follow-up ECG, from the V1 and V2 leads, the end of the QRS wave is a broken QRS wave group! From the inferior wall leads Il, lII, and avF, it looks like a J wave again! It needs to be compared with Brugada syndrome, ARVC, Old myocardial infarction phase identification."

"The patient's cardiac ultrasound and cardiac angiography did not find any abnormalities, and these diseases can be temporarily ruled out."

Lu Chen's explanation was very organized, and the abnormalities were marked on the electrocardiogram.

This time, not only Wang Zhi was listening carefully without saying a word, but even the other deputy chief doctors came over to listen carefully to Lu Chen's explanation.

Just listen to Lu Chen continue: "But whether it is a broken QRS wave or a J wave, in this specific situation, it is a high-risk early warning signal that is prone to ventricular fibrillation and sudden cardiac death! Studies have confirmed that early repolarization is the cause of cardiac arrest. Signs, the risk of ventricular fibrillation is twice that of the normal population!"

"Doctor Lu, can you explain the broken QRS wave in more detail, I don't quite understand it."

Wang Zhi scratched his head. His question represented the voice of the cardiologists in Fengm County People's Hospital, "Hey, I still don't understand..."

Lu Chen was extremely patient, and took out a blank A4 paper again, and began to write on the paper while explaining.

"Broken QRS wave represents myocardial scar and fibrosis with conduction delay, leading to conduction anisotropy in the myocardium, which can be used as a sudden death in patients with coronary heart disease, heart failure, hypertrophic cardiomyopathy, ARVC, dilated cardiomyopathy, and congenital heart disease. Risk Predictor!"

"This electrocardiogram represents the QRS wave in V1 and V2 of the right ventricle, and the terminal is a broken QRS wave group, which is also called Epsilon wave in ARVC..."

……

This teaching round has completely become Lu Chen's chapel.

Although some of them didn't quite understand Lu Chen's explanation, in general, they all understood the cause of the patient's cardiac arrest.

That is Early Repolarization Syndrome (Ion Channel Disease)!
"Congratulations, the completion of the system upgrade has increased!"

"Congratulations, I received the thank you from Wang Zhi +1!"

"Congratulations, received the thank you from Ke Shuwen +1!"

"Congratulations, the thank you from Cheng Lin is worth +1!"

"..."

Lu Chen didn't expect that he could get so many benefits by participating in a teaching round.

What a worthwhile trip!
Director Yin Chao looked at Lu Chen who was talking eloquently, and couldn't help sighing, it really was the waves behind the Yangtze River pushing the waves ahead, and the waves before were shot to death on the beach!

He looked at Lu Chen with an itchy heart. It would be great if there was such a young man in his department!

Comparing Dr. Xiaolin and Lu Chen, the gap is huge!

"Director Yin, are you satisfied with Dr. Lu's explanation?" Li Yao looked at Yin Chao.

"It's a great speech!" Yin Chao smiled, "I finally know why Professor Li brought Dr. Lu here, it's much better than so many old guys like us."

Lu Chen hurriedly said: "Director Yin, you are flattering me. I came to this result based on your previous examination results. Without your hard work in the early stage, I would not have been able to diagnose it all at once."

Lu Chen's modesty also made Yin Chao feel better.

"Congratulations, I received a thank you value of +5 from Yin Chao!"

Seeing the system prompt, Lu Chen was slightly taken aback.

Give 5 thank you points at once?
Director Yin Chao didn't award him any pennant either!

Lu Chen frowned, could it be because of Yin Chao's status as the department director?
Most of the gratitude points he obtained before came from patients or their family members, and then he got them from his younger brothers and younger sisters.

Today is the first time for Lu Chen to get gratitude from a department director!
……

After Lu Chen finished his explanation, Li Yao also made a summary of the teaching rounds.

On the basis of Lu Chen, Li Yao gave her own diagnosis opinion, in addition to the possibility of J wave syndrome.

The doctors, including Wang Zhi, were quite satisfied with the teaching rounds.

In this kind of county-level hospital, everyone's level is uneven, and it is extremely rare to have a doctor teaching them hand in hand.

At this time, Dr. Kobayashi returned to the doctor's office.

He was holding a color ultrasound report in his hand, and his face was a little unsightly.

"Director, Professor Li, the gynecological ultrasound results of the 31-bed patient are out."

(End of this chapter)