I can see health

Chapter 50 Coronary heart disease at 30 years old?
At ten o'clock in the morning, just as Lu Chen finished writing the course of the ward round, a new patient came to the department.

"Junior Brother Lu, it's your turn to admit the patients."

Sun Guoguo glanced at the list of patients admitted and treated, and just arrived at Lu Chen.

"Okay." Lu Chen nodded, saved the written medical records, and pushed the EKG machine to the ward.

The patient was a 31-year-old male.

When I was pulling bamboo shoots on the mountain this morning, I developed symptoms of chest pain, accompanied by cold sweats. After about 10 minutes, the symptoms relieved by themselves.

The patient was thin, with a drunken flush on his face.

First thing, look at the color.

Lu Chen concentrated and glanced at the color on his head, it was yellow!

In the past two days, Lu Chen observed in the ward.

The same disease, if in different stages of development, the color of the patient's head is also different.

For example, most patients with high blood pressure have no complications, and the color of their heads is yellow.

And there is a hypertensive crisis, that is, patients with serious complications, the color of the head is red.

Another example is a patient with coronary heart disease. If an acute myocardial infarction occurs, it will definitely be red!

If it's just ordinary angina, the color is still yellow!
Similarly, if the acute myocardial infarction is in the recovery period, the color of the patient's head can change from red to yellow again.

In short, the color represents the life and health value, and the color can change at any time according to the state of the patient!

……

"Senior Brother Lu, Teacher Sun asked me to come and follow you to collect patients."

Just as Lu Chen finished his electrocardiogram, a young intern girl in the group followed him into the ward with a blushing face.

As for why his face was blushing, Lu Chen couldn't figure it out.

Looking at her badge, her name is Yao Jie, a fifth-year intern at Jinghua Medical University.

"Well, good." Lu Chen nodded with a smile, "Then you can ask about the medical history."

When Yao Jie heard the words, she responded softly, then took out a pen and paper, walked to the patient's bed, and began to inquire about the patient's condition.

Taking medical history is an essential skill for medical students.

No matter how declining Jinghua Medical University is, it is still a first-class medical university with good quality of students, and Yao Jie's medical history inquiry is very standardized.

As she asked, she recorded the main content on paper.

From the main symptoms of the onset, accompanying symptoms, onset time, as well as the way of relief, and the course of treatment, all were inquired in detail.

"Well, the question was very detailed, but there is one thing you forgot to ask." Lu Chen smiled, "The diseases in the Cardiology Department are different from other departments, and the content of the past history inquiry is also different. Think again."

Yao Jie frowned, thought for a moment and said.

"Ask about risk factors for heart disease!"

Lu Chen nodded with a smile, and said, "That's right, through the assessment of risk factors, we can easily determine the risk of a patient suffering from coronary heart disease."

"En." Yao Jie nodded, then went back and continued to ask about the patient's relevant risk factors, including smoking history, drinking history, etc.

"Do you usually smoke? How much do you smoke every day?"

"Smoke, about two to three packs a day."

"drink wine?"

"Drink, drink some white wine every night, about two liang."

"What job? Stay up late?"

"Truck driver, often running at night."

"Have you had high blood pressure or diabetes before?"

"With diabetes, without high blood pressure."

After recording all the medical history, Yao Jie looked back at Lu Chen.

"Brother, is there anything missing?"

"Very good." Lu Chen smiled, "Better than my internship."

Yao Jie blushed, a little embarrassed.

"But what do you consider the diagnosis of this patient?" Lu Chen changed the subject and began to inherit the fine tradition in the group - asking questions.

"This..." Yao Jie looked at the patient on the bed again, "Coronary heart disease?"

"The patient is just 31 years old this year, are you sure he has coronary heart disease at such a young age?" Lu Chen smiled.

"Ah?" Yao Jie shook her lower lip, "Could it be aortic dissection?"

"The pain of dissection is generally difficult to relieve. The patient did not use any medicine, and the pain relieved by itself. Are you sure it is dissection?" Lu Chen said.

"Could it be a pulmonary embolism?" Yao Jie muttered softly.

This brother is really bad!

He looks handsome, but he asks a lot of questions, just like Mr. Sun.

"Junior Sister, don't be affected by my thinking." Lu Chen smiled, "Just follow your own thinking and consider what is the initial diagnosis of this patient?"

Lu Chen smiled, this junior sister is quite clever, she didn't have any confidence, so she told me about several diseases related to chest pain.

Yao Jie thought for a long time before replying.

"Coronary heart disease?"

"Yeah." Lu Chen nodded, "I also consider coronary heart disease."

As soon as Lu Chen finished speaking, the young man on the bed became impatient.

"Doctor, don't talk nonsense! How can I have coronary heart disease at such a young age!"

"I used Baidu before I came to the hospital. Coronary heart disease is a disease of people in their 70s and [-]s."

"On the Internet, it is said that my chest pain may be caused by pleurisy, or it may be caused by my lack of attention."

Lu Chen glanced at the impatient man on the hospital bed.

"According to your current symptoms, electrocardiogram, and bad living habits, the initial diagnosis is coronary heart disease. The final diagnosis can only be made after the results of blood tests and other auxiliary examinations are completed."

Hearing this, the young man still shook his head.

"You doctor is too young and inexperienced. Let me tell you, I just have a good rest. I am tired after going out to pull bamboo shoots. I can rest for two days."

"Of course I would rather you are tired and have no other problems." Lu Chen said lightly, "But you'd better quit smoking and drinking, don't stay up late, and control your blood sugar."

The young man raised his eyebrows, resting his hands on the back of his head, looking indifferent.

"Junior Sister, let's go back and write the medical records."

After asking about the medical history, Lu Chen pushed the EKG machine, turned and left the ward.

Yao Jie nodded and followed closely behind.

Turning back to the office, Lu Chen finished all the doctor's orders, and after Dong Hao reviewed them, he finally clicked on upload doctor's orders.

This time, Liu Mei's voice did not come from the nurse's station, so it should be that the doctor's order was not wrong.

"Junior brother, this patient's electrocardiogram is normal, and coronary heart disease and angina pectoris are still considered?"

Sun Guoguo frowned while holding the electrocardiogram of the young man just now.

Although the medical history was taken by Lu Chen, Sun Guoguo, as a superior doctor, would go through all the patients in order to prevent any missed medical orders or auxiliary examinations.

"Judging from the symptoms he described, chest pain after exercise, accompanied by cold sweat, and his usual irregular work and rest, coronary heart disease is more likely." Lu Chen said.

Sun Guoguo shook her head.

"I am only 30 years old. I feel that the probability of coronary heart disease and angina pectoris is not high. It may be coronary artery spasm caused by long-term smoking. Wait for the patient's test results to come out and make an appointment for a coronary CTA."

"Well, okay." Lu Chen nodded.

……

Half an hour later.

Lu Chen was writing his medical records when a pop-up window popped up in the computer testing system.

"Assess critical value, please accept!"

Lu Chen's eyelids twitched, and a bad premonition suddenly rose in his heart.

(End of this chapter)