I can see health

Chapter 633 No Electric Shock
The second area of ​​the heart.

In the ward.

"Doctor Lu, are you...are you sure to use amiodarone?" the nurse asked.

Lu Chen frowned, the nurses in this magic city are too wordy!

How many times have you asked a question!
"I'm sure!" Lu Chen said in a deep voice.

"Oh, that's good." The nurse pouted, and put the amiodarone in the infusion pump, ready to infuse it to the patient.

The nurse is responsible for helping the doctor to check the correctness of the doctor's order, but if Lu Chen insists, then she will not continue to ask.

At this time, Yu Bin and Yan Shuming walked into the ward quickly.

"Lu Chen, what's the patient's condition?" Yu Bin opened his mouth and asked.

Seeing this situation, the nurse who was dispensing the medicine immediately stopped what she was doing.

Lu Chen explained: "Brother, the patient has a panic attack. This is her electrocardiogram. I'm going to use amiodarone for cardioversion."

Yu Bin was slightly taken aback, but didn't say anything immediately, but reached out to take the electrocardiogram.

"Isn't this ventricular tachycardia? Why amiodarone is used? Is there any special purpose?"

Yu Bin's words were very reserved, and he didn't directly refute Lu Chen.

Beyond his words, why not use electrical cardioversion?
The primary measure for ventricular tachycardia is electrical cardioversion.

On the side, the corner of nurse Yan Shuming's mouth curled up.

She wanted to see how this new young doctor would handle this matter.

"This Lu Chen didn't listen to my advice, but fortunately he brought Yu Bin here. If the doctor's order is wrong, won't the patient be harmed?"

Clinically, many nurses are even more experienced than young doctors.

Yan Shuming secretly thought that he would have to discuss with the director in the future. These new doctors have too little clinical experience, and they still have to study in the department for a period of time before they can be independent.

Otherwise, the stakes are too high!

Lu Chen's complexion didn't change in any way, he glanced at Yu Bin, and then said slowly: "Because...it's not ventricular tachycardia!"

The voice just fell.

All the doctors and nurses in the ward stared at Lu Chen in disbelief.

Yu Bin felt a little displeased.

How could he believe what Lu Chen said!
He looked down at the electrocardiogram in his hand, wide QRS tachycardia, this is ventricular tachycardia!

Moreover, the patient had had attacks many times in the past, and every time the diagnosis was ventricular tachycardia, he was cardioverted.

The three students under Lu Chen also opened their mouths.

Especially the female graduate student Ji Yingying, she had been emphasizing to Lu Chen that this patient is supraventricular tachycardia.

At this time, Lu Chen smiled and said slowly: "Brother Yu, let me ask you a question, why didn't the blood pressure drop in such a patient with frequent ventricular tachycardia?"

Blood pressure, this is also one of the "doubts" that Lu Chen noticed!

Normally, malignant arrhythmias such as ventricular tachycardia and ventricular fibrillation will basically cause a drop in blood pressure.

Yu Bin was also stunned. In his subconscious mind, the patient was suffering from ventricular tachycardia and needed cardioversion, and he hadn't paid attention to the problem of blood pressure at all.

"The patient's blood pressure is low?"

"En." Lu Chenwei nodded.

He flipped through the patient's past medical records.

Echocardiography and coronary angiography of the patient showed no structural heart disease.

The electrocardiogram also showed no long QT or Brugada syndrome.

The electrocardiogram of the patient during the attack did not conform to the electrocardiographic characteristics of left posterior or left anterior branch VT (ventricular tachycardia).

Most importantly, the patient's life value is 72 (-)!
If it is really a ventricular tachycardia attack, such a serious arrhythmia, the change in life value must have more than a negative trend.

Diagnosed as ventricular tachycardia, it seems not very scientific!
"This one……"

Yu Bin frowned, and for a while he was a little undecided.

What Lu Chen said seems to make sense!
If the patient really had a VT attack, why was he hemodynamically stable?
Why is it just a little flustered and uncomfortable, and no other symptoms at all?
Yu Bin picked up the patient's ECG and read it carefully.

He didn't want to let go of any clues.

"Is it true that the patient is not suffering from ventricular tachycardia?"

……

Seeing Yu Bin in a daze, Lu Chen hurriedly urged the nurse, "Hurry up and use the amiodarone."

Yan Shuming glanced at Yu Bin, saw that he didn't respond, gritted his teeth, and gave the patient amiodarone.

"Okay, pay attention to the amiodarone pump rate and monitor the heart rate changes."

Seeing that the nurse had used the medicine, Lu Chen breathed a sigh of relief.

Yu Bin at the side swallowed, glanced at Lu Chen secretly, and asked in a low voice, "Lu Chen, if the patient isn't ventricular tachycardia, what could it be?"

Lu Chen smiled slightly, "Room speed?"

"Ah?" Yu Bin looked at the electrocardiogram repeatedly, his brows were furrowed, and he muttered, "I really didn't see where the supraventricular speed is..."

The differential diagnosis of wide QRS complex tachycardia is a never-ending topic in the Department of Cardiology.

Ventricular tachycardia and supraventricular tachycardia are often difficult to distinguish.

VT is a malignant arrhythmia that often signifies a more dangerous condition and requires more aggressive management strategies.

Supraventricular tachycardia is an arrhythmia with relatively good prognosis.

Especially in some emergency cases, if you can quickly distinguish between ventricular tachycardia and supraventricular tachycardia, you can buy a lot of rescue time for rescue.

……

"Lu... Doctor Lu, are you sure you really don't need electric shocks?"

The man stood at the door of the ward, looking inside.

He was quite excited after seeing the nurse administering medicine to his wife instead of using "electric shock".

At this time, his attitude towards Lu Chen was no longer as arrogant as before.

In the past, every time his wife had a panic attack, she would go to the hospital for cardioversion by electric shock.

This caused the two of them to have a deep sense of fear about this "electric shock".

"No need for an electric shock." Lu Chen said slowly, "We have given the patient an anti-arrhythmic drug for the time being, and now it is enough to monitor the changes in heart rate at any time."

"But..." the man frowned, "When will my wife's heart rate drop?"

"It depends on the specific condition and the patient's sensitivity to the drug." Lu Chen said, "Some people take half an hour, some take three hours, and some take a day or two."

"Could this medicine... be useless!" the man was worried.

Although the electric shock is scary, it is really effective!
After each electric shock, his wife's heart rate returned to normal.

If this medicine treatment is useless, wouldn't that delay the treatment time?

Lu Chen could see the man's worry at a glance.

"Uncle, don't worry, we will evaluate the patient's condition at any time. We don't need electrical cardioversion for now, and we don't need electrical cardioversion either!"

The man wanted to say something else, but the patient on the hospital bed immediately said: "I listened to Dr. Lu, I don't need electric shocks for now, I want to try drugs, even if it takes a day or two, I'm willing to try!"

The man seems to have underestimated his wife's determination not to "shock".

After experiencing the torture of "electric shock", the patient suddenly heard that there is no need for electric shock, and he was very excited.

"Okay, Doctor Lu, we will follow your arrangement," the man said quickly.

Lu Chen nodded slightly, and left the ward after instructing the nurse to pay attention to the changes in the patient's heart rate.

(End of this chapter)