I can see health

Chapter 636 Where is Director Zhang?
The patient's surgery was scheduled for next week.

Because amiodarone was used for cardioversion, the effect of the drug is long-lasting and the effect is very good. In order to avoid the failure to induce supraventricular tachycardia during the operation, the operation was scheduled for next week to metabolize the amiodarone out of the body as much as possible.

After this patient, Yu Bin's attitude towards Lu Chen was quite different.

It turns out that Lu Chen is not only good at publishing papers, but also very proficient in various clinical skills.

Judging from Lu Chen's ECG interpretation skills and communication skills with patients, he is not a rookie!
On the contrary, Yu Bin can vaguely feel that Lu Chen's clinical thinking has even surpassed his by a large margin.

The feeling when facing Lu Chen was like letting him face Director Zhang Shuqing.

This feeling is the strongest when Yu Bin makes rounds every morning.

"Lu Chen, help me see a patient."

"It's the patient with chest pain who took medicine for coronary heart disease and still has pain!"

"That's right, it's 28 beds!"

Lu Chen is like a senior doctor who is omnipotent and answers every question.

"Okay, I'll go and see bed 28 later."

Then other people in the second area of ​​the heart will see a strange scene.

Lu Chen took Yu Bin and other students to round the room together.

This combination is quite weird!
It stands to reason that Yu Bin has managed the bed independently for many years in clinical practice.

Lu Chen has just graduated, and has never been in charge of the bed independently.

Why do the roles of the two seem to be reversed!

"This old lady's chest pain, I don't think it's like a coronary heart disease." Lu Chen finished watching the 28-bed patient.

"It's not chest pain?" Yu Xin frowned, "But after a coronary CTA, the blood vessels are narrowed."

"There must be coronary heart disease." Lu Chen said, "But her chest pain is not necessarily caused by coronary heart disease or angina pectoris."

Lu Chen opened the patient's chest CT image.

"Look at this picture first."

"This... I've seen it." Yu Bin whispered.

"Take a closer look."

"Oh." Yu Bin nodded slightly, trying to find a different place.

However, he read it three or four times and found no abnormality in the patient's chest CT.

"Are you sure there is nothing abnormal?" Lu Chen asked again.

"Really...really not..." At this time, Yu Bin has already flinched a little.

Lu Chen smiled, and put the patient's CT image results back in front of Yu Bin's eyes.

"Brother, look at this place of the patient..."

Lu Chen pointed to a part in the CT.

"This is...the spine?" Yu Bin was stunned.

He is a cardiologist, why don't he go to see the spine if he has nothing to do?

Suddenly, when he looked at the CT image enlarged by Lu Chen again, he was completely stunned.

"Spine deformity?" Yu Bin asked in surprise.

"Yes!" A smile appeared on the corner of Lu Chen's mouth, "The patient is an elderly woman with osteoporosis who is prone to fractures or spinal deformities."

This slight spinal deformity is invisible on the surface and is easily overlooked by everyone.

Even the patients themselves do not know it, they may feel that it is a heartache or a stomachache.

Yu Bin really hadn't thought about this.

"Spine deformity, will it also cause chest pain?" Yu Bin asked doubtfully.

"That's for sure!" Lu Chen nodded, "I have managed a few patients, all of which were caused by spinal deformities..."

Yu Bin's expression changed, and he immediately prescribed the corresponding medicine for the patient.

……

Similar patients are not rare.

Yu Bin slowly discovered that many medical records that were difficult or undiagnosed before were miraculously solved once they were in Lu Chen's hands!

This made everyone in the second heart area realize Lu Chen's clinical prowess.

Such a new doctoral student completely attracted everyone's attention.

"Lu Chen, what day is the surgery?"

"No accident, it should be tomorrow." Lu Chen said.

The operation they were talking about was supraventricular tachycardia that had been misdiagnosed as ventricular tachycardia.

"Okay, then I will go with you to be an assistant." Yu Bin said with a smile, "Can you?"

"Of course, as long as the brother has time to go to the catheterization room, it's fine!" Lu Chen did not refuse.

These electrophysiological surgeries are relatively rudimentary, and there is not much technical content in them.

"Well, Lu Chen, thank you!"

The next day.

After checking the room in the morning, Lu Chen pushed the patient downstairs after the work was done.

The patient's quality of life in the past week is better than that of the previous three or four years!
No more flustered symptoms!
"Doctor Lu, do I have to have an operation?"

At this point, the patient began to waver again.

"Do it!"

How could Lu Chen not understand what the patient was thinking, and said immediately.

"That, that's fine." The patient could only accept it silently.

……

cath lab.

The patient's husband was waiting outside, and Lu Chen pushed the patient into it.

Not long after, Yu Bin also came down.

He has changed into his surgical gown and looks ready to go on stage as an assistant.

"Lu Chen, where is Director Zhang?"

Yu Bin asked curiously.

The surgery is about to start, why don't you see the surgeon?

"What is Teacher Zhang doing here?" Lu Chen wondered.

This kind of ablation surgery is the most basic surgery, so there's no need for Director Zhang to come, right?

"Director Zhang isn't coming? Is he okay?" Yu Bin was startled, "Then, who will do the operation?"

He looked around to see if teachers from other groups came to help with the operation.

However, he did not see the other groups of surgeons.

"I'll do it!" Lu Chen smiled slightly.

"What? What did you say?"

Yu Bin was stunned.

"You, aren't you an assistant?"

"Who says I'm an assistant?" Lu Chen shrugged, "I'm a magician!"

Yu Bin swallowed, "Lu Chen, this joke is not very funny, this is not practice!"

Lu Chen didn't explain much, and entered the catheterization room directly.

"Ah, you..."

Yu Bin stared blankly at Lu Chen walking into the catheterization room, his mind was still in chaos.

He was going to be an assistant, but now...

Yu Bin stayed outside the catheter, watching every step of Lu Chen's next operation in shock!
……

The patient came to the operating table with mixed emotions of anticipation and fear.

Due to the shadow caused by electrical cardioversion, the patient instinctively shouted "Don't shock me" when Lu Chen put in the electrode catheter.

However, after Lu Chen's explanation, the patient calmed down.

The subsequent surgery process went very smoothly.

Electrophysiological examination revealed dual pathways in the atrioventricular node, and it was very easy to induce the typical slow and fast atrioventricular nodal reentrant tachycardia.

When Lu Chen stimulated the atrium rapidly, atrioventricular 1:1 conduction and QRS wave widened (differential conduction), and the widened shape was consistent with clinical tachycardia.

It can be inferred that the patient's wide QRS tachycardia should be atrioventricular nodal reentrant tachycardia combined with differential conduction.

The subsequent ablation process is very simple.

After the improvement of the AV node slow pathway, tachycardia will no longer be induced.

The whole process lasted 40 minutes.

After 4 years, the patient can be described as clearing away the clouds and mists, and the flowers are bright.

(End of this chapter)