I can see health

Chapter 638 Electrocardiogram at 37 minutes
CCU shows classrooms.

Many doctors came to participate in the discussion.

Most of them are senior attending doctors, and there are also some deputy chief doctors and chief doctors.

There are very few doctors like Lu Chen who just came to the hospital.

Lu Chen knew almost no one except his mentor, chief director Liu Jun, and the doctors in the second heart area.

When he was in Jinghua Second Hospital, he participated in many case discussions.

However, they all participated as students and rarely expressed their own ideas.

This time it was different, he was representing Zhang Shuqing's medical team, and he had the opportunity to express his opinion.

"Lu Chen, come here!"

In the noisy environment, Lu Chen suddenly heard a voice. He looked for it, and it was Jiao Jingqiu, the attending doctor of the second heart area.

There was also a young doctor sitting beside her. Lu Chen looked at him strangely, so he probably wasn't from the second zone of his heart.

Lu Chen stepped forward and sat beside Jiao Jingqiu.

"Lu Chen, are you here to study too?" Jiao Jingqiu smiled.

Lu Chen was taken aback, nodded and smiled, "Ms. Zhang asked me to come and take a look. What's the condition of this patient, why are there so many people here?"

"I don't know too well." Jiao Jingqiu shook her head and whispered, "But I heard that the patient seems to be a family member of a leader in the city..."

Lu Chen frowned slightly, and most of the anticipation that had just risen in his heart dissipated in an instant.

He thought it was some difficult patient!

At this time, the male doctor next to Jiao Jingqiu said: "I heard from my colleagues in the CCU that it is a patient with sinus bradycardia, and the patient's elder brother is the leader of a certain unit in the city. The purpose of this discussion , It depends on whether to put the pacemaker on or not."

"That's it? Do you want to have a big discussion in the department?"

Jiao Jingqiu blinked her eyes in disbelief.

"Let's say you're young, you don't have any awareness at all!" The male doctor grinned, "The leader's affairs are all big things! Even if the illness is not serious, you have to show it to the leader!"

"But we clinicians are very busy!" Jiao Jingqiu curled her lips, "Who has the time to talk nonsense with them..."

Lu Chen pursed his lips, but did not speak.

In his heart, he agreed with Jiao Jingqiu's words.

However, everyone is in this environment, and many things cannot be as they wish.

Only when you become stronger can you have a choice.

……

At this moment, Liu Jun on the podium spoke.

"Everyone returned to their seats, and the case discussion began immediately."

As soon as the voice fell, the noisy voice in the classroom gradually disappeared. Everyone sat down, and those who couldn't find a seat stood at the back.

At this time, on the projector in front of the podium, the medical records of the patients under discussion appeared.

Zhang Shuqing also walked onto the stage slowly.

"This case discussion, I invite everyone to come over, mainly about the issue of pacemaker implantation..."

Along with the PPT screening, Zhang Shuqing introduced the patient's condition and auxiliary examination data to everyone one by one.

The presentation of the disease is over.

Liu Jun, director of the Department of Cardiology, stepped onto the podium again, looked around at the crowd, and said slowly:

"The topic of this discussion is whether the patient needs to be implanted with a pacemaker? After the pacemaker is implanted, what treatment problems do they need to face?"

"I won't call names. Let's brainstorm and speak up."

After Liu Jun finished speaking, there were whispers of discussions under the podium.

Lu Chen saw a middle-aged doctor in the front row raised his hand, and Zhang Shuqing immediately handed over the microphone.

"Okay, the first one to speak is Director Qin from the heart area." Liu Jun nodded slightly.

Qin Feng is the deputy chief physician who was just promoted this year. He has made good achievements in the field of electrophysiology.

He stood up, took the microphone, and said slowly: "Just now, I have listened to Director Zhang's introduction of the condition, and I have a certain understanding of this patient."

"The main symptom of the patient is fatigue. The electrocardiogram showed sinus bradycardia. The heart rate was only about 37 beats/min. It may be even slower when falling asleep at night!"

"Other examinations, including blood routine, liver and kidney function, thyroid function, and echocardiography, were all normal."

"The initial diagnosis is sinus bradycardia. If the patient's fatigue symptoms are severe, a pacemaker needs to be implanted!"

Liu Jun nodded slightly when he heard the words.

Lu Chen kept frowning, staring at the ppt screen.

The interface where the PPT is parked on the podium is the patient's electrocardiogram.

……

"Who will speak next?" Liu Jun continued to ask.

"Let me do it!"

Next to Director Qin is a middle-aged female doctor. She wears glasses and has a serious face. She seems to be a director-level figure.

"Director Zhang, here it is."

Director Qin immediately handed the microphone to her.

Liu Jun on the stage smiled, "Okay, then Director Zhang from the fourth district in the heart will express his views."

Director Zhang stood up, her voice was a little cold, she didn't directly ask whether the pacemaker was implanted, but asked: "Has the patient ever taken drugs that lower the heart rate, such as betaloc, digitalis, or What was the heart rate of the patient before? Was it a manual worker or an athlete?"

Director Zhang has many questions.

Basically it all revolves around slowing heart rate.

Long-term oral administration of heart rate-lowering drugs, as well as physical workers and athletes, will have a slow heart rate.

If it is physiological and there are no symptoms of severe dizziness or syncope, no special treatment is required.

If it is because of certain drugs, then stop the drugs. After removing these factors, the patient's heart rate should be able to increase.

On the stage, Zhang Shuqing explained one by one: "The patient has not taken any drugs to lower the heart rate, nor has he ever been a manual laborer, let alone an athlete."

Director Zhang nodded, "I think it's better to be cautious. After completing the dynamic electrocardiogram, we will further evaluate whether to implant a pacemaker."

"Okay, Director Zhang's opinion is good." Liu Jun nodded with a smile.

Next, several directors and senior attending doctors spoke.

However, the opinions of these people are similar to those of Director Qin and Director Zhang at the beginning.

It is necessary to place a pacemaker, or to complete the dynamic electrocardiogram, and then evaluate whether to implant a pacemaker.

……

Lu Chen has not spoken.

He found a copy of the patient's electrocardiogram and looked at it repeatedly.

Jiao Jingqiu also leaned over and took a few glances.

"Lu Chen, what's so interesting about this ECG?" Jiao Jingqiu asked suspiciously, "Isn't it just sinus bradycardia, no matter how you look at it, you can't see anything, right?"

Lu Chen smiled and shook his head, "I'll just take a look."

The electrocardiogram shown on the ppt just now is not very clear.

Lu Chen has never been able to "follow what others say".

It is only after one's own thinking that the final diagnosis can be made.

His electrocardiogram skill is already an advanced card, and his proficiency in electrocardiogram interpretation has reached 93%.

Most of the problematic electrocardiograms, in his eyes, have nothing to follow!

……

at this time.

The male doctor sitting next to Jiao Jingqiu whispered, "Jingqiu, what do you think is the use of this discussion? After discussing it and discussing it in the past, don't they all have the same result?"

Jiao Jingqiu nodded helplessly, "I can't help it, we still need to discuss it! How about... I also come to speak?"

"Ah? You, you want to speak?" The male doctor asked in surprise, "What can you say?"

At this moment, Liu Jun was asking if there was anyone speaking from the podium.

Jiao Jingqiu immediately raised her hand.

"Oh, let's talk about it from the doctor behind."

The microphone was successfully handed over to Jiao Jingqiu.

"Ahem." Jiao Jingqiu cleared her throat, stood up and said, "Isn't this just sinus bradycardia?"

"Severe sinus bradycardia just explains the patient's fatigue, especially the symptoms of fatigue after activity. Sinus bradycardia is also one of the manifestations of sick sinus syndrome."

"Severe sinus slowness with symptoms, just implanted pacemaker, from symptoms to EKG and treatment... Isn't this perfect?"

"This is a very straightforward question..."

Jiao Jingqiu pouted.

Just such a simple question, so many people need to sit together and discuss it for so long?
The family members of this leader are really big names!
The male doctor sitting next to Jiao Jingqiu was in a hurry at this time, and quickly lowered his voice, "Jingqiu, don't say a few words! What are you talking about?!"

On the podium, Liu Jun's face changed slightly, and then returned to normal.

He could hear Jiao Jingqiu complaining inside and outside the words.

This kind of thing is not something a little doctor can complain about.

So many directors in front have no objection, why did you jump out as an attending doctor?
"Okay, I will remember Dr. Jiao's opinion."

Liu Jun nodded to Jiao Jingqiu, his gaze was like a torch.

"Okay, this discussion is over, let's finally summarize our opinions..."

Just when Zhang Shuqing was about to announce the end of the discussion, he suddenly caught a glimpse of Lu Chen raising his hand.

He was slightly startled.

Just now, he was still wondering why his student Lu Chen didn't speak up, but showed his face in front of everyone, showing his presence.

Lu Chen really raised his hand.

However, the discussion is now coming to an end.

Is it necessary to raise your hand to speak now?
It seems that there will be no other different opinions, right?

"Oh? There is also a young doctor speaking." Liu Jun also saw Lu Chen raising his hand, "Then you will make the last speech."

Lu Chen stood up slowly, and took the microphone from Jiao Jingqiu's hand.

Jiao Jingqiu's face brightened, thinking that Lu Chen was really interesting.

It must be to help him complain!
The male doctor at the side sighed slightly, and thought, next time he must stay away from these two...

However, Lu Chen's first sentence stunned everyone present.

"Teachers, I would like to ask a question. Is this patient's ECG a slow arrhythmia or a tachyarrhythmia?"

There were still people whispering in the entire demonstration classroom just now, but now it is completely silent.

Everyone looked at Lu Chen with bewilderment and even a trace of mockery.

On the side, Jiao Jingqiu opened his mouth so wide that he could even stuff a fist into it.

Lu Chen, this is too exaggerated!
On the electrocardiogram, the patient's heart rate was clearly written as 37 beats per minute!

Normal heart rate is 60-100 beats/min.

Less than 60 beats/min is bradycardia.

More than 100 beats/min is called tachycardia.

"Lu Chen, are you okay? Are you out of your mind?" Jiao Jingqiu said in surprise, "The heart rate in this ECG is 37 beats per minute!"

(End of this chapter)