I can see health

Chapter 681 Protruding Pericardium
"Sister Jiao, I think your idea is very possible." The young attending doctor said.

Pericardiocentesis is inherently a risky clinical skill operation.

If the puncture needle accidentally penetrates a few centimeters more, it is very likely to touch the heart and puncture the heart. Even a small rupture will cause pericardial effusion.

However, Lu Chen shook his head slightly.

"I think this possibility is unlikely. Because before the puncture, the color ultrasound of the heart showed a large amount of pericardial effusion, and the puncture needle can draw out the fluid without going too deep."

For a large amount of pericardial effusion, as long as the puncture needle breaks into the pericardium, the fluid can be drained out.

There is no need to go deep into the pericardium at all.

This kind of operation can be done even by a doctor in a county-level hospital.

Moreover, most of the current pericardiocentesis is done under the guidance of echocardiography, and whether it touches the heart can be seen.

"Lu Chen, what you say makes sense." Jiao Jingqiu nodded slightly, "If the puncture needle touches the heart, the hole in the heart may be quite large. Will the patient still be like this?"

There was a lot of discussion.

The etiology of the patient's pericardial effusion has never been determined.

"Lu Chen, what do you think?"

Seeing that Lu Chen hadn't made a comment, Jiao Jingqiu asked.

Lu Chen has not been in Shanghai Hospital for a long time, but his clinical thinking is particularly meticulous, which is recognized by everyone.

However, Lu Chen said helplessly: "In fact, everyone has talked about the cause of pericardial effusion, and I really can't come up with any other tricks."

There are so many causes of effusion, and each person says one.

Basically everything is summed up.

"Oh." Seeing this, Jiao Jingqiu sighed slightly.

After collecting everyone's opinions, in the end, it still failed to discuss why.

This makes people very sad!

What if the pericardial effusion rises again after the patient's drainage tube is removed?

At this time, Lu Chen thought for a while and said softly, "Senior Sister Jiao, this patient hasn't had an echocardiogram after he was admitted to the hospital. How about this, I'll go and do an echocardiogram for the patient."

"You know how to do ultrasound?" Jiao Jingqiu was stunned.

In fact, she originally wanted to review the patient's heart ultrasound.

However, the patient is currently unable to move, and it is definitely inconvenient to go to the ultrasound room. The only option is to do bedside echocardiography.

"It will be a little bit." Lu Chen nodded slightly.

His current cardiac ultrasound technology has reached an advanced level.

"All right, go and try."

Corey always has a small ultrasound machine, but not many people know how to use it.

After all, something like ultrasound requires systematic study and training.

……

Lu Chen soon got the portable ultrasound equipment.

A group of people followed Lu Chen to the hospital bed.

"In fact, ultrasound is very simple, and what makes perfect." Lu Chen took the ultrasound equipment, sat on the right side of the patient, and introduced to everyone, "Practice on the patient a few times, and you will be good at it."

Cardiac ultrasound is a non-invasive examination.

Unlike invasive procedures such as coronary intervention and electrophysiology, it is simple and harmless, and it is easy to accumulate a lot of experience.

"It's easy to say, but it's hard to do!" Jiao Jingqiu shook her head. She tried to learn echocardiography, but because it was too difficult and she didn't have time to practice, she gave up.

Lu Chen took the ultrasound probe of the heart, smeared it with gel, and placed it on the surface of the heart skin.

"This is the short-axis view of the heart, here is the left ventricular outflow tract, the aortic arch..."

While Lu Chen examined the patients, he also explained them to everyone.

There are not many such opportunities.

Ordinary sonographers do not have the spare time to explain ultrasound to everyone.

"The liquid dark area here is pericardial effusion."

"It's easy to tell the difference between fluid and normal heart tissue."

Lu Chen placed the probe on the apex of the patient's heart again.

"This is the section of the apical four-chambered heart..."

Everyone felt Lu Chen's voice pause, and when they looked back, they saw him staring at the screen of the ultrasound machine.

"Lu Chen, what's wrong?" Jiao Jingqiu hurriedly asked.

"Senior sister, look here." Lu Chen pointed to the screen, "This is the apex of the patient's heart."

Jiao Jingqiu blushed, "Even if you point it out to me, I can't understand it..."

"Senior sister, you don't need to understand."

"what?"

"That's not what I mean." Lu Chen quickly said, "I mean that there is obviously a protrusion here. Even if you don't understand the specific picture, you can still see the strong echo stripe of the protrusion."

"Oh, there seems to be a strong echo shadow." Jiao Jingqiu leaned over and took a closer look, "What is this? Normal people don't have this?"

"Definitely not!" Lu Chen said seriously, "I think it's most likely the pericardium."

"Pericardium?" Jiao Jingqiu was startled.

"Yes!" Lu Chen had paused the echocardiogram and circulated it to everyone.

"Protruding pericardium...could it be..."

Suddenly, Jiao Jingqiu was taken aback, and looked at Lu Chen who was beside him in amazement, "Pericardium...a broken heart?"

Lu Chen also nodded slightly, "That's right, it should be a complication after myocardial infarction - rupture of the free wall."

Cardiac rupture is divided into free wall rupture and ventricular septal perforation, but the mortality rate of free wall rupture is close to 100%.

It was the first time Lu Chen saw a person who survived a broken heart.

"The patient has a breach at the apex of the heart, which is considered to be caused by myocardial infarction, and the local visceral pericardium will gradually seal the breach."

Lu Chen couldn't help sighing, fortunately with the help of the pericardium, he saved his life.

This man's life is really big!

On the side, Jiao Jingqiu swallowed, her right eyelid twitched.

She immediately said to the postgraduate student behind her: "Xiao Zhang, please call for emergency consultation from the Thoracic Surgery Department, Ultrasound Department, and CCU!"

"Roger that!"

The graduate student ran out in no time.

Everyone in the ward, everyone couldn't help but break out in a cold sweat.

A ruptured heart with a mortality rate close to 100% is actually in this ward!

"Patients must absolutely rest in bed, avoid emotional agitation, and cannot get out of bed!" Jiao Jingqiu ordered, "If the stool cannot be relieved, we will prescribe laxatives!"

……

5 minutes.

Doctors from the Thoracic Surgery Department, CCU Department, and Ultrasound Department all came.

The director of the ultrasound department came with a formal heart ultrasound instrument.

Portable ultrasound equipment is too small and many functions are not perfect.

Jiao Jingqiu asked the ultrasound department to do bedside ultrasound for further diagnosis.

"That's right, the apex of the heart is the protruding pericardium!" The director of the ultrasound department made the same diagnosis as Lu Chen, "After a myocardial infarction, the myocardium is damaged, and the myocardium becomes weak, and this kind of free wall rupture or ventricular septal perforation may occur. !"

Heart rupture with a mortality rate close to 100% was diagnosed!
Why do you say the death rate is 100%?
Once it ruptures and bleeds, it will cause cardiac tamponade in a very short time, restricting the beating of the heart.

Surgery is usually too late!

However, in this case, the patient was not suitable for hospitalization in the general ward, and was immediately transferred to the Cardiology Intensive Care Unit.

……

in the doctor's office.

Jiao Jingqiu looked at Lu Chen beside her, feeling like she was alive after a catastrophe.

Fortunately, Lu Chen performed an ultrasound and found the protruding pericardium in time.

In case, the pericardium ruptures, the heart ruptures and hemorrhages.

Then this man is beyond salvation!
But even so, he saved his life.

The prognosis of this patient will not be very good, and the risk of severe heart failure and heart rupture is still high.

"Congratulations, I received a thank you value of +5 from Jiao Jingqiu!"

"Congratulations, received from..."

The system popped up a few more reminders, swiped a wave of thank you points, and the completion of the system upgrade also increased.

　Ask for a monthly pass

　　
　
(End of this chapter)