I can see health

Chapter 741 Talented people work harder than you!

The procedures for ward rounds are similar with minor differences.

Gui Peisheng or graduate student in charge of the bed will report the medical history.

Jin Miao explained the current diagnosis, treatment drugs, and the next treatment plan.

Lu Chen stood beside Jin Miao, occasionally asking a few questions, but most of the time, he just listened carefully.

Seeing this, Jin Miao thought that Lu Chen was not proficient in clinical practice, so he couldn't give any advice, and could only remain silent most of the time.

He really misunderstood Lu Chen!
Lu Chen felt that he was new here, so he carefully observed Guanghai's ward rounds and the conditions of the patients in the group.

Therefore, even if any problems were found, they were just written down first, and no questions were asked on the spot.

Instead, prepare to ask questions after the fact.

"Director Lu, this patient may be troublesome. He has been admitted to the hospital for five days. The diagnosis is not clear yet, so further examination may be needed." Jin Miao led Lu Chen to the bed of the last patient.

His original intention was not to embarrass Lu Chen.

Because if this patient asks Lu Chen about the cause, he will not explain it, and he may lose face.

Sure enough, as soon as he said this, the patient gave Lu Chen a strange look when he heard the word director.

There is such a young director?

However, I can't control so much now.

"Director, I've been here for five days, why haven't you found the cause yet?" The patient immediately got up from the hospital bed.

Jin Miao paused just as he was about to leave, he was really afraid of something!

He was about to explain to the patient, but Lu Chen had already taken the patient's medical records from Gui Peisheng beside him.

"Are you transferred from the oncology department?" Lu Chen remembered reading her medical record before the ward round.

The patient was a woman in her 50s. She nodded slightly, "Yes, I was preparing for chemotherapy. I was transferred to the cardiology department because there was a problem with one of the test results. You should quickly solve my heart problem. I want to go back to chemotherapy as soon as possible!"

"Don't worry, I'll take a look at your medical records." Lu Chen comforted.

Jin Miao on the side smiled wryly.

Director Lu Chen is making his face swollen to pretend to be fat!
They have studied this patient in private for a long time, but they have no clue at all. Could it be that Lu Chen knew what the problem was after just one look?
"Doctor Jin, please briefly introduce the patient's condition first."

Lu Chen put down the patient's medical records and picked up the tablet provided by the department.

Tablet PC and hospital intranet link, you can check the test sheets and reports of all patients in the department.

"Okay." Jin Miao nodded, "This patient was transferred from the oncology department last Wednesday. He was diagnosed with lung CA and had already undergone three courses of chemotherapy. This is the fourth course of treatment. High, transfer to our department for continued treatment, mainly to find out the cause of elevated myocardial enzymes.”

"Does the patient have any symptoms?" Lu Chen asked.

"I don't have any discomfort."

Before Jin Miao could reply, the patient spoke up immediately.

Lu Chen nodded. He glanced at the patient's kinase results, troponin and other creatine kinase tests, all of which had increased to varying degrees.

Elevation of myocardial enzymes usually indicates myocardial injury. Common causes include acute myocardial infarction, renal failure, etc.

Jin Miao continued from the side: "The patient does not have any risk factors for myocardial infarction, nor does he have any symptoms of chest pain or tightness. The echocardiography, coronary CTA, and even the electrocardiogram are normal, so we have no clue for the time being."

A normal echocardiogram can rule out cardiomyopathy, such as hypertrophic cardiomyopathy, which sometimes also causes elevated cardiac enzymes.

Coronary CTA is normal, excluding coronary heart disease, such as acute myocardial infarction, which leads to elevated myocardial enzymes.

The electrocardiogram was normal, excluding tachyarrhythmias or slow arrhythmias.

At this time, Lu Chen looked at Jin Miao and asked a seemingly irrelevant question: "What chemotherapy regimen did the patient use before?"

"I... don't know." Jin Miao shook his head, "Then I'll go back to the office later and check the patient's previous medical records in the oncology department."

They are only responsible for diseases in the cardiology department. As for the patients' oncology drugs, they don't ask, and they don't need to know.

Lu Chen frowned.

"Director Lu, does it matter?" Jin Miao asked in a low voice.

"I don't know yet." Lu Chen said softly, and then looked at the patient beside him, "Do you know that you are taking chemotherapy medicine in the oncology department?"

"Uh, it's a new type of drug." The patient thought for a while, "What is it called an immunosuppressant? It's very expensive."

Lu Chen's eyes froze, "Immune checkpoint inhibitors?"

"Well, yes! This is the medicine." The patient nodded quickly.

"Okay, I got it." Lu Chen handed back the medical records to the graduate student beside him, and then said to Jin Miao, "Let's make an appointment for a cardiac MRI for the patient, and I'll check the cardiac enzymes again tomorrow."

"Huh?" Jin Miao was taken aback, "Heart MRI?"

"Yes, our hospital should be able to do it, right?" Lu Chen said.

"It can be done, but it's not doing much now." Jin Miao responded, and he really couldn't find the reason why Lu Chen asked the patient to check the heart MRI.

"Arrange as soon as possible." Lu Chen turned to the patient and said, "After we analyzed your condition again just now, we considered the possibility of myocarditis, so we need to check a cardiac MRI to confirm the diagnosis of myocarditis."

The patient naturally agreed, and now she just wants to be diagnosed early and turn back to the tumor for chemotherapy earlier.

Jin Miao on the side was stunned when he heard the word "myocarditis".

The diagnosis of myocarditis, in addition to myocardial biopsy, is cardiac MRI.

Myocardial biopsy is an invasive examination with high risks, and few people will do it.

If you want to diagnose myocarditis, the only way to do it is to do a cardiac MRI.

However, Jin Miao racked his brains and still couldn't figure out the cause of the patient's myocarditis!

The patient did not have prodromal cold symptoms, nor did he have any symptoms of chest pain or tightness.

Considering myocarditis, you have to come up with an incentive, right? !
It is impossible to get myocarditis for no reason!
After walking out of the ward, Jin Miao summoned up his courage and asked Lu Chen in a low voice: "Director Lu, you are thinking about myocarditis, what is the cause?"

Lu Chen frowned slightly, "Didn't you listen to my question just now?"

"Have you said that?" Jin Miao recalled the conversation just now, and only then did he notice the "immune checkpoint inhibitor" that Lu Chen said.

"Could it be the myocarditis caused by the tumor drug?" Jin Miao asked suspiciously.

He had never heard of this kind of medicine, Lu Chen actually knew that this medicine could cause myocarditis?
Lu Chen nodded, "Go back and look through the literature. Myocarditis caused by immune checkpoint inhibitors is a hot topic in the intersection of cancer and heart disease recently."

"it is good……"

Jin Miao nodded silently.

He really had never heard of this medicine, but Lu Chen spoke clearly and clearly.

Don't be afraid of other people's talents, but be afraid that people with good talents will work harder than you!

(End of this chapter)