I can see health

Chapter 76 Who Diagnosed This?

The cath lab of the Cardiology Department of Jinghua Second Hospital.

A 10-year-old girl is lying on the operating table.

Seeing everything unfamiliar in front of her eyes, she tightly closed her eyes and told herself desperately not to pay attention to the pain from her wrist.

"Little friend, you are so brave! The operation is very fast, and you will be cured soon."

It was the first time for the nurse in the catheterization room to see such a young patient.

"Doctor Ren, the doctor in the upstairs ward did not make a mistake. Is such a young girl going to have a heart angiography? Do you need a stent?"

The nurse looked suspiciously at a tall surgeon next to him.

"That's right, I read the patient's laboratory report and electrocardiogram, and the diagnosis of myocardial infarction should be correct." Ren Feng frowned, "However, this is the first time I have seen such a young patient."

Ren Feng, the leader of the younger generation of coronary intervention in the Cardiology Department of Jinghua Second Hospital.

Most of the difficult operations are done by him.

This time, when he encountered a 10-year-old heart attack, he was also in charge.

"I have seen the youngest patient with myocardial infarction at the age of 18. That patient stayed up late for a long time, smoked and drank, and ruined his body to no avail."

"But this 10-year-old girl shouldn't have any bad habits."

"I always feel that if a stent is placed on such a young girl, it will be too much." The nurse couldn't help sighing.

"Look at the condition of the blood vessels first, and then make a decision." Ren Feng frowned, "If possible, try to do PTCA."

Coronary interventional therapy in a broad sense includes the following:

First, coronary artery balloon dilatation: PTCA in a narrow sense, can improve coronary artery stenosis or blockage.

Second, stent implantation: that is, PCI treatment, which can solve the problem of restenosis.

Third, coronary atherectomy: It can be used when the lesion is very serious and the balloon cannot be expanded.

simply put.

PTCA is to use a balloon to dilate narrow blood vessels, but no stent is implanted.Restenosis occurs in 40% of stenotic lesions after balloon dilation.

PCI is to implant a stent after balloon expansion to reduce the risk of restenosis.

……

A 10-year-old myocardial infarction patient is really rare.

This case also attracted doctors and nurses from several other cath labs.

It takes less than 10 minutes.

At the door of Ren Feng's cath lab, a group of doctors and nurses were already surrounded.

Everyone is paying attention to the situation in the cath lab.

"Brother Ren has encountered such a difficult patient again!"

"Hey, the risk of this kind of patient is too high. Whether to put a stent or not, and what type of stent to put, are all difficult problems! Once something goes wrong, the patient's family will definitely find trouble with the hospital!"

"Yes, the most important thing is that the patient is too young!"

Suddenly a familiar voice came from behind.

"Have you finished your surgery? Are you free to watch here?"

Everyone was taken aback for a moment, and then immediately dispersed, returning to their own cath labs one after another.

Cao Zhiying looked at the backs of everyone leaving with a sullen face, and then turned his gaze to Ren Feng's cath lab.

"Such a young patient?"

Seeing the little girl on the stage, Cao Zhiying frowned, and suddenly became interested.

He walked to the monitoring table in front of the catheterization room and sat down, opened the patient's medical record folder.

"Chest pain, elevated myocardial enzymes, abnormal ECG, the diagnosis of myocardial infarction should be clear."

"Mitral valve prolapse, intermittent claudication, tendon xanthoma..."

Seeing these physical signs and auxiliary examinations, the corners of Cao Zhiying's mouth could not help but rise slightly.

This is an interesting case, which is relatively rare.

Can the little doctor in the upstairs ward diagnose it?
……

At this time, Ren Feng in the catheterization room had already completed coronary angiography.

"Ren Feng, look at the blood vessels in every position of the patient."

The director's voice suddenly came to mind in the cath lab.

Ren Feng looked back.

Cao Zhiying was sitting on the monitoring platform in the catheterization room outside, talking to him with a microphone.

Ren Feng nodded slightly, indicating that he understood.

A contrast agent is injected to visualize the coronary arteries.

"This is...extensive vascular stenosis!" Ren Feng couldn't help sighing in his heart, "It's difficult to do PCI now!"

Extensive vascular lesions are not blocked by one or two blood vessels!
"Ren Feng, let's dilate it with a balloon, and don't put a stent for now."

Cao Zhiying's voice sounded again, and Ren Feng immediately expanded the balloon.

About four 10 minutes later.

The operation was successfully completed!

Ren Feng walked out of the catheterization room, his back was already covered in sweat.

The main reason is that this patient is too young, and Ren Feng is extremely careful in every step of the operation.

Because once something goes wrong, the consequences will be disastrous.

"Ren Feng, what disease do you think this patient is?"

Cao Zhiying asked suddenly.

"Vasculitis, such as Takayasu arteritis, ANCA-related vasculitis, etc."

"And then? No other ideas?"

Ren Feng pondered for a moment, but still shook his head.

"Director, that's all I can think of for the time being."

Cao Zhiying's complexion darkened, and he said seriously: "Ren Feng, it is undeniable that your coronary interventional skills are very good. In the hearts of the entire Jinghua Second Hospital, you can definitely be ranked in the first echelon."

Ren Feng had no expression on the surface, but he was happy in his heart.

It is very rare to be praised by the chief director Cao Zhiying.

"But!" Cao Zhiying suddenly changed his tone, "Do you want to be an excellent cardiologist, or do you just want to be a surgeon?"

"This... is of course a cardiologist." Ren Feng replied immediately.

Cao Zhiying smiled and continued.

"The most important thing for an excellent cardiologist is solid basic knowledge and good clinical thinking ability, instead of performing surgery day after day, just become a craftsman of interventional surgery!"

"Look at you, you can't even analyze this case now. This disease should be hereditary hypercholesterolemia. I remember that there was a case in the third area of ​​the heart before. Have you forgotten?"

Hearing what Cao Zhixin said, Ren Feng immediately reacted.

In his impression, there was indeed such a patient.

"Director, but this disease is a rare disease." Ren Feng broke his position and said helplessly, "I can't think of it for a while, it should be normal. The doctors in the upstairs ward, as the first doctor, didn't diagnose it at the first time. ah!"

While talking, Ren Feng clicked on the medical record in the computer.

"Director, look, the doctor in the upstairs ward diagnosed the same thing as me, and also considered myocarditis, cardiomyopathy, and vasculitis, which is similar to mine!"

However, when Ren Feng clicked on the latest ward round record.

He was stunned.

In the course record, it is clearly written:

Diagnosis: Familial hereditary hypercholesterolemia.

The expression on Ren Feng's face was extremely exciting.

Cao Zhiying on the side also showed surprise.

The doctor in the upstairs ward diagnosed it so quickly? !

His gaze moved down to the signature of the course record.

I want to see who diagnosed this case.

(End of this chapter)