I can see health

Chapter 821 Mu Xiu Yu Lin
After dinner, everyone went back to their homes.

Lu Chen rested in the apartment for a while.

In the afternoon, he will also discuss difficult cases on behalf of Director Yan Wanfeng.

Today, Yan Wanfeng basically doesn't care much about clinical matters.

Most of the clinical affairs of the department are managed by Lu Chen.

in the afternoon.

Oncology ward.

show the classroom.

The directors or deputy directors of the major departments of Guanghai No. [-] Hospital all came to participate in this difficult case.

There is no other reason, one patient's condition is critical and complicated.

Second, the identity of the patient is special.

When they came to the oncology department, graduate students immediately led Lu Chen to the demonstration classroom.

"Hey, Director Lu, you're here."

"Director Lu, the patient with congenital heart disease last time successfully gave birth to a child. This is a good case! We can study it carefully!"

"Director Lu, we also have a troublesome case in our department, you can visit us when you have time."

Lu Chen is now familiar with the directors of other departments.

Everyone gradually became familiar with Lu Chen's identity, but ignored his age.

The main reason is that Lu Chen's ability is too outstanding.

Whether it is clinical ability or surgical ability.

"It's easy to say." Lu Chen smiled slightly and greeted everyone one by one.

The oncology department is a big and rich department!
The most important thing is that the contradiction between doctors and patients in the oncology department is much less than that of other departments!
It is normal for a tumor to be diagnosed but not curable, which is accepted by both the patient and the patient's family!

If it is cured, then it is a good medical skill.

Moreover, the medicines used in the oncology department are very expensive.

Correspondingly, the benefits of the oncology department are also very good.

Before Lu Chen chose a department, he even thought about oncology for a while.

After 10 minutes, all personnel arrived at the scene, and the discussion of difficult cases began.

Director Tang of the Oncology Department stood up first to speak.

"Hello, directors. This time, we have gathered together mainly to solve a case. The patient has a special status, so our department has no choice but to brainstorm and see if we can come up with a good diagnosis and treatment method!"

Director Tang's words made everyone more curious about the identity of this patient.

However, the people in the oncology department kept silent.

We can only give up.

Immediately afterwards, the patient's bed doctor gave a brief introduction to the patient's condition.

Everyone had a medical record sheet in their hands, and with the introduction of the doctor in charge of the bed, everyone quickly knew the basic situation of the patient.

The patient was diagnosed with rectal ca with liver and lung metastases.

After the current targeted drug therapy, he recently experienced dyspnea and decreased activity tolerance.

"Everyone understands the patient's situation." Director Tang said, "What we are most puzzled about is the reason for the patient's symptoms. In addition, in terms of treatment, can we continue the anti-tumor treatment?"

The voice just fell.

A deputy chief physician of the Respiratory Department took the lead and said, "Excuse me, Director Tang, does the patient have a history of lung diseases? Such as emphysema."

"Yes." The doctor in charge nodded slightly, "The patient has a history of smoking for nearly 40 years, and only started to quit smoking in the last year. He has a long history of chronic obstructive pulmonary disease."

"Then before the tumor treatment, have you checked your lung function?" asked the respiratory doctor.

"No." The doctor in charge shook his head. "At that time, the patient's symptoms were very mild, so he didn't notice this problem."

"Well. I read the patient's medical records, and I feel that in terms of dyspnea, heart failure must not be ruled out first. In addition, the state of lung function, long-term emphysema, and lung cancer metastasis, or the lung function must be not good."

Respiratory doctor talked eloquently.

After all, it is the top hospital in the province.

Every director here has a very good resume.

More than 90.00% of them are Ph.D. students, and all have the opportunity to study abroad.

There are even some directors who are big names in the industry.

Everyone expressed their opinions.

After a while, there was a brief pause in the speech.

"Well, the opinions of all the teachers are very valuable." Director Tang said, "Which department teacher will continue to express their opinions next?"

Under the stage, a doctor from the intensive care medicine department raised his hand.

Lu Chen knew him. He was Huang Xiaofeng, the captain of the rescue team some time ago.

"Director Tang, let me tell you my opinion." Huang Xiaofeng said.

"Okay, then let's listen to Director Huang's advice."

Everyone's eyes turned to Huang Xiaofeng.

Huang Xiaofeng smiled lightly, "I have consulted with this patient before, and I noticed his electrocardiogram. I wonder if you have seen it?"

Then, on the screen of the projector on the stage, three electrocardiograms taken after the patient was admitted to the hospital immediately appeared.

"Did you find any abnormalities?" Huang Xiaofeng said, "Although I am not a cardiologist, it is obvious that the AVR and the ST segment of leads V1-V3 in the first ECG showed slight elevation."

"The third ECG, suggesting extensive precordial and inferior ST-segment elevation."

"In addition, the patient's troponin was elevated. Do these all indicate that the patient has myocardial infarction?"

As soon as the voice fell, there were whispers in the classroom.

Lu Chen didn't speak.

In fact, he had already noticed the patient's electrocardiogram.

However, if it is really a myocardial infarction and it is so easy to determine, then this patient does not need to undergo a general hospital consultation at all, right?
Sure enough, after Director Tang heard Huang Xiaofeng's opinion, he said, "Director Huang's opinion is very good. We have considered it before, so we performed a coronary CTA for the patient. You can take a look at the CTA results."

Coronary CTA is a non-invasive examination that, like coronary angiography, can diagnose coronary heart disease.

Afterwards, the tube bed doctor projected the image of the patient's coronary artery CTA on the projector.

Lu Chen raised his head and looked intently.

The patient's anterior descending artery was stenotic, but the degree of stenosis was not severe, only about 40% stenosis.

This degree of stenosis will not cause such serious symptoms at all!
Huang Xiaofeng obviously also saw this result, he was a little bit unwilling to give up, and still asked: "The result of the angiography is normal, but it does not necessarily mean that there is no coronary heart disease! I remember that in the field of cardiology, if there is a disease, coronary microcirculation disorder is done. That is to say, the large main blood vessels may not be narrowed, but the microcirculation disturbance may also lead to heart failure."

Microcirculatory disturbances cannot be detected by coronary angiography or CTA.

After saying this, Huang Xiaofeng glanced at Lu Chen, "Director Lu is an expert in this field, you know it better than me, it should be something like this."

Lu Chen smiled and nodded: "Director Huang, you are right, there are indeed such words."

Seeing that Lu Chen had said that, everyone raised questions.

Is the patient suffering from heart failure caused by cardiac ischemia, as Director Huang Xiaofeng said?

Director Tang's attention was now attracted by Lu Chen.

He suddenly said: "I heard about it a long time ago. Our Guanghai No. [-] Hospital has a very good cardiologist. He is young and has won many honors and awards."

This is naturally Lu Chen.

Everyone also turned their attention to Lu Chen not far away.

Director Tang paused for a while, and continued to smile: "Director Lu came to participate in the case discussion in person today. I think everyone is very interested in Director Lu's opinion on this patient, right?"

Lu Chen finally understood the difficult situation where a tree is more beautiful than a forest and the wind will destroy it.

At this time, everyone present looked at him.

Maybe Director Tang didn't have any malicious intentions.

But at this time, Lu Chen had no choice but to stand up and express his opinions and opinions.

Once there is a slight mistake, he is likely to be labeled by everyone as "unsuitable", "student" and so on.

However, many doctors have already published their own opinions. At the end of the day, Lu Chen, what new tricks can he come up with?

(End of this chapter)