I can see health

Chapter 901
in the ward.

The young girl stared blankly at the ceiling.

A month ago, she was studying in the classroom with her classmates, looking forward to the future.

Maybe tomorrow, or the day after tomorrow, she will meet her Prince Charming.

However, the misfortune of life is so sudden.

Dizziness, fatigue, and then fainting.

Let such a girl be at a loss.

According to the doctor, her heart was beating too slowly.

As the most important organ of the human body, once the heart stops beating, it is dangerous.

Only by implanting a pacemaker to help her heart beat can she avoid this danger.

However, she hasn't dated yet.

She still has a lot of interesting things that she didn't have time to do.

"Dad, do I have to put a pacemaker?"

The girl turned to look at her father.

During this month, the man sought medical treatment everywhere and could only fall asleep late at night.

When I woke up the next morning, I had to continue looking for a hospital for my daughter.

In a month, his hair was a little gray.

"How could it be?" The man forced a smile, "Didn't you listen to Director Lu today? Your electrocardiogram may have other diagnoses."

"And let me tell you, there was a boy with a slow heart rate before, and other experts said that he needs to put a pacemaker. When he arrived at Director Lu's place, he was cured without the pacemaker!"

A smile appeared on the girl's face.

There was also hope in her heart.

However, I don't know when it will start.

Outside the window of the ward, there are dark clouds.

The wind was blowing and the windows were rattling.

Seeing that a storm is about to hit.

……

The cardiology department shows the classroom.

Lu Chen stood on the stage.

Behind him, on the projector, were the girl's three electrocardiograms.

"Let me ask a question, these three ECGs, only high-grade atrioventricular block?"

Lu Chen looked around, and finally stopped his gaze on Gu Xinyue.

Everyone chattered and began to discuss non-stop
"Do you guys see any other possibility of blocking?"

Lu Chen gave some reminders.

Gu Xinyue has followed Lu Chen for a long time.

He knew that every step of Lu Chen had a deep meaning.

Could it be that this patient really has another diagnosis and may not have a pacemaker?
Gu Xinyue frowned deeply, not letting go of any details of the electrocardiogram.

This time, he really saw something.

"Director Lu, I got it!" Gu Xinyue stood up suddenly, "This patient has first-degree atrioventricular block, complete right bundle branch block, and left posterior fascicular block. Consider trifascicular block!"

When Gu Xinyue said this, Jin Miao's eyes lit up.

When he looked at the electrocardiogram again, he saw these three conduction blocks.

This Laogu really has two talents.

On the stage, Lu Chen smiled and nodded.

"Dr. Gu is right. This patient is a combination of three types of blocks. Do you know where the blocks are?"

Lu Chen looked at Gu Xinyue.

Gu Xinyue looked at the electrocardiogram again, frowned, and then said slowly.

"I think atrioventricular node or Hipster system are both possible."

Lu Chen did not deny the answer, but looked at other people.

"What's your opinion?"

Jin Miao stood up, "I think the blocking part is in the Xipu system, right?"

Gu Xinyue wondered: "Why can't it be an atrioventricular node?"

Jin Miao scratched his head, "It's just a feeling. As for the specific reason, I can only understand it myself, and I really can't say it."

Everyone laughed when they heard Jin Miao's words.

However, Lu Chen gave Jin Miao a thumbs up, "Your sixth sense is really accurate, the blocking part is in the Xipu system."

"Director, what is the reason?"

Another deputy chief physician asked.

"As far as I know, this kind of block is clinically possible. We haven't done electrophysiological examination for the time being, so we definitely can't tell the difference."

Lu Chen smiled.

"You only know one, not the other."

"If the patient is older, there is a possibility of AV nodal block."

"But in this 18-year-old girl, the AV node was less prone to problems, and in a patient with a ventricular septal defect, the surgery primarily affected the bundle branch system."

"The reason is also very simple. The interventricular septum is between the left and right ventricles. Surgery generally affects the bundle branch conduction system. The atrioventricular node is quite far away from there, and generally it will not be affected."

This remark is very simple to say.

But it is quite difficult to connect with reality.

"Director, but you said so much, but you didn't say how to treat this patient?" Gu Xinyue asked suspiciously, "Do you need a pacemaker for the next treatment?"

"Or, according to your point of view, this is the coexistence of three kinds of blocks, shouldn't it be better to put a pacemaker?"

Gu Xinyue's question is what everyone wants to ask.

After analyzing it for a long time, Lu Chen corrected the diagnosis of the electrocardiogram, but the general direction remained the same.

This multiple block ECG is indeed an indication for implanting a pacemaker.

At this time, Lu Chen said seriously: "I don't seem to have said that this patient doesn't need a pacemaker?"

"what?"

When everyone heard it, they were all stunned.

Especially Gu Xinyue, her eyes were wide open.

The doctors in the department thought that Lu Chen had other insights.

At this time, I heard Lu Chen continue: "For a young girl in the blooming season, the occurrence of three-branch block is definitely not physiological, it must be pathological. The following four possibilities must be considered."

"First, acute viral myocarditis; second, progressive cardiac conduction block; third, cardiomyopathy; fourth, damage to the conduction bundle system after ventricular septal surgery."

Acute viral myocarditis, the patient did not have any prodromal symptoms of infection, and multiple checks of myocardial injury markers and pro-BNP were completely normal after admission.

The patient did not have any symptoms of chest tightness, chest pain, or dyspnea, and the possibility of acute viral myocarditis is very small.

As for progressive cardiac conduction block, this type of disease is a disease with no obvious organic disease and involvement of the conduction bundle system, the course of the disease is migratory, progressively aggravated, and develops into high-grade or third-degree atrioventricular block.

This type of disease is mostly middle-aged and elderly, and there is a family history.

In addition, from the perspective of cardiac ultrasound, there is no evidence of cardiomyopathy.From the electrocardiogram, there is no evidence of cardiomyopathy, so the possibility of cardiomyopathy is unlikely.

Lu Chen's remarks are extremely convincing.

Of the four possibilities, only the last one remains.

"That's the last possibility, damage to the conduction bundle system after ventricular septal surgery!"

A very common complication of ventricular septal surgery is atrioventricular block, and most of them involve the Hipster system, so this patient can almost lock in the cause of atrioventricular block.

"Director, I still have a question." Gu Xinyue continued, "This patient has been operated for 13 years, why didn't he get sick when he was a child, why does it still happen now?"

Lu Chen thought for a while and then said: "The only reasonable explanation is that the patient underwent surgery when he was a child. As the patient gets older, the conduction bundle system of the heart is also developing, which may affect the conduction with the stretching of the patch. beam system."

"In this case, does the pacemaker have to be used?" Gu Xinyue asked tentatively, hoping to get a different answer from Lu Chen.

This is a young girl after all!

But unfortunately, the reality is always cruel.

Not every disease can be cured perfectly.

Lu Chen's eyes were deep, and he said slowly: "It must be done!"

Before I knew it, it was raining heavily outside the window.

The black cloud overwhelms the city and wants to destroy it.

A completely depressing atmosphere enveloped everyone's heart.

(End of this chapter)