This doctor is great

Chapter 40 What is aortic stenosis?

It took more than an hour to assist the nurse to go through the admission procedures for the 28-bed patient.

The next thing is to check the room.

Thoroughly understand the entire situation of the patient.

This patient was a patient that Dr. Huang Li met when he was in the outpatient clinic.

After diagnosis, it was determined that it was aortic valve stenosis, and it was still calcified aortic stenosis, that is, the aortic valve was calcified to a certain extent, leading to a series of symptoms.

Zhou Mo picked up the plywood, with a pen in his chest, got up and went to the ward, preparing for rounds.

"Zhou Mo, are you going to make a ward round? The new patient?"

"Yes."

"Take me one."

Huang Yiming was irritated by being last last week.As a member of Xueba, he has enough diligence and hard work, and also has his own pride.

Bottom?

He never bottomed out!
So he cut off the black silk, determined to study hard, especially with Zhou Mo's rounds, he can ask Zhou Mo many questions without fear, and enrich his knowledge.

ding dong~~~
"Brother, are you going to eat Western food tonight? I brought this...Mesh 230·jpg"

Gollum~~~
Huang Yiming swallowed.

The bone-scraping steel knife hurts the hero's waist!

"No, no, no time tonight..."

"Ah? Well...Come on Brother Ming! You are the best!"

"You... are so kind... you are not at all the same as those coquettish bastards..." Huang Yiming was moved, feeling that his girlfriend was really understanding.

It is said that women are hypocritical, condescending, and want men to lick their dogs.Now it seems that women are not so unbearable.

"Okay, I'm going to check the room..."

"Wow~~mua~~~ Come on!!"

Not far away, at the nurse's station, Chen Xiaoyun smiled, and then replied a WeChat message from her best friend: "I'm free tonight, let's make an appointment!"

……

bed 28,

Zhou Mo and Huang Yiming came to the hospital bed.

"Bed 28, Zhang Yan..."

Patient Zhang Yan, male, 45 years old, slightly fat, huge rosacea is very conspicuous, red, I don't know if he drinks a lot.

"Hello doctor!" Zhang Yan and his wife greeted him cautiously.

"I'm your bed doctor. My name is Zhou Mo. From now on, you can call me Doctor, or Doctor Zhou... Now I'm here to learn about your situation..."

"Okay, okay...Doctor, you can ask..."

"Okay... You went to the emergency department because of a dizziness, and finally checked the brain CT, and found nothing wrong... Then you felt that there was something wrong with your breathing, so you went to the cardiology department... Right..."

"Yes, yes, yes..." The patient nodded repeatedly.

"According to the diagnosis given to you by Dr. Huang who saw you in the outpatient clinic, the disease you suffer from is called "aortic valve stenosis"..."

Here, a brief explanation of what is "aortic valve stenosis":
The blood circulation of the human body is as follows:
Systemic venous blood --> right atrium --> right ventricle --> pulmonary artery (oxygen) --> pulmonary vein --> left atrium --> left ventricle --> aorta --> whole body...

Aortic valve: It is a portal between the "left ventricle" and the "aorta".

Just can't get in!

Prevent backflow of blood in the aorta!
The so-called "aortic valve stenosis" is a lesion that causes stenosis.

The manifestations are: when opening, the opening is not big enough (with retention)!When closing, the closure is not tight enough (there is backflow)!

There are three main reasons:

Rheumatic heart disease
congenital deformity
Senile aortic valve degenerative disease

Or is there something else...

Zhou Mo glanced at the patient. He was only in his 40s, so senile aortic valve degenerative disease should not be considered.

Zhou Mo: "Do you have a history of rheumatism?"

Patient Zhang Yan: "No..."

Zhou Mo: "Have you had a rheumatism immune check before?"

Patient Zhang Yan: "No..."

Zhou Mo nodded, and then said: "Because aortic stenosis is often caused by rheumatism, so you need to have a rheumatism immune test... After all, you came to our hospital to find out the reason. And fix it, right?"

There was nothing wrong with what Zhou Mo said, so the patient's wife said from the side:
"Doctor, do whatever tests you say you want to do!"

Zhou Mo hurried to save his life: "It's not that I said that I will do any inspection, but I will do whatever inspection is needed according to the condition..."

The patient's wife laughed awkwardly.

Zhou Mo continued to ask: "Did you feel chest tightness or chest pain when you were young, or before? Or family genetic history..."

The patient shook his head: "No..."

Exclude congenital.

"Have you been hospitalized before?"

"No, I've been in good health..."

"You have high blood pressure, right... 5 years history of high blood pressure..."

"Yes……"

"it is good……"

Zhou Mo asked some more questions...

I am thinking about:

What are the symptoms of aortic stenosis?

"I read your medical records, there were several sudden severe heart pains, right..."

"Yes……"

This should be angina.

Aortic stenosis, why angina pectoris?
The reason is that the aortic valve is not fully open (when it is open, it is not as big as it is when it is healthy) --> resulting in insufficient pumping, and a large amount of blood in the left ventricle --> making the left ventricle pressure too large --> increasing the left ventricle -- —> Compression of the coronary arteries —> Insufficient delivery of oxygen to the coronary arteries —> Angina pectoris.

(Coronary arteries: The coronary arteries surround the heart and are responsible for supplying blood to the heart.)
"When does your chest pain usually occur?"

"daytime……"

"Do you work during the day?"

"Yes, I go to work."

"Is it when you are more tired every time you have chest pain?"

"This..." the patient recalled, "It seems, probably...it should be..."

Zhou Mo nodded, and wrote down the suspected "Exercise Angina Pectoris" on the paper.

In addition to angina pectoris, aortic stenosis can also cause syncope and amaurosis.

The reason is that the pressure of the left ventricle is too high --> the load of the left atrium is too large --> left heart failure --> blood supply problems --> insufficient oxygen supply to the brain --> syncope and amaurosis.

The reason why the patient was admitted to the hospital was that he was sent to the emergency department because of sudden syncope. After recovering, he went to see a doctor in the cardiology department and was admitted to the hospital today.

So it can be confirmed that the patient has this symptom.

Next, Zhou Mo continued to ask:
"How's your breathing?"

Patient Zhang Yan: "I feel like I can't breathe. I always breathe slowly, otherwise it will be very uncomfortable..."

Zhou Mo nodded.

Difficulty breathing is also a symptom of aortic stenosis.

The reason is that the pressure of the left ventricle is too large --> the load of the left atrium is too large --> leading to pulmonary venous hypertension and pulmonary capillary hypertension --> pulmonary congestion --> dyspnea.

so far,

"Difficulty breathing"

"angina pectoris"

"Swoon"

All three are there.

They are the classic triad of aortic stenosis.

but,

Whether it is aortic valve stenosis or not, we need to continue to ask more carefully.

……

ps: The rich woman has been deleted...

ps: Recommendation tickets, monthly tickets, tipping and feeding ports...

　ps: There are many headaches in this chapter, but I try to keep the logic as simple as possible... Because the wording is simplified, it will inevitably be imprecise, please forgive me.

　　
　
(End of this chapter)