This doctor is great

Chapter 63 Wang Lilong was hit!

Zhou Mo was preparing for the B-ultrasound,
while thinking.

Common mechanisms of post-activity chest pain include:
[-]. Increased myocardial oxygen consumption;

Second, the breathing movement is accelerated and increased;

Three, chest wall movement changes or increases in magnitude.

After reading the previous inspections, one of the suspicions is that there is a problem with the valve.

There is also a third type of mechanism that can be considered, such as radiculitis, tuberculosis of the thoracic spine, or osteoporosis caused by low calcium...

Later, we need to improve the thyroid function blood test and CT of the thoracic spine.

"By the way! Special types of cervical spondylosis may also cause chest pain!"

At this moment, Zhou Mo thought of cervical spondylosis.

There was no problem with the physical examination just now, but I forgot to ask about occupational diseases.

Zhou Mo asked, "What do you do for work?"

Li Mei: "The cashier in the office..."

Zhou Mo: "Do you usually feel pain in the cervical spine? Numbness?"

Li Mei shook her head: "No."

Zhou Mo nodded. Although the patient said so, he can consider doing a comprehensive X-ray examination of the cervical spine later.

When encountering such difficult and miscellaneous diseases, more inspections may be required, and a lot of money will be spent.

Ultrasound B is ready,
Zhou Mo began to push the probe of the B-ultrasound to the patient's side.

First of all, the question about the heart sound just now,

So Zhou Mo immediately looked at the valves of the heart, the mitral valve, tricuspid valve, aortic valve, etc...

"Ok?"

"There seems to be no problem..."

"There is no problem with closure, and there is no major problem with regurgitation..."

"The heart is a little hypertrophic..."

5 minutes later……

"Doctor, are you still okay?" The patient Li Mei felt that it had been a while and couldn't bear it.

And the couplant is a bit cold, which is not very comfortable.

"Wait a second..."

At this time, Zhou Mo didn't find a problem inside his heart, so he changed his mind.

Look at the coronary artery!
Color Doppler can see blood flow, speed and other things, although the difficulty will be much higher, and many doctors will not.But Zhou Mo couldn't be bothered.

After all, Zhou Mo is a talented person!
effort!

Will not let people down!
Why check coronary artery?
Because he just thought of a disease,

If it is not angina pectoris, then you can consider a relatively rare disease——

"Coronary artery blood flow is too slow"!
Or another name - Syndrome X!
It is also called "microvascular angina"!
1 minutes later……

Zhou Mo smiled!
found it!
It turned out to be "X Syndrome"!
Because from Zhou Mo's color ultrasound blood flow measurement, its blood flow value was one-third slower.

This disease can explain why the patient Li Mei's exacerbation during exercise also resembles angina pectoris.

The blood flow in the blood vessels is slow, and the blood vessels are small. When the exercise intensifies, it will naturally be too late to supply the heart, resulting in something similar to angina pectoris.

"Okay, I probably found the reason."

Zhou Mo put down the probe and smiled.

"Ah? Doctor, have you found the reason?!"

Li Mei looked at Zhou Mo in surprise, and sat up abruptly.

Zhou Mo: "I just checked with a B-ultrasound. Your coronary blood flow velocity is a little slower than that of ordinary people. It should be "X Syndrome"..."

(For diseases named after syndromes, the primary cause is generally not found.)
Then Zhou Mo introduced to the patient Li Mei what Syndrome X is.

"It turned out to be so!"

Li Mei was a little excited. The Syndrome X that Zhou Mo mentioned was too similar to her symptoms, and no one in the other hospitals she went to mentioned this disease at all.

Zhou Mo: "However, B-ultrasound is not the most accurate. I think you should do a coronary angiography. Only coronary angiography is the real gold standard."

"Do it, do what you say!" Li Mei said firmly!

At this time, she can be said to have survived a desperate situation, she can get rid of the hat of mental illness, and get rid of the strange eyes of the people around her. Naturally, she will not let go of such an opportunity.

Zhou Mo said again: "The price of coronary angiography is a bit high, maybe several thousand, please ask the CT room for details..."

Li Mei: "I did this. It costs more than 5000 yuan to go to a hospital..."

Zhou Mo: "You are going to do it, right?"

Li Mei nodded fiercely: "Do it! Naturally!"

Spending money is nothing, as long as it can cure the disease, it is better than anything else!
Zhou Mo: "Okay, I'll make an appointment for you. There aren't that many people for this inspection, so it's probably possible to do it tomorrow..."

Zhou Mo took the ipad and clicked on the hospital's system to make an appointment.

Sure enough, there is a seat the day after tomorrow (Monday) morning, and you can make an appointment.

Click to make an appointment.

"Okay, I've made an appointment for you the morning after tomorrow. As soon as the results come out, you can tell if you have Syndrome X."

"Thank you doctor!!"

……

……

Zhou Mo was overjoyed after he took care of the patient.

It's a great sense of accomplishment to handle patients independently!
out of the clinic,
Wang Lilong ran over quickly, with an apologetic expression on his face: "Zhou Mo...I was sorry just now, I just wanted to learn more from you..."

Zhou Mo showed a professional smile: "It's okay, as long as the patient doesn't mind."

Wang Lilong hit the snake with a stick: "What happened to the patient just now?"

Zhou Mo: "It should be Syndrome X."

Wang Lilong: "Syndrome X?"

After searching in my mind, I realized what kind of disease it was.

Wang Lilong: "Are you sure it's the disease?"

Zhou Mo nodded: "The color ultrasound can see the blood vessel flow velocity, and the flow velocity of a certain section of her coronary artery is obviously a bit worse..."

After finishing speaking, go back to the duty room and fill in the admission, case, first journey...

Wang Lilong stood there blankly.

"Coronary blood flow velocity... speed measurement?"

"how can that be?"

"Isn't this a difficult knowledge point for color Doppler ultrasound?"

at this time,

Mr. Chen of the B-ultrasound came in quickly from the west district with a portable color Doppler ultrasound, which was similar to a large laptop.

"Hey, little dragon..."

"Ms. Chen...Mr. Chen, you are..."

"There is a patient who wants to have a B-ultrasound test..."

"Can I go with you to observe and learn?"

"Okay... let's go..."

quickly,

Wang Lilong followed Teacher Chen to one of the wards, bed No. 3.

This is a patient with an enlarged heart.

Wang Lilong watched Mr. Chen press the buttons back and forth, and the probe kept dangling around the patient's precordial area.

blah blah~~~
cropped quite a few images...

high speed!

Wang Lilong: "........."

Skull pain.

Completely incomprehensible.

Not to mention studying.

Two minutes later, the color ultrasound examination was over, and Mr. Chen told the doctor in charge of the examination results.

Wang Lilong was beside him, pretending to study hard.

"Let's go, it's done..."

B-ultrasound teacher Chen left the ward with the color Doppler ultrasound in his arms.

Wang Lilong followed.

"Teacher... can I ask a question?"

"what?"

"Is it difficult to learn B super?"

"B-ultrasound is easy to get started. As long as you are proficient in anatomy, it is not difficult to get started with black-and-white B-ultrasound. You are an eight-year Ph. replied.

Wang Lilong thought of Zhou Mo.

"Then... what about the color ultrasound?"

"Color ultrasound is an upgraded version of black and white, it will be much more difficult, and even more difficult is the small organs..."

"What if we need a color Doppler ultrasound to measure the coronary artery?" Wang Lilong asked.

"Measurement of coronary artery... This is very difficult, even for small organs, let alone blood flow... Without three or four years of special research, it is difficult..."

Mr. Chen didn't say a word. These three or four years are based on countless operating experiences in the B-ultrasound room.

For example, in the Department of Cardiology, he has not done so many cases, and he is only able to master this skill now, and he is not very accurate in many cases.

"Three or four years?"

Wang Lilong lost his mind for a moment.

He thought of his own rhetoric: "Give me 3 days... no, 2 days, I will definitely learn the B-ultrasound machine!"

Now it seems that it is a joke!

.

(End of this chapter)