This doctor is great

Chapter 84 The Unremarkable Puzzle-solving Patient

Seeing the little girl out of danger, Zhou Mo breathed a sigh of relief.

"How? Did you suddenly feel that you could become a hero?" Senior Brother Chen Bing laughed.

Zhou Mo blushed suddenly.

indeed,

Just now he was thinking that he would become a hero, stepping on colorful auspicious clouds, and save that little girl who was in crisis.

This may be every doctor's dream.

Every doctor wonders if he will suddenly encounter someone who is critically ill. As a doctor, he will stand up and win applause to satisfy the vanity of young people.

but,

This kind of thing is relatively rare, only when I went to eat with Huang Yiming last time, I saved a patient who suffered from cardiac arrest.

And this time, the mvp of the audience is the little girl's father!
Great!
Although not standard, the little girl was successfully rescued!

Here, applause should be given to the father of the little girl!
Heimlich first aid method and cardiopulmonary resuscitation are relatively important first aid methods in daily life. Many people should take the initiative to learn these two skills.

Maybe, one day, it could save a life.

……

the next day,
In the morning, Director Niu didn't come because he had something to do, so we didn't do the rounds in the group this morning.

Zhou Mo finished the ward rounds (Li Mei, a 29-bed patient with syndrome X, and Wu Xi, a 28-bed patient with hypertension and chronic kidney disease), and then began to follow Senior Brother Chen Bing to receive his patients.

34 beds, the patient is a conventional myocardial infarction, hospitalized for observation.

35 beds, the patient is hospitalized for observation after interventional surgery.

These two don't need to pay much attention. After Zhou Mo understood the situation in detail, he began to follow Senior Brother Chen Bing to bed 36.

36 bedside,

Zhou Mo observed the patient in front of him.

The patient is still young and strong, but his face is dull, tired and lack of energy.

Accompanying him on the bed was his wife, a more fashionable woman.

"Hello, Doctor Chen..." The patient and his wife greeted Chen Bing and Zhou Mo politely when they saw Chen Bing and Zhou Mo walk in.

Chen Bing: "This is Dr. Zhou, he will be in charge of managing your condition these two days..."

Zhou Mo: "Hello, my name is Zhou Mo. From now on, you can call me Doctor Zhou."

The husband and wife hurriedly said, "Hello, Doctor Zhou..."

Senior brother Chen Bing introduced this patient to Zhou Mo.

"His name is - Liu Mo."

"34 years old, male."

"Chest tightness and shortness of breath for two months."

"Then the day before yesterday, I was admitted to the cardiology department."

"When he was admitted to the hospital, I checked his body: his body temperature was normal, his abdomen was soft, his bowel sounds were normal, his heart sounds were normal, his lungs were normal..."

"Then, the day before yesterday, I did a routine blood test and myocardial enzyme spectrum for the patient, and found that all the indicators about the heart were normal."

"what?"

Zhou Mo was surprised.

The patient has been suffering from chest tightness and shortness of breath for 2 months. How could there be no problem with myocardial enzymes?

It doesn't make sense!

Even if it's a little bit higher.

Zhou Mo couldn't help asking, "Where's the electrocardiogram?"

Electrocardiogram is a must in cardiology.

Senior Brother Chen Bing: "I did an electrocardiogram, which reminded Dou Huan, but I didn't find anything special..."

The electrocardiogram is really all-encompassing, simple and complex, easy to get started, but difficult to master. Even a director with decades of experience may sometimes not be able to find out the real cause of a problematic electrocardiogram.

Zhou Mo: "Have you done any other checks?"

Senior Brother Chen Bing: "I went to Lao Chen and had an echocardiogram, but I didn't find any problems. There is no organic disease in the heart, and there is nothing wrong with ejecting blood..."

Zhou Mo: "What else?"

Senior Brother Chen Bing: "I also did a 24-hour dynamic electrocardiogram, and there were indeed paroxysmal sinus ailments, and several of the time points of occurrence basically matched the patient's symptom onset time... But, nothing can be seen."

Having said that, Senior Brother Chen Bing had a headache.

Because of this patient, nothing was found, but chest tightness and shortness of breath have been going on for 2 months.

Zhou Mo pondered.

This patient is really strange! !

Electrocardiogram, nothing found.

Myocardial enzyme spectrum revealed nothing.

Xin Chao, found nothing.

Dynamic cardiogram, found nothing.

Why does the patient have chest tightness and shortness of breath?

Is it a psychological reason?
Mental illness?
Zhou Mo was also at a loss.

However, the more he encountered such weird patients, the more excited Zhou Mo became.

The feeling of solving puzzles can make people intoxicated!
"Let me check you up..."

"Okay, please trouble Dr. Liu."

The patient Liu Mo looked at Zhou Mo gratefully.

He has been tormented by his own chest tightness and shortness of breath. He used to climb stairs and walked like flying, but now, climbing stairs is a painful thing, especially the house he lives in is a stair room without elevators. He lives on the 8th floor , It's just painful!
"I'm Dr. Zhou, not Dr. Liu..." Zhou Mo said speechlessly.

"Ahem... please trouble Dr. Zhou." Liu Mo apologized.

Zhou Mo began to do a physical examination for the patient Liu Mo.

The first is observation.

Patient Liu Mo's lips were not obviously cyanotic, that is to say, there was no hypoxia.

Cyanosis, in clinical medicine, is called cyanosis.

Simply put, the blood is deprived of oxygen.

To put it in a deeper way, the reduced hemoglobin in the blood increases, and when the color turns purple.

Then the cardiopulmonary auscultation, 3m came out, but Zhou Mo didn't hear any problems.

I measured my blood pressure. Although it is a bit high, it is not particularly high, it is normal.

Heart rate, 55 beats/min.

Nothing was found.

Because the patient's condition is quite 'normal'.

Senior Brother Chen Bing looked at his watch: "Okay, my time here is almost up, I have to pack up, you continue..."

Zhou Mo continued to lower his head to check without looking back: "Go..."

Senior Brother Chen Bing: "..."

I'm leaving, why don't you be polite, just wave goodbye.

What the hell!ruthless!
At this time, Zhou Mo was thinking about the patient's condition with all his thoughts.

too weird.

So exciting! !
"The patient has paroxysmal sinus slowness, do you want to do an atropine test?"

Atropine test is one of the commonly used methods to identify sick sinus syndrome (SSS). This method is simple and safe, and it is still widely used clinically.

Simply put, it is to compare the ECG before and after the intravenous injection of atropine to find the difference.

but!

Soon Zhou Mo shook his head again.

Injecting atropine is risky!
Because atropine is a cholinergic M receptor blocker, it can relieve the tension of the vagus nerve, and at the same time increase the excitability of the sympathetic nerve relatively, increase the electrical instability of the myocardium, and cause myocardial damage...

Therefore, there are certain safety hazards in the atropine trial, even for young patients without structural heart disease.

Zhou Mo generally doesn't consider this method.

Next,
Zhou Mo started to get started.

The chest cavity was checked, and the abdominal cavity was also checked.

just in case.

After all, there are thousands of human diseases, and there will always be some coquettish sluts who do not take the usual path.

Zhou Mo first listened to bowel sounds.

Bowel sounds: When the intestinal tube is peristaltic, the gas and liquid in the intestinal cavity flow along with it, producing an intermittent sound of air passing through water (or grunting), which is called bowel sounds.

Upon hearing it,
Well, bowel sounds are okay!

Periodic cooing.

.

(End of this chapter)