This doctor is great

Chapter 86 Gallstone Heart Syndrome

"Did the B-ultrasound find anything?" Huang Yiming stretched his neck beside him.

He can't read B-ultrasound pictures.

Every time he watched Zhou Mo operate the B-ultrasound, he felt like a waste.

"I found gallbladder stones." Zhou Mo said.

"Huh? Gallstones?"

The patient Liu Mo and his wife were shocked.

They just came to check for heart disease, why did they suddenly find gallbladder stones?

They were a little hard to accept for a while.

"No, I don't feel anything at all." Liu Mo said in disbelief.

Zhou Mo: "Then have you ever felt nauseous or nauseous after eating greasy food?"

Liu Mo thought for a while, and finally nodded: "Indeed... I didn't pay attention to it before, I always thought it was a bad appetite."

Zhou Mo: "Gallstones may cause nausea."

Now Liu Mo gave up!
beside,

Huang Yiming was thinking.

"Gallstones? Could it be gallbladder syndrome?"

More than 3 hours from noon today, there was Zhou Mo's reminder of pain in the liver area, so Huang Yiming went to check the literature on purpose, about the connection between the liver and the heart.

Then, he came across the literature on biliary heart syndrome.

If he hadn't investigated it, he probably wouldn't have been able to think of gallbladder-heart syndrome all at once.

Liu Mo and his wife were on the side, they could hear clearly, and asked anxiously.

"Doctor Zhou, what is Gall-Heart Syndrome?"

Zhou Mo looked at Huang Yiming: "You checked the literature, right?"

Huang Yiming patted his chest: "Checked."

Zhou Mo: "Can you memorize the guide?"

Huang Yiming: "Hehe... Brother Mo, you still want to trick me, there is no guideline for gallbladder syndrome..."

Zhou Mo laughed: "I didn't expect you to see it through... You can explain to them what gall-heart syndrome is..."

Huang Yiming raised his head.

After all, he is a master of SYS Ph.D., and his memory is still very strong. He can basically describe the contents of the documents he has read recently.

Patient Liu Mo and his wife looked at Huang Yiming.

Huang Yiming said: "Biliary-cardiac syndrome roughly means a disease of the biliary system, which causes heart symptoms."

"Because doctors don't know enough about this disease at present, there are no guidelines or norms for the diagnosis and treatment of gallbladder-heart syndrome, both at home and abroad."

“至于原因，目前多数学者认为心脏受T2～T8脊神经支配，而胆囊受T4～T9脊神经支配，二者在T4～T5脊神经处存在交叉。”

"When biliary tract disease occurs, neurofeedback may cross the T4-T5 spinal nerves, causing heart spasm and contraction, reducing coronary blood flow, causing myocardial hypoxia, and inducing angina pectoris and myocardial infarction. "

"Of course, there is another theory: it has nothing to do with the nerves, but a problem with the biliary system, which causes toxin absorption and water and electrolyte disorders, which leads to myocardial metabolism and electrical activity disorders, coronary spasm, and angina pectoris and arrhythmias."

Patient Liu Mo, wife, (reader): "..."

Confused.

The fruit on the tree, you and me under the tree...

Liu Mo coughed: "The doctor is really good... Then what should I do about my illness?"

Zhou Mo: "First of all, for the time being, further examinations are needed. Do a B-ultrasound or CT to see if there are really gallbladder stones. I suspect that gallbladder stones are the real culprit."

Because Zhou Mo's B-ultrasound results cannot be used as evidence, the patient needs to go to another department to find a professional teacher for B-ultrasound or CT. .

Liu Mo didn't know the seriousness of gallbladder stones yet, so he focused on gallbladder-heart syndrome: "If I really have gallbladder stones, how can I treat my disease?"

Zhou Mo: "Because there is no conclusion on what causes the gallbladder-heart syndrome, there is no special way to cure it. The only way is to solve the gallbladder problem, so that the gallbladder-heart syndrome can be finally cured."

Next,
Zhou Mo didn't say too much.

Because we have to wait for B-ultrasound or CT, the final conclusion will be made.

"B-ultrasound and CT are both available. B-ultrasound requires color Doppler ultrasound. The price is about 100, and CT is about 200. It is more accurate, and there are fewer people. The queue does not take so long. You choose one, and then I will make an appointment for you..."

Liu Mo's wife: "That's not right, Dr. Zhou, didn't you just have a B-ultrasound? Why do you need a B-ultrasound and CT?"

Zhou Mo: "This... because of my personal reasons, I can only help you look at it, but I can't give you a report, and of course I won't charge you money. If you want to diagnose, you need a formal report, so you have to go to the following The radiology department does CT or B-ultrasound."

The wife looked bewildered.

Do not understand.

"Choose B-ultrasound or CT?" Zhou Mo asked.

"CT... Thank you doctor."

"CT...Let me see (pick up the ipd and start flipping through it), I will be free tomorrow at 11 o'clock in the morning, I will make an appointment for you... By the way, don't eat greasy and spicy food, pay attention to your diet..."

"Okay okay."

……

Next, Zhou Mo went to the rounds of other beds.

……

17:00
After Zhou Mo checked the room, he returned to the duty room.

Huang Yiming came over excitedly.

"Brother Mo, I think the 36-bed patient can write a paper called "Clinical Diagnosis and Treatment of Gallbladder Syndrome"..."

This kind of rare patient can still form a good paper by summarizing the essence of the predecessors.

As a medical student, there are not too many papers.

Zhou Mo nodded: "Yes."

Huang Yiming: "Then I'll write it, and when the time comes, I'll add your name, Brother Mo, and you will be number one."

Zhou Mo thought for a while, then nodded: "Okay, I'll fix it for you then..."

Huang Yiming slapped the table excitedly: "Just do it!!"

Then excitedly ran to look through the information.

bell bell~~~~
At this moment,
Zhou Mo's cell phone rang.

Senior Brother Chen Bing: "Zhou Mo..."

Zhou Mo: "Brother, have you and your teacher arrived in Shenzhen?"

Senior Brother Chen Bing: "We arrived at the hotel and checked in. Now I have time to call you and ask about the three patients I handed over to you..."

Zhou Mo smiled and said, "There is nothing wrong with beds 34 and 35. I seem to have found the reason for Liu Mo, an ordinary patient with chest tightness and shortness of breath in bed 36."

"What? Found the reason?"

Senior Brother Chen Bing said in surprise, "Tell me, why?"

Zhou Mo: "My current diagnosis is gallbladder-heart syndrome... because the patient has tenderness in the upper abdomen, percussion pain in the liver area, and positive Murphy's sign, it is suspected to be cholecystitis. Gallstones were found, but the patient has not felt pain for a long time, so he did not realize that he had gallstones."

"The patient has symptoms of coronary heart disease + symptoms of biliary system disease, but has no history of coronary heart disease...this is the first clue."

"During the clinical examination, there was tenderness in the upper abdomen, no rebound tenderness, positive Murphy's sign, and no abnormality on cardiac auscultation...this is the second clue."

"Electrocardiogram and echocardiography didn't find any problems... This is the third clue."

"In short, this series of features all point to gall-heart syndrome."

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ps: Regarding the next department, gastroenterology is temporarily considered.

Gastroenterology involves the esophagus, stomach, small intestine, large intestine, liver, gallbladder and pancreas.

It is very complicated, and the derivation and evidence-based are very interesting.

Then it is more related to daily life, with a lot of common sense, and book lovers may have a sense of substitution when writing it.

Of course, the opinions of book friends will also be respected:
The opinions of the readers are:
1: Gastroenterology (this chapter says)
2: Other departments (described in this chapter)
3: Increase emergency (this chapter says)

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(End of this chapter)