This doctor is great

Chapter 99 Emergency Patient! (additional chapter 1)
have lunch.

The new weekly rankings that we love to see are announced.

There is no doubt that Zhou Mo won the first place. Whether it is clinical work, papers, or saving lives yesterday and Sunday, this week's first place is well deserved.

In other words, I won the first place in 3 weeks and the second place in 1 week.

Three week king?
What an embarrassing name!
"Brother Mo, awesome!" Huang Xinyi gave Zhou Mo a thumbs up while eating.

"Just get used to it..." Zhou Mo laughed.

"By the way, have you seen Xiao Tong?"

Zhou Mo looked around, but he didn't see Xiao Tong all morning.

Instead, his teacher, that is, the female doctor who was on the night shift yesterday and then ran home to turn off the computer, was typing at the computer. Zhou Mo had rarely seen her here before.

"No, I saw you this morning."

"I saw that he went to Professor Qi's office, and then followed Professor Qi out of the cardiology department. I don't know where he went."

"It feels like something happened..."

As medical students, everyone is still very concerned about the situation of their partners.

Huang Yiming found out that everyone didn't know about it, so he simply talked about what happened last night in the chat group of medical students.

"what?"

"Isn't it disgusting?"

Everyone was startled.

Unexpectedly, this kind of thing happened, which made these medical students feel sad.

Seeing the dull atmosphere, Zhou Mo said, "Eat! Eat! Don't think too much, maybe things are not that bad, trust Professor Qi."

The crowd nodded.

I continued to bury my head in eating, but my mood was still low.

……

In the afternoon, Zhou Mo went through the discharge procedures for Wu Xi, a 28-bed patient with high blood pressure and chronic kidney disease.

So the 28 beds were vacated again.

Zhou Mo had a hunch that he might have to delay getting off work today.

really,

16:08,

A new patient arrives.

For those who came from the emergency department, the doctor in the emergency department directly pushed them in on a flat car, and the patient saw that something was wrong.

The elderly patient, breathing oxygen, was sweating profusely, clutching his chest and whimpering in pain.

The family member was a son, who was looking at the patient anxiously, and was dragged by the nurse to go through the formalities.

……

Zhou Mo took over the patient and pushed into the ward.

Zhou Mo didn't have time to ask the patient, so he directly asked the doctor who came to the emergency room:
"How is the patient?"

The emergency doctor spoke very quickly and reported the condition:
"Patient, male, 69 years old..."

"Two hours ago, when I was moving the sundries, I had a sudden chest pain and then fell into a coma. 2 was sent to the emergency room..."

"No past medical history of cardiovascular..."

"After waking up, the patient complained of tearing chest pain in the precordial area, no radiating pain, accompanied by profuse sweating, accompanied by dyspnea, no nausea, vomiting, no dizziness, amaurosis, the chest pain persisted and could not be relieved..."

Focus: precordial tear pain!
"The result of the physical examination is that the body temperature is 35.4°C, the blood pressure is 185/101mmhg, the respiration is 18 times/min, and the blood oxygen saturation is 98%..."

"There is no special abnormality in the cardiopulmonary auscultation, the blood pressure of the left and right upper limbs is balanced, and there is no edema in the lower limbs..."

The emergency doctor quickly talked about the front and back, very capable.

Zhou Mo can also quickly grasp the patient's condition.

The focus is tearing pain, and the first reaction is aortic dissection.

Another is acute myocardial infarction!
There is no such thing as high blood pressure. It may be that the patient has not been tested for several years. He does not know that he has high blood pressure and thinks that he does not have high blood pressure.

"What about the electrocardiogram?"

"here."

The emergency doctor thought Zhou Mo was a bit young, but Zhou Mo's steady voice and confident appearance gave the emergency doctor a certain sense of trust.

"The electrocardiogram taken in the emergency room..."

Zhou Moyi took the electrocardiogram.

"Ok?"

This electrocardiogram is very special!

8+2!

This is a very classic type of ECG, which represents left main or similar left main lesions.

(Boss can make a picture?)
Left trunk, what is it?

The coronary artery has two main trunks, the left and the right, and the left trunk is called the left trunk, which shares two-thirds of the blood perfusion to the coronary artery.

So it is very important, known as the "widow's blood vessel"!
Once something goes wrong, sudden death at any time!
(Left trunk, big picture?)
Seeing this "8+2" classic left main lesion ECG, Zhou Mo's face suddenly changed.

"Sister Liu, help me push the lottery!"

Zhou Mo shouted.

The emergency doctor was taken aback.

I wipe?

This doctor can do B-ultrasound?
"Also, call Teacher Huang Li for me, and see if any director is here. There is an urgent patient here..."

"it is good."

Cardiology nurses are very reliable in many cases!
Calling someone over there, Zhou Mo recalled the documents related to the electrocardiogram that he had read while performing a physical examination on the patient.

"and many more……"

"There are a few papers that seem to say that 8+2 is not necessarily the problem of the left main body. There are also small parts such as acute pulmonary embolism, myocardial hypertrophy, microvascular disease, and acute aortic dissection. "[-]+[-]" ECG characteristics..."

"Could it be an aortic dissection?"

At this moment,
ta ta tao~~~~
Teacher Huang Li rushed over and rushed into the ward.

"what happened?"

"The emergency room teacher will help you introduce the condition, I will do an examination first..."

"it is good……"

Then the emergency teacher introduced the condition to Mr. Huang Li.

wow~~~
At this time, the bedside B-ultrasound was also pushed by the nurse.

First of all, it depends on the condition of the heart.

Zhou Mo quickly adjusted the parameters, applied the gel, and began to look at the patient's precordial area.

After 10 seconds,

Zhou Mo thumped!
Big trouble!

Severe aortic regurgitation!

The function of the aortic valve is that after the heart pumps oxygen-rich blood to the body, the aortic valve prevents this part of the blood from flowing back.

Its location is in the left heart.

It happens to be the area perfused by the left main coronary artery (which supplies blood to the heart).

It regurgitated, the biggest possibility is left heart necrosis!
In other words, the biggest possibility is that there is a problem with the left main trunk, and there is no way to supply blood to the left heart, resulting in massive myocardial necrosis of the left heart!

Therefore,
The patient in front of him must have had an acute myocardial infarction!
Also, another possibility is:
Aortic dissection!
After the aortic dissection appeared, it was torn down, all the way to the left trunk, and then destroyed the left trunk, causing acute myocardial infarction!
That is, aortic dissection combined with acute myocardial infarction!
Zhou Mo's mind turned wildly all of a sudden!

"How is it? Ultrasound B?"

At this time, Dr. Huang Li just got a complete understanding of the patient's situation from the emergency doctor.

His face was very serious.

Zhou Mo said quickly: "It's not good, the aortic valve regurgitation, and the amount is huge!"

"What?! Aortic valve regurgitation!"

Teacher Huang Li's face suddenly changed.

"Teacher, have you seen the 8+2 electrocardiogram?"

"I see!"

"So I think that there should be a problem with the left trunk, leading to a big problem with the left heart..."

After hearing this, Teacher Huang Li's face changed drastically.

He understands!

He didn't care about anything else, ran out of the ward, and shouted to the nurse's station:

"Hurry up, contact the director of intervention! There is a patient here, it's urgent!"

"Also contact the Cardiac Surgery Department for emergency consultation!"

Loud and urgent!
.

(End of this chapter)