world famous doctor

Chapter 56
When Zhou Chen brought Yuan Lili back to the emergency room again, the male doctor with glasses had obtained the examination reports about Yuan Lili sent back from various departments on the computer.

He stared at one of the pictures uploaded back on the computer screen and was fascinated.

After the film is magnified, the high-signal blood pool and infarcted myocardium can be clearly seen so that people can recognize the inactive myocardium in the patient's heart cavity at a glance.

The male doctor with glasses made a comprehensive analysis, and his face gradually became serious.

"How could this be?"

The emergency doctor raised his head and took a deep look at Zhou Chen, completely bewildered.

He couldn't figure it out.

Why was Zhou Chen able to predict the condition of a patient with no previous medical history so accurately before she became ill?

coincidence?

No way.

It's really incredible.

The male doctor with glasses turned his attention to Yuan Lili. Looking back, it was understandable that the incidence of myocardial infarction was already high as Yuan Lili was so fat and she was pregnant.

Right now, the most important thing is to treat her in time to prevent hypotension, cardiogenic shock, or even death.

Zhou Chen went up to study with the male doctor in emergency glasses.

Zhou Chen pointed to the electrocardiogram and said, "I think Yuan Lili has a myocardial infarction with partial blockage of the coronary arteries."

As a professional emergency doctor with many years of experience, the male doctor with glasses was naturally able to tell at a glance that Yuan Lili had indeed suffered a myocardial infarction caused by partial blockage of the coronary artery.

The technical term is non-ST-segment elevation myocardial infarction.

However, he felt that there was absolutely no need to discuss it with Zhou Chen.

Zhou Chen is not a doctor in the hospital, so he can't give any constructive advice at all, staying here will only add to the chaos.

He glanced at Zhou Chen and scolded, "Stop talking so much that it affects my work, okay?"

Turning around, he went out, called a few nurses, and pushed Yuan Lili to the emergency room on the first floor with a push bed.

They first give the patient the most conventional treatment of airway patency and cardiac rhythm stabilization, as well as oxygen inhalation.

At the same time, the male doctor with glasses notified several doctors from the emergency department and doctors from the cardiology department to come for consultation and treatment.

When Zhang Jian passed by the door of the emergency room, Zhou Chen stood there and looked at him.

Zhou Chen asked, "Doctor Zhang, can I go in?"

Zhang Jian paused.

Since the last time Zhou Chen used endoscopic hematoma evacuation in the emergency room to treat the old lady surnamed Qian, Zhang Jian still had a lot of trust in Zhou Chen.

Without thinking too much, Zhang Jian nodded in agreement.

"Let's go, let's go together."

As the male emergency glasses doctor who was just on duty, he briefly described the patient's situation as quickly as possible:

"The patient presented with persistent pain in the precordial region without inducement in my clinic one and a half hours ago, accompanied by symptoms of sweating all over the body. After my further diagnosis, there was no abnormality in the auscultation of both lungs. Physical examination: BP140/100mmHg, consciousness clear……"

When he saw that Zhou Chen was also brought to the emergency room by Dr. Zhang Jian at this moment, he suddenly paused, feeling a little annoyed.

Who is this kid?

After a pause, the male doctor in glasses looked back at the ECG monitor and continued to describe:

"Heart rate 82, regular rhythm, ECG showed t wave avF lead pathological q wave, v4-6 inversion, troponin increased twice, cardiac electrocardiogram ultrasound showed inferior wall motion weakened, left ventricular ejection fraction 50% , decreased left ventricular function..."

Several cardiologists and emergency physicians had a brief discussion. After carefully evaluating the patient's condition and risk, they came to the conclusion that PCI percutaneous coronary intervention should be performed immediately.

"Has the patient's family members come?" Dr. Zhang Jian asked.

A female nurse went out and called a few times: "Is Yuan Lili's family there?... Yuan Lili's family?"

A tall and thin young man hurried forward.

"I, I am Yuan Lili's husband."

"Okay, you wait here, we will be on call later."

The nurse then turned around and entered the emergency room again, and replied to Dr. Zhang Jian, "Her husband is outside."

Zhang Jian nodded, turned around and went out, and saw a young guy fidgeting at the door.

"Are you Yuan Lili's husband?"

"It's me, it's me, what's wrong with my wife?" The tall and thin guy looked extremely anxious.

"She is now suffering from acute myocardial infarction and is in the emergency room. We are going to perform PCI on her..."

Dr. Zhang Jian and the tall and thin man briefly explained the risks and benefits of PCI, and handed him the informed consent form.

The tall and thin guy was in a daze, his legs softened, and he squatted down immediately.

"Are my wife and children going to be okay?"

"We are doctors, we will do our best to treat her, please sign quickly."

Doctor Zhang Jian urged.

The tall and thin guy tremblingly held a pen, wrote his name crookedly and handed it back.

After Zhang Jian returned to the emergency room, he nodded to the doctors.

"The informed consent form for the operation and the anesthesia have been signed, and the patient will be transferred to the interventional room immediately."

"Wait!"

In the crowd, an extremely discordant voice suddenly appeared.

This voice came from Zhou Chen.

In addition to Dr. Zhang Jian, there were two nurses at the scene. They had seen Zhou Chen perform endoscopic hematoma evacuation in the emergency room to treat the old lady Qian, so they were particularly impressed by Zhou Chen.

In the eyes of the male doctor with glasses in the emergency department, Zhou Chen was like a shit-stirring stick.

The male doctor with glasses stepped forward and looked directly at Zhou Chen: "You young man, why did you come to our emergency room? Get out quickly, this is not the place for you to stay."

Turning around, he waved at the nurse: "Quickly transfer the patient to the intervention room."

Zhou Chen came to the emergency bed step by step, looked down at Yuan Lili, and said:

"I want to ask everyone, is PCI necessary?"

No one answered his question directly.

"Who are you? Why are you here?" A doctor asked.

"I think that now give her oral aspirin, intensive drug treatment first, don't just do PCI every now and then, maybe let me give her a try of thrombolysis."

When Zhou Chen said that, he had some considerations.

Because once external intervention and PCI surgery are performed, plaque stability will be completely destroyed, and patients will need strict and formal long-term dual antiplatelet therapy.

Generally speaking, in principle, PCI should be used when it should be used, and it should be used as much as possible, and there are many contraindications.

The most important thing is that during the operation, there is also the risk of cardiac arrest.

Moreover, after PCI, postoperative restenosis and late vessel loss may occur.

There is also a situation where excessive medical treatment occurs from time to time. Some doctors, in order to make money, will do whatever it takes to install a ten-thousand-yuan stent during PCI surgery, and they can receive a kickback of 2000 or more.

What's more, for an imported stent, the doctor can receive tens of thousands of yuan in rebates.

There is a story among interventional doctors:
A patient was hospitalized and had two stents installed. When he was discharged from the hospital, the doctors learned that the patient was a coal boss, and they immediately regretted it.

If I had known that this patient was so rich, I should have installed more stents for him.

Still no one paid attention to Zhou Chen.

Instead, a doctor looked at Zhou Chen and whispered to a nurse:

"Call the psychiatric department and ask, is there a patient who has come out?"

Zhou Chen continued with a loud voice:
"I have to remind all the doctors that when the contrast agent allergy test was performed just now, the patient was found to be positive, and have you considered that she is a pregnant woman, and the fetus in her womb cannot be exposed to radiation? Dare to perform PCI on her, isn't it too ambitious?"

"Have an accent, get praise +22"

(End of this chapter)