Gou is practicing medicine in the clinic

Chapter 68 The Combination of Valvular Insufficiency and Diarrhea
It's kind of like doing the math.

When I first learned, I could only do simple addition.

Later, I learned subtraction, even multiplication, and division, and I can do some comprehensive problems.Think comprehensively from multiple angles and calculate comprehensively.

This is a dramatic improvement in diagnostic thinking skills.

There seems to be only one level difference between the attending doctor and the resident doctor, but there is a huge gap in clinical ability and diagnosis and treatment level.

The attending physician can stand alone, but the resident physician still has a strong dependence.

Even senior resident physicians still need to consult with superior doctors all the time in clinical diagnosis and treatment. It is difficult for them to complete independently when encountering cases with slightly higher risks or difficult diseases.

Under normal circumstances, the attending physician can already solve problems for the chief physician or the team leader in the ward.

Only some particularly difficult questions need to be consulted with the chief physician.

In most cases, even for the rescue of patients, the attending physician can independently lead the residents, trainees, and interns under him, and then cooperate with the nurses to complete the rescue task.

At this moment, Li Jingsheng has preliminarily possessed the level and ability of attending in the field of cardiovascular medicine.

Of course, it is not enough just to have a good diagnosis, and the efficacy and pharmacokinetics of the medicine must also be improved, so as to truly have the ability of diagnosis and treatment of the main medicine.

At present, it only has the diagnosis ability of the attending level.

"The patient's valvular insufficiency is definitely not congenital. Because I have asked just now, the patient has had a physical examination and has never had a heart attack. He can hear a heart murmur, so it can be basically determined that it is caused by valvular insufficiency, but which valve is closed? Incomplete, still undiagnosed."

Damn, this medical skill upgrade is like a matryoshka game, it's too high.

You can gain a lot every time you level up, and you have a higher level, but you are still a little weak when facing some difficult and complicated cases.

His current doctor level is a senior resident doctor, which also leads to his medical skills can only be upgraded to the proficient level.

Because medical skills can only be higher than the level of doctors.

At this point, the properties panel is strictly limited.

This limitation is more reasonable.

Otherwise, it would be too scary for an intern to have director-level medical skills.

It feels like a baby carrying a big knife.

Even if the interns really have director-level medical skills, because the foundation is very weak, all aspects of medical knowledge have not yet reached the corresponding level, and they cannot be integrated.Therefore, it is difficult to develop the level of director-level medical skills.

The improvement of a doctor's level should be an improvement of a comprehensive overall ability, not just a single medical skill.

"It is impossible to determine which valve is insufficient by listening to heart sounds, so let's ignore this for now. Anyway, my purpose is to find out the cause, specific treatment, and diagnosis. The doctors in large hospitals will worry about it."

Li Jingsheng decided not to dig into the horns.

There are four heart valves, the mitral valve, tricuspid valve, pulmonary valve, and aortic valve.

Let's put aside the specific valve insufficiency for the time being.

"There are many reasons for valvular insufficiency, among which heart enlargement is more common in acquired heart disease."

Metaphorically speaking, a valve is equivalent to a door.

The heart is the house.

Due to some special reasons, the volume of this house has become larger, but the door is still the original size, which may cause the door to not be closed tightly.

There will be gaps.

The function of the heart is to pump blood, which is a kinetic energy station of the arterial blood and venous blood in the whole body.

Arterial blood is exported to all parts of the body, providing oxygen and nutrients.The venous blood is then recovered.

In this way, life is endless, forming the blood circulation of the human body.

Considering that this patient often stays up late to work overtime and sits for a long time, it is very easy to cause heart enlargement.

Because when a person is sitting, the load on the heart will increase.

As for someone who said, isn't the load on the heart greater when standing?You are wrong.

The gastrocnemius muscle on the calf is the second heart of the human body, and it works when a person walks.This can greatly reduce the burden on the heart.

Therefore, it is not only when a person is lying flat that the burden on the heart is the least.

When walking upright, the burden on the heart should be minimal.

This is a bit like a horse standing and resting, it always has one leg empty, and the four legs are constantly rotating.

The gastrocnemius muscle of the human calf can help the heart easily complete the recycling of distal venous blood and the distal delivery of arterial blood.This is equivalent to putting the heart in a relatively relaxed semi-rest state.

Doctors often advise everyone to exercise more, which is the reason.

Of course, the benefits of exercise are not limited to this one.

If office workers, especially those who sit in the office, need to sit for a long time, there is one of the simplest ways to prevent the occurrence of lower extremity venous thrombosis.

That is toe hooking.

Hook your toes back hard.

This may pull the ligaments at the beginning, which is a bit painful, but as long as you can persist in doing this action, it will be very good for your body.

"The patient is likely to have an enlarged heart and then cause valvular insufficiency, which is why the abnormal heart sound occurs. But in theory, valvular insufficiency will not cause diarrhea symptoms..."

Li Jingsheng thought about it, and felt that although the patient had diarrhea and heart valve insufficiency at the same time, the two were not related.

There should be no danger for now.

Only the patient mentioned that the abdominal pain shifted upwards.

This again has to make people vigilant.

"Diarrhea causes pain in the lower abdomen and middle abdomen, which can usually be relieved on its own. As long as there is no intestinal obstruction or perforation, most of them will not be dangerous. But if it is pain in the upper right abdomen, you must consider whether the appendix is ​​inflamed. If it is pain in other parts of the upper abdomen , It may also be a problem with the ascending colon. But this patient clearly described twice that there is a dull pain in the left chest."

Li Jingsheng frowned in thought.

The patient held his stomach tightly, with a painful expression, and was about to be unable to hold back, mainly worrying about pulling on his body.

If someone had filmed this scene, it would be quite hilarious.

But behind this, a doctor in a small clinic is doing his best to save a life.

Carefully investigate possible potential dangers.

"Is there chest tightness?"

Li Jingsheng asked the patient.

"No...can you please give me some antidiarrheal medicine quickly, I have to go home and go to the toilet."

The patient urged with some embarrassment.

"I have a toilet here. If you are in a hurry, you can go to solve it at any time. I always feel that your chest pain symptom is very strange, and it may be extremely dangerous. It's just that I can't think of what is wrong for a while, so give me a little more time .Even if you don't buy medicine from me, I can help you eliminate some potential dangers, which is also beneficial to you."

Li Jingsheng had no choice but to try to appease the patient.

Sincere communication is conducive to mutual trust between doctors and patients.

It is often easier to communicate with these young people with higher education.

Because they are more capable of understanding.

The patient might not be able to hold back any longer. After thinking about it for about three seconds, he asked where the toilet was, and ran in, clutching his stomach.

Only one folded city daily was left, the current day's.

The report on the Sunshine Clinic and Li Jingsheng can be vaguely seen above.

Very few people subscribe to newspapers these days.

Some companies or public units have mandatory subscriptions.

Even so, newspapers are still declining and are being replaced by emerging self-media.

Because the types of news on self-media platforms are richer and more time-sensitive.

Many news events can be searched on the same day.

Formal newspapers, TV stations, and news platforms have strict review mechanisms, so the timeliness is inevitably much slower.

There is also the content, the same eulogy, ordinary people will get tired of watching too much.Some interesting and unusual little news are more in line with the tastes of ordinary people.

It was a great honor for Li Jingsheng's small clinic to be featured in the newspaper, but the publicity effect it brought was not as remarkable as expected.

However, its publicity effect should be relatively long-lasting.

It shouldn't be difficult to maintain the heat for at least ten days and half a month.

Li Jingsheng is looking forward to tomorrow's new health care medicines and tonics will continue to sell well after they arrive.

Rent is now the only mountain weighing on his head.

After glancing at the city daily that was folded into a rectangle, Li Jingsheng seriously thought about the cause of this patient again.

Now it is basically clear that the patient should have eaten unclean food, then contracted a virus or bacteria, and had diarrhea.

At the same time, due to staying up late and sitting for a long time, the heart enlarges and valve insufficiency occurs.

Why does diarrhea cause chest pain?
No cough or anything.

It's definitely not radiating pain.

Li Jingsheng thought hard.

Is it viral myocarditis?

The fatality rate of this disease is quite high, but as long as it is discovered in time and received regular treatment, it will generally not cause serious consequences.

This disease often occurs after catching a cold and is a serious complication after catching a cold.

Especially some office workers who lack exercise.

It's just that patients with viral myocarditis will have prodromal symptoms before the onset, manifested as fever, muscle soreness and so on.In the acute attack stage, patients may experience general fatigue, chest tightness, palpitations, chest pain, etc., and the symptoms will continue to worsen.

Although this patient also had chest pain, the symptoms were mild and mainly labor pains.

Therefore, the possibility of viral myocarditis can be basically ruled out.

If it's not this disease, what kind of disease could it be?

Li Jingsheng found that after his cardiovascular internal medicine diagnosis was upgraded to the proficient level, his level improved significantly.

He can clearly feel the great progress in the in-depth analysis and investigation of the cause of the patient.

It is completely different from before.

Chest pain, diarrhea, and it's also associated with valve insufficiency...what the hell is it?

He asked the patient that before diarrhea, there was no pain in the chest.

It was on the second night of diarrhea that I started to have a slight chest pain.Today is the third day, and the chest pain has obviously worsened.

He racked his brains and thought hard.

Suddenly, a flash of light flashed in my mind.

Valvular insufficiency is very harmful. In addition to causing regurgitation, deterioration of heart function, hemoptysis, chest pain, and syncope, the biggest hazard is virus invasion.

　Thank you two book friends, the rogue is invincible, book friend 20200404152938467 for your support, thank you very much.

　　
　
(End of this chapter)