This Doctor is Great

It took more than an hour to assist the nurses to go through the admission procedures for the 28-bed patients.

The next step is to check the room.

Thoroughly understand the entire situation of the patient.

This patient is a patient that Dr. Huang Li met when he was in the outpatient clinic.

After diagnosis, it is determined that it is aortic stenosis, and it is also calcified aortic stenosis, that is, the aortic valve, which has a certain degree of calcification, resulting in a series of symptoms.

Zhou Mo picked up the splint paper, with a pen in his chest, got up and went to the ward to prepare for rounds.

"Zhou Mo, are you going to the ward round? That new patient?"

"Yes."

"Take me one."

Huang Yiming was stimulated by being at the bottom last week. As a member of the Xueba, he has enough diligence and hard work, and also has his own pride.

Bottom?

He never made it to the bottom!

So he cut off the black silk, determined to study hard, especially with Zhou Mo, he could ask Zhou Mo a lot of questions without fear to enrich his knowledge.

ding dong~~~

"Brother, are you going to eat western food tonight? I brought this... Mesh 230·jpg"

Gulu~~~

Huang Yiming swallowed.

The bone-scraping steel knife, the knife wounds the hero's waist!

"No, no, no time tonight..."

"Ah? Well... Come on, Ming! You are the best!"

"You...really wonderful...not at all like those coquettish bitches..." Huang Yiming was moved, feeling that his girlfriend was really understanding.

It is said outside that women are hypocritical, high above, and want men to lick dogs. Now it seems that women are not so bad.

"Okay, I'm going to check the room..."

"Hey ah~~mua~~~ Come on!!"

Not far away, at the nurse's station, Chen Xiaoyun smiled, and then replied to a friend's WeChat message: "If you are free at night, make an appointment!"

……

bed number 28,

Zhou Mo and Huang Yiming came to the hospital bed.

"28 beds, Zhang Yan..."

The patient Zhang Yan, male, 45 years old, is slightly fat, with a huge rosacea, which is very conspicuous and red. I don't know if he drinks often.

"Hello, doctor!" Zhang Yan and his wife greeted him cautiously.

"I'm your doctor in charge of the bed. My name is Zhou Mo. You can call me Doctor or Doctor Zhou in the future... Now I'm here to learn about your situation..."

"Okay, okay... Doctor, please ask..."

"Okay... You were admitted to the emergency room because of a dizziness. In the end, a CT scan of the brain was performed, and no problems were found... Then I felt that there was a problem with breathing, so I went to the cardiologist... Right..."

"Yes yes yes..." The patient nodded again and again.

"According to the diagnosis given to you by Dr. Huang, who helped you see a doctor in the outpatient clinic, the disease you suffer from is called "aortic valve stenosis"..."

Here, briefly explain what "aortic valve stenosis" is:

The blood circulation of the human body is as follows:

Systemic venous blood --> right atrium --> right ventricle --> pulmonary artery (oxygen) --> pulmonary vein --> left atrium --> left ventricle --> aorta --> whole body...

Aortic valve: It is the door between the "left ventricle" and the "aorta".

Just can't get in!

Prevent the backflow of blood in the aorta!

The so-called "aortic valve stenosis" is a disease that causes stenosis.

The manifestations are: when opening, the opening is not large enough (there is stagnation)! When closing, the closing is not tight enough (there is back flow)!

There are three main reasons:

rheumatic heart disease

congenital deformities

Senile aortic valve degenerative disease

or something else...

Zhou Mo took a look at the patient. He was only in his 40s, so senile aortic valve degenerative disease should not be considered.

Zhou Mo: "Do you have a history of rheumatism?"

Patient Zhang Yan: "No..."

Zhou Mo: "Have you ever had a rheumatism test before?"

Patient Zhang Yan: "No..."

Zhou Mo nodded, and then said: "Because aortic valve stenosis is caused by rheumatism, many of them are caused by rheumatism, so you need to do a rheumatism immunization test... After all, you came to our hospital to be admitted, and you also wanted to find the cause. Then cure it, right?"

There was nothing wrong with what Zhou Mo said, so the patient's wife said:

"Doctor, do whatever test you say you want to do!"

Zhou Mo hurried to save his life: "I don't mean to do any inspections as I say, but to do whatever inspections need to be done according to the condition..."

The patient's wife laughed awkwardly.

Zhou Mo continued to ask: "Did you ever feel chest tightness, chest pain, etc. when you were a child? Or family history..."

The patient shook his head: "No..."

Congenital is excluded.

"Have you been hospitalized before?"

"No, I have always been in good health..."

"I have high blood pressure, right... 5-year history of hypertension..."

"yes……"

"it is good……"

Zhou Mo asked some more questions...

I'm thinking about:

What are the symptoms of aortic valve stenosis?

"I read your medical records, and there have been several times when my heart suddenly suffered severe pain..."

"yes……"

This should be angina.

Aortic valve stenosis, why is there angina pectoris?

The reason is the insufficiency of the aortic valve opening (the opening is not as large as the opening when it is healthy) -> the pumping is not strong enough, and a large amount of blood is retained in the left ventricle -> the left ventricular pressure is too large -> the left ventricle is enlarged - -> Compression of the coronary arteries -> Insufficient oxygen delivery in the coronary arteries -> Angina pectoris occurs.

(Coronary Artery: Coronary arteries surround the heart and are responsible for supplying blood to the heart.)

"Your chest, when does it usually happen?"

"daytime……"

"Do you work during the day?"

"Yes~www.readwn.com~ I work."

"Does it mean that every time you have chest pain, you are more tired?"

"This..." The patient recalled, "It seems, probably... it should be..."

Zhou Mo nodded, and wrote on the paper what was suspected to be "exertional angina pectoris".

In addition to angina pectoris, aortic stenosis will also cause syncope and amaurosis.

The reason is that the left ventricular pressure is too large -> the left atrium is overloaded -> left heart failure -> blood supply problems -> insufficient oxygen supply to the brain -> syncope, amaurosis.

The reason why the patient was admitted to the hospital was that he was sent to the emergency room because of sudden syncope. After he recovered, he went to see a cardiologist and was admitted to the hospital today.

So it can be confirmed that the patient has this symptom.

Next, Zhou Mo continued to ask:

"How's your breathing?"

Patient Zhang Yan: "I feel like I can't breathe. I always breathe slowly, otherwise it will be very uncomfortable..."

Zhou Mo nodded.

Difficulty breathing is also one of the symptoms of aortic stenosis.

The reason is that the left ventricular pressure is too large -> the left atrium is overloaded -> leading to pulmonary venous hypertension and pulmonary capillary hypertension -> pulmonary congestion -> dyspnea.

so far,

"Difficulty breathing"

"Angina"

"Syncope"

All three are there.

They are the classic triad of aortic stenosis.

but,

Whether it is aortic valve stenosis or not, we need to continue to make more careful diagnosis.

……

ps: The rich lady has been deleted...

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