This Doctor is Great

have lunch.

The new week's rankings, which are delighted to hear, are announced.

There is no doubt that Zhou Mo won the first place, whether it is clinical, thesis, or saving lives yesterday and Sunday, all of which make this week's first place deserved.

That is, I got 3 weeks first and 1 week second.

King of three weeks?

What an embarrassing name!

"Brother Mo, you are awesome!" Huang Xinyi gave Zhou Mo a thumbs up while eating.

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

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

Zhou Mo looked around, but did not see Xiao Tong all morning.

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

"No, I saw it 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 that everyone didn't know about it yet, so he simply said what happened last night in the medical student's chat group.

"what?"

"Too disgusting, isn't it?"

Everyone was startled.

Unexpectedly, this kind of thing happened, making these medical students feel a sense of sadness.

Zhou Mo saw the dull atmosphere and said, "Eat! Eat! Don't think too much, maybe things aren't so bad, you have to trust Professor Qi."

The crowd nodded.

Continue to bury your head to eat, but the mood is still low.

...

In the afternoon, Zhou Mo handled the discharge procedures for Wu Xi in 28 beds with hypertension and chronic kidney disease.

So 28 beds were empty again.

Zhou Mo had a hunch that he might be late for get off work today.

really,

16:08,

A new patient arrives.

Those who come from the emergency department are directly pushed by the emergency doctor, and the patient looks wrong.

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

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

...

Zhou Mo took over the patient and advanced to the ward.

Zhou Mo didn't have time to ask the patient, so he directly asked the doctor who came to the emergency department:

"What's the condition of the patient?"

The emergency doctor Ba La Ba La speaks very quickly to report the condition:

"Patient, male, 69 years old..."

"Two hours ago, when I was carrying the sundries, I had a sudden chest pain, and then fell into a coma. 120 was sent to the emergency room..."

"No previous history of cardiovascular disease..."

"After the patient woke up, he complained of tear-like chest pain in the precordial area, no radiating pain, profuse sweating, dyspnea, no nausea, vomiting, no dizziness, amaurosis, persistent chest pain that could not be relieved..."

Key point: tear pain in the precordial area!

"The result of the physical examination was that the question was 35.4°C, blood pressure 185/101mmhg, respiration 18 breaths/min, blood oxygen saturation 98%..."

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

The emergency doctor was quick to talk back and forth and was very capable.

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

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

Another is acute myocardial infarction!

If there is no high blood pressure, it may be that the patient has not been tested for several years and does not know that he has high blood pressure, thinking that he does not have high blood pressure.

"What about the electrocardiogram?"

"here."

The emergency doctor saw that Zhou Mo was a little young, but Zhou Mo's calm voice and confident appearance gave the emergency doctor a certain sense of trust.

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

Zhou Moyi took the electrocardiogram.

"Ok?"

This electrocardiogram is very special!

8+2!

This is a very classic ECG, which represents left main or left main-like lesions.

(Can you get a picture?)

Left Trunk, what is it?

The coronary arteries have two major trunks on the left and right. The one on the right is called the left trunk, and it shares two-thirds of the blood perfusion to the coronary arteries.

So it is very important, known as the "widow blood vessel"!

Once there is a problem, you can die at any time!

(Left trunk, big picture?)

Seeing this "8+2" classic ECG of the left main trunk lesion, Zhou Mo's complexion suddenly changed.

"Sister Liu, help me push the lottery!"

Zhou Mo shouted.

The emergency doctor was taken aback.

I wipe?

Does this doctor still have B ultrasound?

"Also, help me call Mr. Huang Li over, and see if there is any director here. There is a relatively urgent patient here..."

"it is good."

Cardiology nurses are very reliable in many cases!

Calling someone over there, Zhou Mo performed a physical examination on the patient while recalling the ECG-related documents he had read.

"and many more……"

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

"Is it possible aortic dissection?"

At this moment,

ta ta tao~~~~

Teacher Huang Li rushed over and rushed into the ward.

"What's wrong?"

"The emergency teacher can help introduce the condition, I'll do a check first..."

"it is good……"

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

wow~~~

At this time, the bedside ultrasound was also pushed over by the nurse.

First, look at the condition of the heart.

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

After 10 seconds,

Zhou Mo was stunned!

Big trouble!

Severe aortic valve regurgitation!

The function of the aortic valve is to prevent the backflow of this part of the blood after the heart pumps the blood containing oxygen to the whole body.

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 has refluxed, and the biggest possibility is that the left heart is necrotic!

That is to say, 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 a large area of ​​myocardial necrosis in the left heart!

so,

The patient in front of me must be acute myocardial infarction!

Also, there is another possibility:

Aortic dissection!

After the aortic dissection appeared, it was torn down, all the way to the left main trunk, and then the left main trunk was destroyed, causing acute myocardial infarction!

That is, aortic dissection with acute myocardial infarction!

Zhou Mo's mind turned wildly at once!

"How is it? Ultrasound?"

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 quickly said: "Not good~www.readwn.com~ The aortic valve regurgitation, and the amount is huge!"

"What?! Aortic regurgitation!"

Teacher Huang Li suddenly changed his face.

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

"I see!"

"So I think there should be a problem with the left main trunk, which caused a big problem in the left heart..."

After Mr. Huang Li heard this, his face changed greatly.

He understands!

He couldn't care less, ran out of the ward, and shouted to the nurse station:

"Quick, contact the director of intervention to come here! There is a patient here, it's urgent!"

"There is also contact with cardiac surgery, emergency consultation!"

It's loud and urgent!

.