When doctors have a simulated operating room

The patient was diagnosed with heart failure.

Before, Zhang Yi relied on his naked eyes to see the symptoms, and thought that it was just a symptom of heart failure.

Unexpectedly, the electrocardiogram results showed infarction!

There is indeed a difference between what the naked eye sees and what the machine checks.

Although the difference is not too big.

However, it is a bit too broad to look for the cause of the disease based on ST segment elevation.

It is a heart problem, yes.

But in heart disease, there are several reasons for ST segment elevation, such as fulminant myocarditis or acute myocardial infarction, aortic dissection, and even acute pericarditis, which may cause the symptoms of the patient in front of him.

Different diseases have different treatments.

If the judgment is wrong, the treatment will also be wrong.

In this way, the patient will miss the golden treatment period.

Especially for patients with urgent conditions!

One mistake and the person is dead!

So we have to make a diagnosis quickly!

After thinking for a while, Zhang Yi did the elimination process in his mind.

First of all, aortic dissection is impossible, because the dissection is very obvious, but Zhang Yi looked carefully and did not find that the patient had dissection.

Secondly, pericarditis must also be ruled out. Pericarditis is accompanied by effusion, and the patient did not have effusion.

So the most likely ones are myocarditis and myocardial infarction.

Zhang Yi decided to treat it as fulminant myocarditis first.

In addition to improving cardiovascular power and circulating blood volume, the treatment of fulminant myocarditis also requires one of the three measures of anti-infection, anti-virus, and improving immunity.

Because the main causes of fulminant myocarditis are these three.

We all know that exercise can cause the heart to beat faster, promote blood circulation, and increase lung capacity.

This is a good thing.

But remember not to exercise a lot after catching a cold, because the pathogens are already in the blood at this time, and exercise speeding up the heartbeat will give the pathogens an opportunity to take advantage.

The pathogens will take this opportunity to continuously erode myocardial cells and damage the myocardium.

This leads to myocardial necrosis and dysfunction.

This disease has a very rapid onset, and the sudden death rate in the acute phase is as high as 80%.

It is especially common in adolescents and young adults.

(So if you have children at home, especially those who are prone to colds, try not to let your children exercise before the cold is healed. It is better to be safe than sorry.)

There is no time to waste in the acute phase.

"Add another set of acyclovir and metronidazole mixed with 100 ml of saline to another channel."

"Okay!"

Acyclovir and metronidazole are antiviral drugs and anti-infective drugs respectively.

Directly take two-pronged approach, and then use cardiotonic drugs, I hope this person can survive.

Just at this time, Chen Fang came with a doctor from the ultrasound department.

Seeing that the patient was not in a good condition, with shortness of breath and cyanosis, the doctor from the ultrasound department did not delay and immediately examined him.

The results of the examination are as follows:

Ultrasound findings: The size of each chamber is normal, the aortic root is not wide, the main wave is high, and the dicrotic wave is clear. The main valve is thin and can be opened and closed. The mitral valve is thin, the anterior leaflet is double-peaked, and the posterior leaflet is reversed. The ventricular septum is not thick and moves in the opposite direction to the left ventricular posterior wall. The ventricular septum and ventricular wall activity are diffusely weakened in the fasting state...

Ultrasound prompts: 1. The ventricular septum and ventricular wall activity are diffusely weakened; 2. Mild regurgitation of the tricuspid valve, mitral valve, and pulmonary valve; 3. Left ventricular systolic dysfunction.

As soon as I saw the test results, the diagnosis of myocarditis became more solid.

Fortunately, there was no arrhythmia.

In this case, arrhythmia cannot be saved even with medication.

The door of the emergency room was opened, and Xiao Li, the doctor who had just gone out to hospitalize the patient, came back.

At the same time, he handed the phone to Zhang Yi:

"Doctor Zhang, this is a call from a family member. No matter how I explain, it doesn't make sense. Please talk to her."

Zhang Yi covered the receiver and asked in a low voice: "Male or female? Is it the patient's wife?"

Xiao Li nodded: "Yes, it's his wife."

After Zhang Yi glanced at the patient lying on the bed, he gave Chen Fang a look before going out to answer the phone.

"Hello, how are you? I'm Zhang Yi, a doctor at Union Hospital."

The person on the other end of the phone was indeed a woman, but her voice seemed very arrogant.

"What doctor or not! Where's Zhao Xiaolong? Tell him to answer the phone quickly! Stop pretending, or I'll kill him with a knife!"

Hearing this, Zhang Yi couldn't help but frown.

Who is this?

Is she really the patient's wife? ?

"That... don't get excited, I'm really a doctor at Union Hospital, Zhang Yi. Have you heard of Zhang Yi? He was just on the hot search the day before yesterday, the one who sutured the eggshell membrane, do you know? ?

That's me."

Alas.

No way.

Zhang Yi, the family member who couldn't communicate, could only bring up his own name~

Sure enough!

Young people are all surfing the Internet, even if they don't know, they have more or less heard of it.

"Zhang Yi? ? Are you the awesome doctor they said?"

"Yes, yes, it's me. Your husband Zhao Xiaolong is now in the emergency room of our Union Hospital. His condition is very bad. The preliminary examination results show that he may have myocarditis or myocardial infarction. Can you come to the hospital as soon as possible? ? We will discuss the specific condition and treatment with you in person."

"Hahaha!"

There was a sudden burst of laughter on the other end of the phone!

"You are Zhang Yi? ? ? Hahaha, is it true? ? I've seen your photo, you are a handsome guy, do you have a girlfriend? ? I'm about to divorce Zhao Xiaolong, please consider me~"

Zhang Yi:...

Zhang Yi closed his eyes, and the curse in his heart was on the tip of his tongue, but he swallowed it.

Forget it.

I'm a doctor, I have to talk and communicate well~

Can't be angry~!

Zhang Yi took a deep breath and gritted his teeth and said: "Sorry, I'll tell you again, Zhao Xiaolong is in a very bad condition! You are her family member, you should come to the hospital as soon as possible, otherwise you may not even see him for the last time..."

Beep beep.

Beep beep.

Beep!

No wonder the patient was so resistant when he heard the word "family member". He sat up in his dying dream, and didn't want his family member to come to the hospital even though his consciousness was blurred.

He thought this person didn't want his family member to worry.

Unexpectedly, he didn't want his family member to come and further aggravate his condition...

Hey~ What's going on!

Helplessly, Zhang Yi, who failed to communicate, had to take his phone back to the emergency room.

Just then, the doctors in the office also came to the emergency room for rounds.

Kang Yanming walked up to Zhang Yi with a team of people:

"What's wrong, Zhang Yi? Is this patient newly admitted?"

Zhang Yi nodded: "Well, he came to the hospital with unexplained abdominal pain for more than 3 hours, and worsening chest tightness and shortness of breath. They were found by a few foreigners. But the situation is very bad now. The ST segment is elevated over a large area, and there are signs of infarction. This is the result of the echocardiogram. Please take a look. "

Kang Yanming took the examination form and looked at it carefully.

His expression became serious: "Did this person say why he had abdominal pain? Did he do an abdominal ultrasound? What are the results of the blood gas analysis? Are there any other tests? Where are the family members? Are they here?"

"No, when I saw him, I couldn't communicate normally. I used lidocaine first, so the patient has no signs of ventricular fibrillation now. The family members have been contacted, but they don't seem to be willing to come."