I Can See Health

Chapter 76: Who diagnosed this?

  Chapter 76 Who Diagnosed This?

  The catheterization laboratory of the Department of Cardiology, Jinghua Second Hospital.

   A 10-year-old girl is lying on the operating table.

   Looking at the unfamiliar things in front of her, she closed her eyes tightly and told herself desperately to ignore the pain from her wrist.

   "Little girl, you are so brave! The operation is very fast, and it will be healed soon."

   The nurse in the catheterization lab was the first time I saw such a young patient.

   "Doctor Ren, the doctor in the upstairs ward is not mistaken, is such a young girl doing a cardiac angiography? Need a stent?"

   The nurse looked suspiciously at a tall surgeon beside her.

   "Yes, I read the patient's test sheet and electrocardiogram, the diagnosis of myocardial infarction should be correct." Ren Feng frowned, "However, this is the first time I have seen such a young patient."

  Ren Feng, the leader of the younger generation of coronary intervention in the Cardiology Department of Jinghua Second Hospital.

  Most of the difficult operations are done by him.

   This time, when he encountered a 10-year-old heart attack, he was also in charge.

   "I have seen the youngest patient with a myocardial infarction at the age of 18. That patient stayed up late for a long time, and smoked and drank alcohol, which ruined his body."

   "But this 10-year-old girl shouldn't have any bad habits."

   "I always felt that such a young girl would suffer too much if she had a stent." The nurse couldn't help sighing.

   "Look at the blood vessels first, and then make a decision." Ren Feng frowned, "If possible, try to do PTCA."

   Coronary interventional therapy in a broad sense includes the following:

   First, coronary balloon dilatation: PTCA in the narrow sense, can improve coronary stenosis or obstruction.

   Second, stent implantation: that is, PCI treatment, which can solve the problem of restenosis.

   Third, rotational coronary atherectomy: it can be used when the disease is very serious and the balloon cannot be opened.

simply put.

  PTCA is to use a balloon to expand the narrowed blood vessel, but no stent is implanted. Restenosis occurs in 40% of stenotic lesions after balloon dilation.

  PCI is balloon dilation followed by stent implantation to reduce the risk of restenosis.

  …

  10-year-old patients with myocardial infarction are rare.

   This case also attracted doctors and nurses from several other cath labs.

   Less than ten minutes.

   A group of doctors and nurses were already surrounding the entrance of Ren Feng's catheterization lab.

  Everyone is paying attention to the situation in the catheterization room.

   "Brother Ren has encountered such a difficult patient again!"

   "Hey, the risk of this kind of patient is too high. It's a problem whether to put a stent or what type of stent to put! Once something goes wrong, the patient's family will definitely ask the hospital for trouble!"

   "Yes, the most important thing is that the patient is too young!"

   A familiar voice suddenly came from behind.

   "You are all done with surgery? Are you free to watch here?"

   Everyone was stunned for a moment, and then they immediately went back to their catheterization room.

  Cao Zhiying had a sullen face, watching the backs of everyone leaving, and then turned his attention to Ren Feng's catheterization room.

   "Such a young patient?"

   Seeing the little **** the stage, Cao Zhiying frowned and suddenly became interested.

   He walked to the monitoring table in front of the catheterization lab, sat down, and opened the patient's medical record folder.

   "Chest pain, elevated myocardial enzymes, abnormal ECG, the diagnosis of myocardial infarction should be clear."

   "Mitral valve prolapse, intermittent claudication, tendon xanthoma..."

   Seeing these signs and auxiliary examinations, the corners of Cao Zhiying's mouth could not help but rise slightly.

  This case is quite interesting, and it is relatively rare.

   The little doctor in the ward upstairs, can you diagnose it?

  …

   At this point, Ren Feng in the catheterization lab has completed coronary angiography.

   "Ren Feng, look at the blood vessels of the patient in all positions."

   The director's voice suddenly came to mind in the catheterization room.

  Ren Feng looked back.

  Cao Zhiying was sitting on the monitoring station in the catheterization room outside, speaking to him through the microphone.

  Ren Feng nodded slightly, indicating that he understood.

   The contrast agent is injected to visualize the coronary vessels.

   "This is... extensive vascular stenosis!" Ren Feng couldn't help sighing, "It's difficult to do PCI now!"

  The lesions with extensive blood vessels are not vascular blockages in one or two places!

   "Ren Feng, let's expand it with a balloon. Don't put the stent first."

  Cao Zhiying's voice sounded again, and Ren Feng immediately performed the balloon dilation operation.

   After about forty minutes.

  Surgery completed successfully!

  Ren Feng walked out of the catheterization room, his back was sweating.

   Mainly because the patient was too young, Ren Feng was extremely careful in every step of the operation.

   Because once something goes wrong, the consequences are unimaginable.

   "Ren Feng, what kind of disease do you think this patient has?"

  Cao Zhiying asked suddenly.

   "Vasculitis, like Takayasu arteritis, ANCA-related vasculitis, etc."

   "Then what? No other ideas?"

  Ren Feng pondered for a moment, but still shook his head.

   "Director, this is all I can think of for the time being."

  Cao Zhiying's face sank, and he said solemnly: "Ren Feng, it is undeniable that your coronary intervention technology is very good. In the heart of the entire Jinghua Second Hospital, you can definitely be ranked in the first echelon."

  Ren Feng has no expression on the surface, but his heart is full of joy.

It is rare for    to be praised by the chief director Cao Zhiying.

   "But!" Cao Zhiying suddenly changed his words, "Do you want to be an excellent cardiologist, or do you just want to be a surgeon?"

   "This...of course it's a cardiologist." Ren Feng replied immediately.

  Cao Zhiying smiled and continued.

   "The most important thing for an excellent cardiologist is solid basic knowledge and good clinical thinking ability, instead of performing surgery day after day, just become a craftsman of interventional surgery!"

   "Look at you, I can't even analyze this case now. This disease should be familial hereditary hypercholesterolemia. I remember that there was a case of three areas in my heart before, so you forgot?"

   Hearing what Cao Zhixin said, Ren Feng immediately reacted.

   In his impression, there was indeed such a patient.

"Director, but this disease is a rare disease." Ren Feng said helplessly, "I can't think of it for a while, it should be normal, the doctors in the ward upstairs, as the first doctor, they didn't diagnose it at the first time. what!"

   While talking, Ren Feng clicked on the medical record on the computer.

   "Director, look, the doctor in the ward upstairs made the same diagnosis as me, and also considered myocarditis, cardiomyopathy, and vasculitis, which is similar to me!"

   However, when Ren Feng opened the latest ward round record.

   He was stunned.

  In the disease course record, it is clearly written:

   Diagnosis: familial hereditary hypercholesterolemia.

   The expression on Ren Feng's face was extremely wonderful.

Cao Zhiying on the side of    also showed a surprised look.

   The doctor in the ward upstairs, diagnosed so quickly? !

   His gaze moved down to the signature of the medical record.

  I want to see who diagnosed this case.

   (end of this chapter)

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