I Can See Health

Chapter 130 Contradictions!

At this time, "Professor Lu" was lying in front of the computer, writing down the course of the disease.

Sun Guoguo could no longer stop Lu Chen's behavior of "lacking" in the department.

We can only hope that as the school team selection approaches, he can "turn back the prodigal son"!

"Dududu..."

The phone vibrated slightly.

Lu Chen stopped typing, took out his cell phone, and took a glance.

I saw the information notification board, someone was in Aite himself.

The words Professor Lu came into view.

Lu Chen's face was not red, his heart was not beating, he opened WeChat and clicked on the group chat of Jinghua Electrophysiology Association.

"It turned out that I was asking for help to see an electrocardiogram."

When he scrolled up the chat history, he immediately saw two electrocardiograms appearing in the group.

Click on the ECG and zoom in!

Lu Chen started the picture reading mode.

The heart rhythms on both electrocardiograms were atrial fibrillation.

But the basal heart rate is different, and the shapes of other waveforms are also different.

The first electrocardiogram showed rapid atrial fibrillation with frequent ventricular premature episodes and ST depression.

The second picture is the electrocardiogram after treatment. It shows slow heart rate atrial fibrillation with extensive ST segment depression and T wave inversion.

After reading the electrocardiogram, Lu Chen still didn't reply.

Someone in the group started asking questions.

"Dr. Fan, do your electrocardiograms belong to the same person?"

"Yes, it's the same patient. After medication, the heart rate dropped, and then the electrocardiogram was reviewed!"

"Dr. Fan, please tell me more about the patient's medical history."

"Okay, the patient was admitted to the hospital with dyspnea, and we are considering heart failure... After the patient finished intravenously injecting cedilan, the symptoms of chest tightness and palpitation began to worsen..."

…

After intravenous administration of cedilan, the symptoms of chest tightness worsened

Lu Chen frowned.

Judging from the electrocardiogram, rapid atrial fibrillation combined with heart failure is an absolute indication for cedilan.

How come the symptoms worsened after intravenous administration of cedilan?

Everyone else in the group was silent for a moment when they saw Fan Zhiping's words.

After all, this side reaction is somewhat unreasonable.

Lu Chen didn't say anything for the first time.

He kept making deductions in his mind, trying to sort out the diagnosis and find the cause of the side effects of cedilan.

Although an electrocardiogram does not represent the diagnosis of any disease, sometimes do not underestimate the information contained in an electrocardiogram.

A small graphic, each waveform shape or the change of vector can reflect the state of the heart!

An excellent cardiologist is also an excellent electrophysiologist. He will look for clues to diagnosis from changes in details.

And now Lu Chen is embarking on such a path!

…

About five minutes passed.

People in the group started to speak one after another.

"The electrocardiogram shows ventricular premature disease and T wave inversion. The possibility of digitalis poisoning cannot be ruled out. It needs to be combined with the blood concentration of digitalis."

"Is it an allergy to cedilan that causes bronchial asthma, acute pulmonary edema, coronary spasm, and myocardial ischemia? The symptoms are relieved after diuresis, atomization and other treatments."

"Is it possible that the patient had hypokalemia, which then led to digitalis poisoning?"

"..."

Most of the public opinions focus on digitalis (silver) poisoning.

Lu Chen shook his head slightly. He didn't quite agree with the opinions of the doctors in the group.

Half a vial of cedilan intravenously, such a small dose.

Moreover, the patient did not experience gastrointestinal symptoms or yellow green pigment.

There should be no chance of digitalis poisoning!

For a while, no one in the group could come up with a conclusion.

Fan Zhiping has been paying attention to the news in the group to prevent missing some useful information.

How he hopes to see "Professor Lu" appear again!

I still remember the last time I was in the emergency department, it was Professor Lu who noticed hypokalemia at a glance!

Just when everyone was silent.

An ID with the prefix "Jinghua Electrophysiology" spoke.

Min Xiaobo from Jinghua Electrophysiology: "Dr. Fan, does the patient have lung disease? For example, chronic obstructive pulmonary disease?"

Fan Zhiping, who was paying attention to the group news, looked happy.

Although Professor Lu did not speak last time, Dr. Min, who wears the title "Jinghua Electrophysiology" on his head, should also be an expert from the Jinghua Electrophysiology Association!

Fan Zhiping quickly replied: "The chest CT results are out. The patient has chronic bronchitis and COPD."

Min Xiaobo, who was lying in the duty room, looked at the message that popped up on his phone and smiled slightly.

It was just as he expected!

He continued to reply in the group: "I am currently considering pulmonary heart disease. Perhaps patients with chronic obstructive pulmonary disease have hypoxemia. The use of cedilan increases myocardial oxygen consumption, thus aggravating the symptoms of myocardial ischemia."

Seeing Min Xiaobo's reply, Fan Zhiping frowned.

Even if you have pulmonary heart disease combined with heart failure, you won't have such side effects when using cedilan, right?

Fan Zhiping posted in the group: "Professor Min, I still don't quite understand what you mean."

Min Xiaobo, who was lying in the duty room, sat up.

After a pause, he began to organize his words and then posted them in the group.

"The patient's electrocardiogram showed rapid ventricular rate atrial fibrillation and frequent premature ventricular episodes when he was admitted to the hospital. Logically speaking, it is appropriate to use cedilan."

"However, the CT scan of the patient's lungs showed chronic bronchitis and emphysema. It should be that pulmonary heart disease was combined with right heart failure, and blood accumulated in the systemic circulation. At this time, after intravenous injection of cedilan, its cardiotonic effect caused the left heart to shoot out to the whole body. The blood is reduced, including the heart itself and the coronary arteries, and the blood ejected from the right heart to the lungs is increased. "

"But the left atrium is large and the left atrial pressure is high. The blood flowing back into the left heart is reduced, and the blood accumulates in the lungs. UU Reading www.uukanshu.net Invisibly, left heart failure develops, and chest tightness, chest pain, and dyspnea occur. Wheezing mainly in the expiration phase and rales in the lower lungs."

"These are all manifestations of left heart failure. After treatment with diuretics and asthma, the symptoms were relieved. The electrocardiogram was still atrial fibrillation and frequent premature ventricular episodes, but the ST segment depression and T wave inversion in the leads were common, indicating myocardial ischemia. Change."

"Personally, I think it is secondary left heart failure caused by intravenous administration of cedilan, resulting in insufficient coronary blood supply."

Fan Zhiping looked at this long speech and had to admire the experts from the big hospital!

Detailed enough!

Wonderful enough!

And it’s convincing enough!

A group of "flattering" people immediately appeared in the group.

"Like it, Professor Min's analysis really enlightened me!"

"Professor Min is amazing! He can analyze all this!"

"Thank you Professor Min for your advice!"

Lu Chen also had to admit that this was an extremely wonderful speech.

Without solid theoretical knowledge, there would never be such a clear-thinking judgment!

However, Lu Chen discovered a "flaw" in it.

According to Min Xiaobo, the patient not only had left heart failure, but also right heart failure.