I Can See Health

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Sun Guoguo has a relatively stable personality. When dissection cannot be completely ruled out, she will not easily let the patient undergo interventional surgery.

"Let's do it at the same time!"

After thinking for a few minutes, Sun Guoguo decided to contact the cath lab to prepare for the interventional surgery.

On the other side, they contacted the CT room and said that patients with chest pain should undergo enhanced chest CT scan to rule out the possibility of aortic dissection.

"Lu Chen, you will push the patient to do enhanced CT later. If the results are OK, then we won't go back to the ward and push the patient directly to the cath lab."

"Okay, senior sister." Lu Chen nodded.

This is currently the safest way.

However, it was an enhanced CT scan and an interventional surgery. The patients and their families were a little frightened by this posture.

Sun Guoguo directly communicated the condition with the patients and their families, obtained informed consent for all operations, and signed their names.

Afterwards, Lu Chen pushed the patient to the CT room.

…

The patient's brows did not relax during the whole journey and were furrowed.

When he arrived at the door of the CT room, the patient's chest pain worsened again!

"Just give me a dose of morphine." Lu Chen said to the accompanying patient.

"Okay." The nurse nodded.

A morphine injection was prepared in the rescue box in advance, and the nurse directly administered 4 mg of morphine intravenously for analgesic treatment.

Morphine injections are strictly controlled anesthetic drugs.

Regardless of whether the patient has a myocardial infarction or aortic dissection, excessive pain is not conducive to recovery from the disease.

In particular, it might increase the oxygen consumption of the heart, so Lu Chen decided to give morphine injections.

Because we had communicated with the CT in advance, as soon as we arrived in the CT room, the injection for angiography was done, and the examination was immediately arranged.

The enhanced CT scan was completed very quickly.

Lu Chen took a quick look and found that there was no obvious dissection in the thoracoabdominal aorta. It was probably not chest pain caused by aortic dissection.

The rest is acute myocardial infarction!

On the ward side, after the enhanced CT is completed, the image results are directly uploaded to the medical record system.

In the ward, Sun Guoguo has also seen the CT images.

"If you don't see the dissection, then push it directly into the cath lab. I contacted the doctor in the cath lab." Sun Guoguo also called Lu Chen and asked him to send the patient directly to the cath lab for emergency interventional surgery.

Now Lu Chen felt completely at ease and stepped up his pace to push the patient directly to the cath lab.

…

It took less than 10 minutes.

Lu Chen handed the patient over to the doctors in the cardiology department's cath lab.

The cath lab once again sent doctors out to communicate with the family members.

There is no need to communicate too much during surgery. Only when communication is in place can doctor-patient disputes after surgery be avoided as much as possible.

The doctor in the cath lab spoke very quickly, regardless of whether the family member understood it or not, and directly put the consent form in front of her.

"Sign it."

The patient's wife also got a general idea. The general idea is that this stent is effective, but expensive.

And there may be problems, but if you don’t do it, you’re dead.

"There's nothing more to say, I'll sign." The patient's wife picked up the pen, gritted her teeth, and her fingers were trembling.

After signing the surgery communication, the surgery began.

but……

The accident came as expected.

…

Cardiology catheterization room.

Ren Feng, an interventional cardiologist, stared at the screen and used X-rays repeatedly, but he couldn't see any obvious stenosis or blocked coronary arteries.

Several large blood vessels are still very smooth!

What's going on?

Ren Feng on the stage was sweating on his forehead, and he started to curse, "tmd, I didn't see any abnormalities on the chest CT scan."

After stepping down, Ren Feng pulled out the CT film he had just made.

After repeated checks, there was indeed no aortic dissection!

Combined with the current coronary angiography, there is no myocardial infarction.

nothing!

The patient has severe chest pain, which is obviously a problem!

But no problem was found, this is no joke.

Fortunately, the patient's chest pain seemed to have improved at this time, and his brow relaxed a little.

Otherwise, all the interventional doctors in the cath lab will really be driven to death.

"End the operation." Ren Feng said to the assistant and nurse on the side, "Tell the family that the patient did not have acute myocardial infarction or coronary heart disease. There is no coronary heart disease at all."

Although the coronary arteries are slightly narrowed, it is far from causing myocardial ischemia, hypoxia, and frequent attacks of angina.

The patient was quickly pushed back to the eighth zone of the heart.

…

The eight zones in my heart at this time.

Lu Chen, Sun Guoguo and others have already seen the results of coronary angiography.

Everyone was a little confused.

It's not aortic dissection, nor acute myocardial infarction!

At this time, the patient's wife walked into the doctor's office.

"Dr. Sun, what is the cause of chest pain? Isn't it coronary heart disease? It has always been treated based on coronary heart disease. In the past, nitroglycerin could also relieve chest pain. Isn't it said that nitroglycerin is a specific drug for coronary heart disease. "

The patient's wife was obsessed with "coronary heart disease" this time.

There was nothing she could do, she was really worried.

This is not the case, and that is not the case. There needs to be an explanation for what the disease is!

"The chest pain I had just now was really scary. It felt like I was going to die all of a sudden."

Sun Guoguo was also depressed, but depression could not solve the problem.

However, she immediately thought of a remedy.

Judging from the severity of the patient's chest pain, it must be related to the condition of the heart, lungs, or large blood vessels.

Since no obvious problems were found in coronary angiography and chest CTA, it is very necessary to do a cardiac color ultrasound!

The human heart is like a house, with walls, water pipes, and circuits.

An electrocardiogram looks at electrical circuits (the electrical conduction system of the heart), a coronary angiogram looks at water pipes (coronary arteries), and a color Doppler ultrasound looks at walls, doors and windows.

Problems with the house's electrical circuits and water pipes can cause chest pain.

Broken walls (myocardium) and doors and windows (valves) can also cause chest pain. Therefore, this cardiac color Doppler ultrasound is a must.

Originally, patients with coronary heart disease routinely underwent cardiac color Doppler ultrasound.

But it was too urgent just now, so I raced against time to get on stage.

Sun Guoguo also felt that cardiac color Doppler ultrasound might be a redundant test.

But looking back now, cardiac color Doppler ultrasound is still a must.

Of course her family agreed to do it. As long as she found the cause of the disease, she couldn't be confused like this.

Besides, she had done all the dangerous and expensive coronary angiography, including a cardiac color Doppler ultrasound.

…

Sun Guoguo returned to the ward and re-auscultated the patient's heart. It seemed that there was a little murmur, but it was not too obvious.

"Junior Brother Wei, please give the patient a bedside heart ultrasound." Sun Guoguo said.

"Okay!" Wei Zhongwen nodded.

However, within two minutes, he returned to the ward.

"Senior sister, the teacher in the ultrasound room is doing ultrasound in the CCU on the fourth floor. It may take more than ten minutes!" Wei Zhongwen said.

Cardiac ultrasound is not a routine emergency examination, and some small hospitals do not even have bedside emergency ultrasound.

"Okay, then we can only wait!" Sun Guoguo frowned.

The patient has recurring chest pain, and cardiac color Doppler ultrasound is imperative!

At this time, Lu Chen on the side suddenly said: "Senior sister, how about I do an ultrasound test?"