I Can See Health

Remember [new] in one second! The first step in admitting a patient is to inquire about the medical history and conduct a physical examination.

Lu Chen handed over all these tasks to the female intern Su Rui.

She was worthy of being a student at Kyoto University School of Medicine. Her consultations and physical examinations were so thorough that Lu Chen couldn't find anything wrong with her.

The patient, Li Wenqian, is 28 years old.

A few months ago, I started to feel flustered occasionally.

"The heart will suddenly beat violently, accompanied by a sense of chest pressure." Li Wenqian added. .

Lu Chen nodded slightly, "In our medical terms, it's called palpitations and chest tightness."

The patient initially thought it was a heart problem.

"I'm not even thirty yet! My heart is not in good condition!" Li Wenqian was so scared that she peed just thinking about it.

After all, heart disease is no small matter. No matter how small a heart problem is, it can make people miserable.

Severe heart disease can even lead to sudden death. Can you not worry about it?

"I went to the hospital for treatment at that time!" Li Wenqian recalled. "The cardiologist at the hospital below us auscultated my heart and did an electrocardiogram. No problems were found, except that the heart rate was a little too fast."

Lu Chen wondered, his heart rate was too fast, which didn't mean anything.

Some people's heart rate increases when they see a doctor. This is caused by physiological stress.

The patient's health value is 74 (-), so it seems there shouldn't be too many problems.

"Did you take any medication afterwards?" Lu Chen asked.

"Take it." Li Wenqian nodded, "I still remember that the doctor prescribed metoprolol tartrate tablets to me."

Metoprolol tartrate is a beta-receptor blocker. There are many beta-receptors in the heart. Once blocked, cardiac activity will be inhibited, so it can be used to treat tachycardia and heart failure.

Many patients with arrhythmias and high blood pressure take this medicine. It is a very common and widely used medicine.

"Is your heart condition getting better?"

"It got better, and then I was busy with work, so I didn't take it to heart." Li Wenqian said, "But two months later, the symptoms came again! That familiar heart discomfort came on suddenly, It was like being shocked, and then my heart was beating wildly for several minutes, 5-6 times a day, and the situation was even worse than before.”

"Is taking metoprolol tartrate effective?" Lu Chen asked doubtfully. From the patient's description, it did sound like some kind of paroxysmal arrhythmia.

"It didn't work." Li Wenqian sighed, "This symptom of heart discomfort has seriously affected my daily life and work. Later, I went to the hospital again and chose to do it when I was most uncomfortable. Heart ultrasound and electrocardiogram, but still no problems were found.”

Su Rui, a female intern on the side, said: "It may be that the arrhythmia occurred for a short period of time and stopped suddenly. Although you still feel uncomfortable, the arrhythmia has actually passed, so the electrocardiogram found no problem."

Many arrhythmias stop suddenly. It is impossible for ordinary electrocardiogram to hit that point exactly, so there is no way to detect abnormalities.

"Hey, that feeling is really uncomfortable. It feels like I'm about to die." Li Wenqian said helplessly.

Clinically, there is a professional medical term called near-death feeling.

"Later, the doctor at the local hospital gave me a different medicine." Li Wenqian took out another box of medicine from her bag, metoprolol succinate tablets.

Metoprolol succinate tablets and metoprolol tartrate tablets are medicines with one ingredient.

However, the latter is a short-acting drug, and one pill can only last a few hours; the former is a long-acting drug, and one pill can last about a day.

"By the way, there is another medicine..." Li Wenqian took out another medicine in a porcelain bottle from her bag, Suxiao Jiuxin Pills.

Suxiao Jiuxin Pill is used for coronary heart disease, not arrhythmia, but people will curse when they are anxious, so take it with you just in case.

"Have the symptoms eased?"

"No..." A bitter smile appeared on Li Wenqian's face, "All the medicines combined have no effect, not at all. I still feel uncomfortable and have the feeling of dying."

Lu Chen frowned deeply.

According to the patient's description of symptoms, it looks like some kind of arrhythmia.

And the health value on her head is 74 (-), so there should be no fatal disease, otherwise the change trend cannot be a minus sign.

"Have you done a 24-hour dynamic electrocardiogram?" Lu Chen asked.

24-hour dynamic electrocardiogram, as the name implies, requires the ECG box to be worn for 24 hours.

As long as there is an arrhythmia attack within 24 hours, it can catch it.

"I've done it, more than once, but it didn't work."

As she spoke, Li Wenqian took out a few more checklists from her bag.

Lu Chen took it and took a look.

There were a total of three dynamic electrocardiogram results. Except for the occasional fast heart rate, no abnormal problems were found.

"I've been to many hospitals, but now there's really nothing I can do." Li Wenqian sighed helplessly, "I can only come to your hospital."

If the Department of Cardiology at Kyoto University First Affiliated Hospital couldn't solve it, then she would be really desperate!

Lu Chen already had a basic understanding of the condition, and he conducted a more careful physical examination on the patient.

Cardiopulmonary auscultation did not reveal any problems.

"Senior Brother Lu, do you think it could be an autonomic nervous disorder?" Su Rui suddenly said.

Lu Chen nodded slightly, Su Rui's suspicion was clear.

Autonomic nerve dysfunction can also lead to symptoms such as palpitations.

The so-called autonomic nerves may not be well understood by everyone.

To put it simply, it means some autonomic nerves that control the internal organs, including sympathetic nerves and parasympathetic nerves.

If there is something wrong with them, the internal organs will feel and move poorly, so it is possible that autonomic nerve disorders may cause heart palpitations.

However, Li Wenqian interrupted: "I checked the information on the Internet. Some people said that it was an autonomic nervous system disorder, and they told me to take some B-group vitamins, oryzanol, etc., but it didn't work for me."

Lu Chen discovered that these people who came to Kyoto Hospital for medical treatment had a thorough understanding of their own conditions and often looked up information online.

Su Rui frowned slightly. If it wasn't autonomic nerve disorder, what else could it be? She ran through other possibilities in her mind.

At this time, Lu Chen said: "If there is really no way to detect arrhythmia, we can do electrophysiological examination."

Arrhythmia is like a thief. The thief always waits until the night is dark and windy, and the lights are dim to commit crimes.

After he got it, he quickly hid it and the police couldn't do anything to him (similar to an ordinary electrocardiogram).

Okay, then step up patrols, and there will be 24-hour guard patrols (24-hour dynamic electrocardiogram).

But even so, thieves still have ways to evade police patrols and attack behind the scenes.

What can we do in the end?

There is only one way, UU Reading www.uukanshu.net If you want to find out the thief, you can only go door to door to register and visit.

This is called taking the initiative, which is like an electrophysiological examination of the heart. It is directly close to the heart and stimulates the heart (knocking on the door to register). If there is a problem, it will be induced.

"How should this electrophysiological examination be done?" Li Wenqian asked immediately.

"It's a minimally invasive surgery." Lu Chen explained, "Use electrodes directly deep into the esophagus to stimulate the heart near the esophagus to see if it can induce arrhythmia. If it can, then find a way to perform radiofrequency ablation surgery to burn away the lesions. "

Lu Chen's description was very straightforward.

Li Wenqian was a little frightened when she heard this.

It's so scary to operate a knife on your heart!

"I, I..." Li Wenqian swallowed, "This... I'll think about it first. Doctor, please let the director come and see me first..."

Lu Chen shrugged his shoulders. He couldn't help it. These patients didn't quite believe him, so they still had to let Deputy Director Xiao Shikang do the rounds.