Sleepless Doctor

　　 "President Xue, do you know the situation of the county hospital?" Wu Mian asked D County Hospital with a smile... What do you want to know, Mr. Wu? "

　　 Xue Chunhe is a little curious. It’s enough for Mr. Wu to be the head of the medical department at the Bajingzi Hospital of Traditional Chinese Medicine. Is it that Mr. Wu is still going to upgrade along the county and township and experience the novice village again?

"Be more detailed, the more detailed the better." Wu Mian did not shy away. "The county hospital refused to accept patients on the rescue helicopter. This ill will come out, but you can't come and beat him up. No, you can talk about the situation, I Think about it recently."

　　 "Hehe." Dean Xue smiled. He could imagine why Wu Mian was so irritable at the time.

　　 One side is a comrade with severe burns, while the hospital refuses to admit patients, even if Teacher Wu goes to the county hospital in a helicopter to make a fuss, Dean Xue understands.

　　 But with the ability of a doctor, it seems very difficult to retaliate against the big capitalists.

　　 "Teacher Wu, the county hospital has been restructured and sold to the capital." Dean Xue said, "It is said that it is a large capital in the south, integrating more than 30 hospitals in the north and preparing to go public."

　　 "Make false accounts, and then wait for the lock-up period to rush to sell at a higher point?" Wu Mian smiled, "Forget about other companies, use the hospital as a bargaining chip, they are really brave."

　　 "Mr. Wu, we all know the reasons for this, there is nothing we can do." Dean Xue sighed and said, "In the future, these public hospitals in the provincial capital may not be able to keep them."

　　 "The ultrasound probe is placed on the stomach, and the xiphoid process is examined." Wu Mian suddenly raised his volume and said something inexplicable.

　　 The director of the emergency department was doing echocardiography. Just after the heart examination, the patient’s heart had no problems, but the strange thing is that the ST segment changes are real.

　　 It is estimated that it is a rare symptom. The director of the emergency department was guessing. When he heard Wu Mian's words, he subconsciously pressed Wang Chengfa's stomach with a B-ultrasound probe, preparing for a subxiphoid examination.

　　 Next second,

witness the miracle!

　　 The moment the B-ultrasound probe is pressed into the stomach, the ECG changes, the elevated ST segment disappears, and the ECG returns to normal.

　　When the incident happened suddenly, Wang Chengfa didn't have time to react, so the B-ultrasound probe was pressed on his stomach.

　　 When the oscilloscope on the ECG monitoring returned to normal, it was too late to stop it.

　　 The director of the emergency department lifted the B-ultrasound probe, and the ST-segment elevation oscilloscope appeared on the ECG again.

　　 He was stunned. He felt that he was dazzled. He just wanted to press the B-ultrasound probe again. He didn't expect his wrist to be grabbed by Wang Chengfa. "Director, don't do it, I'm fine."

　　 Wang Quan couldn’t understand the ECG, but he noticed something was wrong, and he opened his mouth and said cursingly, “My dad said he couldn’t do it, you didn’t hear it! He knows how to do a checkup, but there’s nothing wrong with the check, a bunch of..."

　　 "Shut up!" Wang Cheng said angrily. At this time, he couldn't bother to pretend, his sickness and weakness disappeared, and he drank Wang Quan full of confidence.

"Echocardiography found an ejection fraction of 60%-65%, no segmental ventricular wall motion abnormalities, no characteristic octopus tank-like manifestations, no pericardial effusion. It is not consistent with ST-segment elevation myocardial infarction Do you think it’s weird?" Wu Mian asked with a smile.

　　 The head of the emergency department nodded, staring at the ECG monitor screen in a daze, really wondering why this is the case.

"Echocardiography does not support common diseases such as STEMI, pericarditis and stress cardiomyopathy." Wu Mian said with a smile, "That's because you overlooked one point. This was also at the National Congress of Emergency and First Aid 2 years ago. I said A question of the past."

　　 The director of the emergency department grinned, "Ms. Wu, do you remember me?"

　　 "You are sitting in the third row from the bottom and you have been playing with your phone."

　　 "..." The director of the emergency department almost cried out. Teacher Wu, can you give me some face? In meetings, everyone has to have fun, and a few people take it seriously.

"I said very clearly at the time. If you encounter a problem that you don't understand, you must first think about the right or wrong of the medical history." Wu Mian said with a smile, "I gave a few examples at the time, one is pretending to be vomiting; the other is pretending to be vomiting. Burns. It seems necessary to talk about pretending myocardial infarction next time..."

　　 As he said, Wu Mian paused, looked at Wang Chengfa, stretched out his right hand and gave a thumbs up.

　　 "Director Wang, awesome!"

　　 "Even I was almost deceived by you, you are considered a talent."

　　 "What are you talking about!" Wang Quan scolded, but his eyes flickered when he looked at Wu Mian, vaguely a little frightened.

　　 "Speaking quietly, you can lose a little bit less. When you speak so loudly, in the end... Director Wang, you are not going to go home? You have to wait here for me to finish?" Wu Mian's eyes were clear and he looked at Wang Chengfa.

　　 Wang Chengfa's face was pale, and he was dumbfounded for a while, and didn't know what to do.

"Director Bao Hongchao, I remember correctly," Wu Mian said with a smile, "You will have the same effect when you press on the patient’s stomach with your hand. The change in the ECG oscilloscope is not necessarily a heart problem. It may also be caused by external reasons."

　　 Wu Mian looked at Wang Chengfa and took a step forward. Wang Chengfa suddenly felt like a mountain was pressing on his head. His chest was stuffy and he couldn't breathe.

　　 How did he know? Wang Cheng found that Zai no longer doubted, but he couldn't explain why Wu Mian knew his secret.

　　 "The exact pathophysiological mechanism is still not very clear, but in theory, several research institutes are currently conducting research on this, and there are many possible speculations."

　　 "Generally speaking, heart displacement is often accompanied by electrical axis changes and electrical alternation, but Director Wang did not discover this."

　　 "Secondly, the visceral-heart reflex is dominated by increased vagal tension, but Director Wang has no bradycardia or heart rate fluctuations."

"Stress cardiomyopathy is mostly related to microvasospasm or dysfunction, but Director Wang's electrocardiogram changes rapidly, and no characteristic apical balloon-like changes are seen. That is to say, microvasospasm can be preliminarily ruled out as a major cause of investigation. ."

"In terms of pericarditis, there was no pericardial effusion in echocardiography, and the rapid changes in the electrocardiogram were not consistent. Therefore, it can be considered that the direct stimulation or compression effect of the dilated gastrointestinal tract on the heart caused ST-T from this case. Dynamic changes."

　　 "Director Wang, you really refreshed my three views." Wu Mian said with a smile, "Do you know why I can say so much? Because it was said in the papers given by the two research institutions last year and the year before."

"The paper at that time was passed by me because there were some small problems with the logic before and after. This is one aspect. The main reason is that I think it is a bit absurd. According to their logic, the dilatation of the gastrointestinal tract causes the ECG oscilloscope to change. Simply put, It's just enough to support it."

　　 "You are really full." Wu Mian said with a smile, "Last night at midnight, I drove all the way to the provincial capital to avoid the wildfire? How much did you eat?"