Start as an Emergency Physician

The conference room was silent.

The deputy director of cardiac surgery, He Jianyi, Jiang Xiaoqi and others all looked at Zhou Yuan with puzzled eyes.

"What does this have to do with infective endocarditis... Wait..."Jiang Xiaoqi was suddenly stunned.

Zhou Yuan saw Jiang Xiaoqi's expression and knew that the latter was also aware, and explained: "The patient has aortic regurgitation, and the diarrhea in the past few days is an opportunity, and severe diarrhea makes microorganisms and germs enter the patient's heart through the blood vessels, thus triggering infective endocarditis. ......"

Severe diarrhea leading to infective endocarditis is not uncommon.

The so-called infective endocarditis is fundamentally different from the viral myocarditis that is often misjudged by the emergency department as a common fever and cold.

Infective endocarditis is mainly caused by bacterial infection, characterized by the formation of vegetations, such as small rashes, small pustules, etc., which mostly occur in patients with underlying structural heart disease, Zhao Qiang suffered from heart disease when he was a teenager, and in recent years, it has been found that aortic regurgitation is a common patient with infective endocarditis.

The main lesion site of viral myocarditis is in myocardial cells, and the onset of the disease also has seasonal factors, which has little to do with whether the patient has heart disease, and the clinical manifestations are no different from the common cold.

Zhou Yuandao: "Zhao Qiang himself has aortic regurgitation, and under the influence of infective endocarditis, the blood in the heart is seriously regurgitated, resulting in acute heart failure. "

Of course, all this is just Zhou Yuan's inference at present, but the words have already come to this point, and they are basically facts, and they only need to be checked for final confirmation.

He Jianyi stood up, feeling more and more incredible that Zhou Yuan was incredible, and said: "Zhang Ling, you go to arrange the work of the patient's family, it is best to let the patient's parents come over, this is not a minor illness..."

There were all doctors here, and they knew exactly what that was there.

Why do you have to call your parents over? Because you may never get off the operating table again...

Maybe this is the last meeting between Zhao Qiang and his parents!

The deputy director of the cardiac surgery department and Lu Chenxi both lowered their heads.

After a while, the deputy director stood up and said, "The patient's condition can't wait, surgery must be carried out to replace the aorta within tomorrow, otherwise heart failure will take the patient's life at any time!"

Lu Chenxi, who had been silent, made her first sentence at this time: "I agree. "

Zhou Yuan nodded, "I'll go and improve the inspection, Zhang Ling, and the work of the family will be handed over to you." "

After the meeting dispersed, Zhou Yuan hurriedly ran to the imaging department, and He Jianyi, Lu Chenxi and others followed, and they also needed to confirm whether Zhao Qiang had infective endocarditis.

The report from the laboratory department was also sent by Lin Wen.

"Progressive anemia..."

Zhou Yuan's voice was low, and he said: "The blood test found that Zhao Qiang had progressive anemia, and the body was normocytic anemia, the count of white blood cells increased significantly, and the neutrophils were also abnormally elevated!"

"Accelerated erythrocyte sedimentation rate, C-reactive protein words and deeds, increased serum globulin..."

A series of abnormal indicators were reported by Zhou Yuan.

Looking at the test sheet is actually an important indicator to test a doctor's professional level, and some doctors may not know what some of the values on the test list represent all their lives.

In the hospital, those who can read the test sheet and directly judge the condition according to the test list are basically the big guys...

He Jianyi and the others' faces became grim.

The doctors that Zhou Yuan reported just now are not much different from infective endocarditis!

Finally, Zhou Yuan found a fatal ventricular arrhythmia in Zhao Qiang's electrocardiogram, and the property suggested atrial fibrillation regurgitation!

Zhou Yuan and the others tightly grasped a word - regurgitation!

"It has been confirmed that acute heart failure caused by infective endocarditis requires immediate relief of the infection and the operation can be completed as quickly as possible!"

For such patients, the sooner the surgery is done, the better, there is no question of the right time, because the best time is always in the last second!

The patient has acute heart failure caused by blood reflux carrying microorganisms and germs, so the risk of reflux can be eliminated by solving the problem of reflux.

In order to block the regurgitation channel, the aortic valve with incomplete closure must be replaced, that is, aortic valve replacement!

"Let's go, go and talk to the patient. He Jianyi broke the silence and said.

......

Inside the hospital room.

In fact, when Zhang Ling returned to the ward, before she could remind Li Li to invite Zhao Qiang's parents, as soon as she entered the door, she saw that the parents of both families were standing in front of Zhao Qiang's hospital bed at the moment, with a look of distress and regret.

The distress is that Zhao Qiang has been tortured so much, as for regret... Zhao Qiang had heart problems before, but Zhao Qiang kept saying that it was okay, so they believed it, after all, there had never been an accident for so many years, maybe it was just that the doctor was alarmist?

To be honest, Zhang Ling is a little envious of Zhao Qiang, the hospital has seen more truth than the church and the train station, too many couples are flying separately when disaster is coming, and too many relatives have turned against each other because of expensive medical expenses.

Family members like Zhao Qiang, just seeing it, the doctors and nurses will be very happy.

"Nurse, when will my son wake up?"

Zhao Qiang's mother was a little hoarse, obviously she had just cried.

"Yes, when will my son get better, is he okay?" said Li Li's mother.

The two families have already become a family because of the loving Li Li and Zhao Qiang, Li Li is the daughter of the two parents, and Zhao Qiang is naturally the son of the two parents.

Zhang Ling shook her head and explained Zhao Qiang's current situation to everyone, which was also the task assigned to her by Zhou Yuan and others.

After a while, Zhou Yuan came back with He Jianyi and others.

"He used to say that it was fine, but it was definitely not really fine, the heart ranged from fifty millimeters to seventy millimeters, and it could be seen that it could not be formed in a day or two, it could take months, maybe even a year or two!"

As soon as he stepped into the door, Zhou Yuan heard Zhang Ling talking about Zhao Qiang's condition in detail.

Seeing that several doctors came in, and there was also a bald one, it was said that the bald head was the strongest fighting force in the group of doctors, so the eyes of Zhao Qiang's family all stopped on the bald deputy director of cardiac surgery... Ready to talk about the head.

Zhang Ling was suddenly a little embarrassed, she talked well, and Zhao Qiang's family suddenly crossed her and looked behind, as if she didn't exist...

But she didn't complain much, there is naturally a difference between doctors and nurses.

Just as Zhang Ling was about to retreat, Zhou Yuan stepped forward and said in a low voice: "Nurse Zhang Ling who should be lectured has already finished explaining." Infective endomyocarditis, which causes acute heart failure in the setting of aortic regurgitation, is the final diagnosis. "

Hearing this, Zhang Ling's eyes immediately lit up, and he looked at Zhou Yuan gratefully.