Doctor Peerless

Chapter 625
Chest pain, chest tightness, fast heart rate.

There is also the possibility of viral myocarditis.

And for this disease, Bai Mingming has been deeply impressed recently.

The owner of the gym that Bai Mingming often goes to, thinks it was this disease that he suffered from back then.At that time, the boss fell directly off the treadmill.

Bai Mingming's memory is still fresh.

The age group of onset of this disease is mainly young adults.In severe cases, it can lead to heart failure and sudden death.

Bai Mingming had this idea, so he didn't dare to neglect it.

He immediately began to ask the patient about his medical history carefully.

Soon the patient gave back a useful piece of information. A week ago, he had a bad cold, which was very serious at the time, and he went to the community hospital to hang water for two days.

With this message.

Bai Mingming felt that the boy had a high probability of suffering from viral myocarditis.

The next work is the necessary examination and diagnosis.

Bai Mingming called the nurse and gave the doctor's order.

Ask the nurse to take the patient for an electrocardiogram and myocardial enzymes.

These are the two standard tests for judging viral myocarditis.

Of course, if the condition is confirmed, further examinations can be done, such as cardiac color ultrasound and so on.

The ECG examination is relatively fast.

The nurse took it to the emergency department, and there was no need to queue up. It took 10 minutes to check and 2 minutes to wait for the report.In addition to the journey, it took only ten minutes to go back and forth.

Myocardial enzymes comparisons are time consuming.

This test is a routine biochemical test, and blood is drawn.

The collected target blood will be placed in special testing equipment.Generally speaking, it will take at least two or three hours to have results.

Of course, the actual device detection takes less than an hour.

Because of the consideration of efficiency, the hospital collects a batch of specimens and then tests them together.

Again, because of the emergency.

The result of this detection has been greatly accelerated.

In less than half an hour, the test report of myocardial enzymes was also obtained.

The patient returned to the emergency room.

The nurse handed over the two test reports to Bai Mingming.

Heart problems, of course, the first step is to look at the electrocardiogram.

When Bai Mingming took a look, he was a little dumbfounded.

Generally speaking, in viral myocarditis, the patient's heart rate will be abnormal, and there will be ST-T changes on the electrocardiogram. The common one is T wave inversion or decrease, and there may also be mild ST segment shift.

But the patient's electrocardiogram, the report reads: ST segment: no deviation. T wave: duration and amplitude are normal, no pathological deviation.Diagnosis: 1. Sinus rhythm. 2. Normal electrocardiogram.

What kind of situation is this.

The electrocardiogram showed everything was normal.

Bai Mingming panicked, so he hurriedly read the second myocardial enzymes report.

Let’s popularize science here. It’s not surprising that heart problems can be detected by electrocardiogram and CT.Why do blood biochemical tests can also see the problem.This also depends on the examination content of myocardial enzyme spectrum.

Routine five-item myocardial enzyme spectrum examination can detect acid dehydrogenase, phosphocreatine kinase, creatine kinase isoenzyme, aspartate aminotransferase, and α-hydroxybutyrate dehydrogenase.

These five enzymes are normal enzymes in cardiomyocytes.

In the blood of normal people, the content of these five enzymes is very low.However, if the myocardium is damaged, these five types of enzymes will be released from the cardiomyocytes, and the level of myocardial enzymes in the blood will increase.

Therefore, by detecting the level of myocardial enzymes in the blood, the patient's myocardial condition can be judged.

Besides, Bai Mingming hastily picked up the report of myocardial enzyme spectrum to have a look.Once again, it was heartbreaking.All five indicators are at normal levels.

I'm dizzy!

Test reports are brutal.It was like a slap on Bai Mingming's face.

The possibility of the patient having viral myocarditis was completely ruled out.

The wall clock in the emergency room struck ten fifty.

The patient had been in the emergency center for almost an hour.The cause has not been found yet.

The two inspections I did just now were completely in vain.

Outside the emergency room, there are family members of patients waiting anxiously.

Bai Mingming was a little anxious at the moment.

But he is also an "old man" in the emergency center.

He knows that not to panic when things happen is an essential quality of an emergency doctor.

He took a deep breath, stabilized his emotions, and continued to investigate the cause.

On the other hand, Bai Mingming also knew that the patient's condition was not that simple.

He called a nurse beside him and said, "Go and see if Team Leader Zhou and Team Leader Liu have time, and said that there is a troublesome patient with chest pain in the emergency room."

The nurse moved.

Two or three minutes later, Liu Zhengqing followed the nurse.

Bai Mingming naturally hoped that Zhou Sheng could come over.First, from Bai Mingming's recent observations, Zhou Sheng is much better than Liu Zhengqing in handling some difficult cases.Secondly, the relationship between Bai Mingming and Zhou Sheng was even better.There is not much psychological burden to ask Sheng Zhou for advice.

But Zhou Sheng didn't come, Bai Mingming guessed it was probably because Zhou Sheng was busy.Liu Zhengqing's presence was also able to help him solve some problems.

When a young doctor encounters an emergency, he always hopes to have a great god by his side.Even if this Liu Zhengqing was not considered a great master, with more than ten years of medical experience, in Bai Mingming's opinion, it was quite reliable.

After Liu Zhengqing arrived.

He simply asked Bai Mingming about the patient's condition.

He looked down at the patient on the hospital bed, thoughtfully.

This patient is relatively young and thin, but he is quite tall. The bed is two meters long, and he will be well when he lies on it.It is estimated that the patient is at least 1.8 meters tall.

Liu Zhengqing instantly thought of a disease, spontaneous pneumothorax.

This condition is more common in thin and tall men.Frequent colds, after strenuous exercise, are an incentive for the onset of the disease.During the attack, the patient will have difficulty breathing and chest pain.

Liu Zhengqing had an idea, and immediately raised it, "Could it be a spontaneous pneumothorax?"

Sometimes, it is the authorities who are confused, but the observers are clear.

After being instructed by Liu Zhengqing, Bai Mingming felt that it was a bit reliable.

Spontaneous pneumothorax is also a common clinical disease.

Bai Mingming must know the cause of this disease and its diagnosis and treatment.

No longer waiting for Liu Zhengqing's reminder, he has already begun to determine whether the patient has this disease.

First, of course, is the consultation.

Bai Mingming asked the patient: "Have you ever done strenuous exercise during the day?"

The patient lay on the bed, and said weakly: "Before eating, I played basketball for more than an hour. The kind in the whole court, the running is a little more aggressive..."

There is a play!

Bai Mingming and Liu Zhengqing looked at each other.

Liu Zhengqing said: "Listen to your lungs."

Bai Mingming nodded, and put on the stethoscope hanging around his neck.

Spontaneous pneumothorax, auscultating the breath sounds of the lung lobes, there will be signs of weakening and disappearing.

Auscultation can quickly and easily judge the condition.

Bai Mingming knew this very well, so he immediately started to operate.

……

(End of this chapter)