I'm just a veterinarian! You've unlocked the Great Physician System!

Chapter 222 Contrast Agent Allergy: No Words Can Talk to That Damn It! [Second Update, Requesting Monthly Tickets]

"Uh-huh."

Zhang Lingchuan nodded.

He's been dealing with the emergency room for a while now.

I know a little bit about it.

"Vice President Huang, hello, hello. I have a distant cousin named Fang Yuan, who is also a doctor in your emergency department."

As soon as Zhu Panxiang entered, she began to speak with a smile on her face.

"Hello Ms. Zhu, what symptoms would require you to go to the emergency room? Where does it hurt?"

Huang Xiangning nodded, and then began to inquire about the patient's medical history.

Zhang Lingchuan also took a look at Aunt Zhu Panxiang, who was lying down with a frizzy, ramen-noodle-like hairstyle and a jade pendant. He was surprised to find that she was actually a relative of Teacher Fang Yuan.

"It's like this, Vice Dean Huang, my chest is really hurting, and I can hardly breathe."

Zhu Panxiang pointed to the area on her left chest and said.

Generally speaking, chest pain is the most common reason for people to visit the emergency room.

After the other person finished speaking, Zhang Lingchuan began to record the medical history.

Since you're in this position, you naturally have to be prepared for it.

"Chest pain? Is there any pattern to your chest pain? Does it hurt when you're active or when you're not active, or is there no pattern at all, sometimes it hurts when you're active and sometimes it hurts when you're not?"

Huang Xiangning asked carefully.

Emergency medicine professionals not only need to learn how to perform surgery, but also often need to understand their patients.

To make the right or very close to right judgment at the first moment.

"Um... let me think, it seems there's really no pattern to it. Sometimes it hurts even when I'm not moving, and sometimes it hurts even when I'm moving. It's just weird! I probably have coronary heart disease. I came here to get a coronary angiography. I heard the emergency department can do it faster, so I should be able to get it done today. Vice President Huang, please just write the order and get the coronary angiography done for me."

Zhu Panxiang stretched out her hand at that moment.

She also had two large gold bracelets on her wrists.

She looked like a very wealthy middle-aged woman.

"Ms. Zhu, so you've come here specifically for a coronary angiography, right? But don't worry, there's a normal consultation process in the emergency room. Xiao Chuan, what do you think of Aunt Zhu's symptoms?"

After Huang Xiangning finished speaking, she looked in Zhang Lingchuan's direction and asked with a somewhat peculiar expression.

[Host detected to be undergoing medical consultation; system-assisted scanning in progress...]

[Accurate detection... 5 tests remaining.]

[Regular testing... 2 test remaining for the day.]

[Initiating precision testing... Precision testing rejected...]

[Initiating standard detection, please wait...]

Zhang Lingchuan on the other side had already started a system scan.

After all, there are two chances to receive a gift every day.

It grants prestige points whether used on animals or humans.

Anyway, you'll have to keep refreshing it.

They started swiping right away.

"Actually, chest pain doesn't necessarily mean coronary heart disease, and it's not always 100% a heart problem; it could be due to other factors."

Zhang Lingchuan answered.

This is the result of his scan.

System scan complete.

Patient's name: Zhu Panxiang.

[Patient's gender: Female.]

[Patient's age: 61 years old.]

[Patient Status: The patient currently experiences persistent chest pain, which radiates in a semi-circular pattern from the back to the front of the corresponding intercostal space, described as a stabbing or burning pain. The pain worsens with coughing, deep breathing, jumping, laughing, sneezing, or turning the body, and can be both persistent and intermittent.]

Patient diagnosis: Intercostal neuralgia, diabetes, myocardial ischemia.

[System notification: This patient is obese, suffers from diabetes and myocardial ischemia, and experienced intercostal neuralgia due to weakness after being hospitalized for exposure to cold. Local damage and fatigue may also be contributing factors. Please recommend appropriate examinations for this patient.]

It seems that coronary heart disease was not observed.

But I did see one case of diabetes.

In other words, this woman may have made a mistake in her own assumptions.

Although I am a veterinarian, I have heard from some friends that they have encountered quite a few patients of this type in their clinical practice.

[The patient is currently eligible for an allergy test. Would you like to use an allergy testing kit?]

And after he finished speaking.

Zhang Lingchuan discovered that there was actually a prompt for using an allergy-related prop card.

According to the prop card, it will automatically alert you if a patient is found to have an allergy to modern medical drugs.

"use!"

In the end, Zhang Lingchuan decided to use the prop card.

After all, this was the first time he had obtained such an item card, and he didn't know how it would turn out.

Since you've already given me the prompt, I might as well check it out.

[Successfully used, allergy analysis in progress...]

After he used it.

The prompt in front of me transformed into a screen from an allergy analysis.

"Hey! You little doctor, if you're not skilled enough, don't talk nonsense. Do you think I don't know my own body? This is a heart problem, I know it perfectly well!"

Hearing Zhang Lingchuan speaking beside Huang Xiangning.

Zhu Panxiang immediately looked at him with a sidelong glance, her whole demeanor showing displeasure and annoyance!

He was clearly annoyed by Zhang Lingchuan's words.

Huang Xiangning remained silent.

Because this is a necessary part of being a doctor: dealing with patients and being questioned by them.

She felt that Xiaochuan was definitely capable of handling it.

"Auntie, have you had any tests done?"

Zhang Lingchuan was a little curious.

Since the other party is so certain that it's a heart problem, or something like coronary heart disease, then they must have done some tests, right?

"Of course I had a check-up at our county hospital!"

At that moment, Aunt Zhu Panxiang shook the large jade pendant on her chest and said...

"Oh? What was done? A cardiovascular CTA?"

He asked.

Huang Xiangning, however, was slightly surprised.

I really didn't expect that the other person would have such comprehensive knowledge, even knowing about cardiovascular CTA.

This kid even said he didn't want to be a doctor.

Could it be because of Lao Shen?

Old Shen is two-faced. He says he supports studying human medicine, but behind Xiao Chuan's back, he tells him that he wants to take up the banner of veterinary medicine.

Huang Xiangning initially thought that Lao Shen wasn't like that, but she discovered that he had met with his old flame behind her back recently, so Huang Xiangning couldn't help but become suspicious.

Looks like I'll have to ask him sometime.

If Lao Shen really does such a thing, she'll take out the washboard her family bought for their wedding!

He won't die from kneeling!

Lost in thought, Aunt Zhu Panxiang seemed to have gotten into a fight with Zhang Lingchuan!

“I didn’t have a CTA, but I did have several ECGs, and they all showed myocardial ischemia. I’ve seen a local doctor who thinks it’s coronary heart disease. My cousin also saw a doctor who said it’s most likely a heart problem. What, isn’t that enough? You little doctor, shut up! Don’t waste my time! Vice President Huang, please order a coronary angiography for me. I need to get a full checkup!”

The woman took out several electrocardiogram reports from her bag.

"Ms. Zhu, don't worry. Actually, this Dr. Xiao Chuan is quite capable and won't waste your time, right, Xiao Chuan? How do you interpret this electrocardiogram?"

Huang Xiangning was not in a hurry.

He glanced in Zhang Lingchuan's direction and asked how the electrocardiogram came about.

"Hmph! What could he possibly see!"

Hearing Huang Xiangning's biased words towards Zhang Lingchuan, the aunt was quite dissatisfied.

He immediately started speaking in a bad mood.

However, since he was the dean, she couldn't vent her anger on him, so she could only continue to look down on Zhang Lingchuan.

After all, he looks like a new doctor.

They have neither the qualifications nor the ability.

All they do all day is question this and that.

I don't know why Vice President Huang is so protective of him.

What level of skill could someone like that possibly possess?

"These three electrocardiograms show inverted T waves in the precordial leads, which is indeed a change indicating myocardial ischemia. Combined with the patient's individual symptoms, it is indeed easy to make a diagnosis of coronary heart disease."

And this possibility is, however, the most likely.

Zhang Lingchuan looked at the electrocardiogram and began to speak.

Now that he's in the hospital, he'll definitely need to learn the relevant knowledge.

Otherwise, they wouldn't even know when they'd be exposed.

This includes things like how to read an electrocardiogram (ECG).

Based on these three electrocardiograms, myocardial ischemia is confirmed. In addition, the person is obese and has chest pain, so coronary heart disease is also a possibility.

However, myocardial ischemia is actually caused by a variety of factors.

For example, obesity can also lead to myocardial ischemia.

"So you think Ms. Zhu has coronary heart disease and that she needs to undergo coronary heart disease tests?" Huang Xiangning asked after Zhang Lingchuan finished speaking.

"No, I don't think it's necessarily coronary heart disease, but rather just myocardial ischemia. Obesity is one of the contributing factors. Myocardial ischemia alone, coupled with chest pain, is not enough to make a diagnosis of coronary heart disease. Furthermore, the chest pain in this person is somewhat different from the chest pain caused by coronary heart disease."

Zhang Lingchuan continued.

His system test results have clearly stated that it is not coronary heart disease at all.

It is intercostal neuralgia.

Myocardial ischemia is most likely caused by obesity, and the other person also has diabetes.

"You little doctor! Are you out of your mind?! The evidence is presented, and you still find other problems! It's only because we're in a hospital; if this were in our county, I'd smash your shop! You're a complete quack!"

I'm so angry.

Aunt Zhu was absolutely furious.

He's a complete quack.

However, Huang Xiangning gestured for the other party to continue.

Generally speaking, this is the normal teaching process.

And it basically doesn't take up much of the patient's time.

Patients like this are relatively rare.

However, that doesn't stop her from thinking that what Xiaochuan said makes sense, because there are many possible causes for chest pain.

For example, angina pectoris caused by coronary heart disease is mainly chest pain after exertion. If someone says that their chest pain occurs both when they are not tired and when they are tired, then this is not a typical symptom of coronary heart disease.

Common causes include stomach pain, intercostal neuralgia, costochondritis, and cardiac neurosis.

Further investigation is needed to determine which one it is.

After all, the other party had not undergone any relevant examinations before, only an electrocardiogram.

In fact, an electrocardiogram (ECG) doesn't tell you much when it comes to checking for coronary heart disease.

Generally, it involves performing a coronary CTA, which can be understood as an enhanced CT scan of the heart, and has a 95% accuracy rate for coronary heart disease.

The downside is that there might be 5% of flaws that are not easily visible.

The advantages are that it is non-invasive, convenient, and will basically not cause harm to patients.

Another option is the coronary angiography that Ms. Zhu mentioned.

This type of imaging has a high accuracy rate, but the patient is undergoing an invasive procedure.

Simply put, it involves inserting a catheter into a blood vessel. Even the most skilled doctor can cause some damage to the blood vessel, and the patient will need to stay in the hospital for two or three days after the surgery.

But now most people prefer to choose imaging.

If you really want to check for coronary heart disease, CTA is the most appropriate first step.

If it is confirmed that there is a possibility, then angiography will be performed.

Checking this often doesn't require a one-step solution, because there might not be a spot there...

"Vice Dean Huang, please hurry up and order the angiography for me. I came here specifically for the angiography. Why are you making this junior doctor bother me? I really don't want to waste my breath on him."

Zhu Panxiang was really angry.

If she had known it would be like this, she wouldn't have booked an appointment with that specialist.

Just like in the news, these deans are all from powerful families and academic cliques—look at them, so protective of their own!

This is absolutely outrageous!!
"Ms. Zhu, don't worry. Actually, Xiao Chuan's analysis is correct. The price of an angiography is quite high, usually around five or six thousand yuan. Also, your chest pain is not typical of coronary heart disease angina. You can do other screenings first."

Huang Xiangning said.

Don't let Ogawa's profession as a veterinarian fool you.

But when it comes to doing things, they are indeed reasonable and well-founded.

She liked it more and more the more she looked at it.

"Vice President Huang, is it okay if I don't want to do any other tests? I just want to have a coronary angiography! I don't mind the price! Just order a coronary angiography for me! Is that alright?!"

At this moment, Zhu Panxiang was truly enraged.

She has a bad temper even at home.

In other words, the other party is a dean.

If it were an ordinary person, she would have cursed him out with a torrent of abuse!

"Ms. Zhu, if you want to have the examination, of course you can. We are doing this for your own good. After all, coronary angiography is an invasive procedure, and it is actually more convenient to do a coronary CTA."

If the other party wants to open it, then there's definitely no problem.

The emergency department will definitely meet the other party's needs.

However, as medical professionals, they recommend that the patient undergo a CTA scan first, out of consideration for the patient's health.

If there are no problems, then there is no need to do contrast imaging.

If there are any problems, then we'll do an angiography.

"Yes, some people may be allergic to the contrast agent during a cardiac angiography. You will then have to undergo an allergy test, which is quite troublesome. So unless there is a very strong medical indication, it is not recommended to do it. I think you may have intercostal neuralgia."

Zhang Lingchuan is a little eccentric now.

The allergy card was successfully used.

This indicates that the patient is currently allergic to contrast agents.

Although about one in ten thousand people are allergic to contrast agents each year.

And this middle-aged woman was one of them.

The key point is that the other person doesn't have coronary heart disease at all, so there's no need to waste money on this treatment.

……

Zhu Panxiang stared at the two of them.

"What? They won't give you a coronary angiography? Why won't they do it?!"

After a while, the other party shook Fang Yuan over.

“Um… Aunt, actually Dean Huang and Dr. Xiao Chuan are doing this for your own good. Especially don’t look down on Dr. Xiao Chuan. He just received a banner of appreciation today, so his words are quite valuable.”

After hearing the whole story, Fang Yuan was speechless.

Got it!
This cousin completely disregarded the kindness of Vice President Huang and Xiao Chuan.

They even want to drag me into this to judge.

In fact, the suggestions given by both the dean and Ogawa were correct.

"Oh, so someone sent you a banner. No wonder you're so arrogant. But don't worry, I definitely won't send you a banner. I'm here to have a coronary angiography. I don't want to do any other tests, and I don't want to listen to his analysis! Xiao Yuan, go and tell them quickly! Otherwise, I won't be able to get my procedure done today!"

Zhu Panxiang looked at Fang Yuan.

She just said that she came here to have a cardiac angiography.

There are acquaintances.

It's the emergency department.

They're actually planning to use this kind of deception.

She didn't want to be fooled.

Furthermore, she would absolutely never receive a banner from someone else!
"Deputy Huang, Xiao Chuan, I'm really sorry. My cousin is used to being domineering at home. Why don't we just order a coronary angiography for her? She came here specifically for a coronary angiography."

Fang Yuan apologized to the two of them with a helpless expression.

The next step is to have Huang Xiangning undergo a coronary angiography.

“Okay, I’ve always said there’s no problem with performing a coronary angiography. I will meet the patient’s needs.”

Without saying a word, Huang Xiangning immediately ordered a coronary angiography.

She had said before that performing a coronary angiography was possible, but they were analyzing the patient's condition and making an appropriate judgment.

Most importantly, less than three minutes after they arrived, the other party called for reinforcements to come over.

It didn't take up much time.

A normal patient consultation should take at least two or three minutes.

Xiao Yuan's cousin does indeed have an excessively impatient personality.

"Xiao Chuan, I'm sorry, that's just how she is..."

Seeing that the cardiac angiography had already begun, Fang Yuan apologized to Zhang Lingchuan again.

That's quite a coincidence, isn't it?

Xiao Chuan was actually treating his own cousin.

"It's alright, it's alright. Teacher Fang, please make sure she does the allergy test properly and doesn't miss it!"

Zhang Lingchuan said helplessly.

What can they do if they can't listen to reason and advice?

Let them do as they please.

"What? Xiaochuan, did you find something?"

Fang Yuan had watched all of Zhang Lingchuan's medical videos.

Netizens commented that if Xiao Chuan deliberately reminded them, it must mean he had discovered something.

So Fang Yuan asked with great curiosity.

"What else could be found? The main thing is that the last time I had a severe high fever, I developed a conditioned reflex, so I must do the allergy test well in order to avoid any unexpected situations."

Zhang Lingchuan gave a reply.

You definitely need to come up with a good reason.

Otherwise, it's easy to expose yourself.

"Oh, I see. I must say, that incident last time was truly terrifying. Alright, I'll talk to her. I'm so sorry, so sorry. Actually, you shouldn't try to analyze things with someone like her. Her way of thinking is already fixed. Once she thinks something is a certain way, she won't listen to anything else."

Fang Yuan nodded.

Then came the third apology.

Only then left.

As Zhang Lingchuan was leaving, he noticed that Aunt Zhu glared at him fiercely again.

　Second update delivered, 10,000 words today. Please give me some monthly votes, everyone!

　　
　
(End of this chapter)