When I'm on the night shift, all the department heads can't sleep.

After Meng Chi's girlfriend said, "His dad also collapsed while playing basketball," there was a few seconds of silence next to the observation post.

The medical report his girlfriend had found was still on his phone. Lin Ye didn't ask any further questions, but instead zoomed in on the echocardiogram section.

The interventricular septum is 13 mm, marked next to it as slightly above the reference range.

Lin Ye added a sentence to the medical record: The physical examination showed that the ventricular septum was thickened and the father died suddenly during exercise.

Qin Hai was working on the previous emergency records, with several unfiled electrocardiogram sheets next to his computer.

He handed over the medical record, glanced at the two newly added sentences, and slowly frowned.

The three electrocardiograms were laid out on the table in sequence.

The first two electrocardiograms showed little change, and the latest one isn't particularly alarming either.

But when it's placed alongside the newly added medical history, it can no longer be treated as nothing.

The troponin result is the same as the previous tube, hovering near the upper limit of the reference range. It doesn't seem heavy on its own, but it's an eyesore here.

The next troponin test is not yet due, but the newly added medical history has already piled up next to the electrocardiogram.

Meng Chi, who had previously used the meeting tomorrow morning as an excuse, now leaned against the headboard, swallowing back the words that were on the tip of his tongue.

Nurse Zhao came over to check vital signs and happened to hear the whole story.

As soon as the blood pressure cuff swelled up, Nurse Zhao looked down at the readings while talking non-stop.

"Young man, don't hide this from the doctor. You're not just hiding it from them, you're putting the risk on your own."

His girlfriend stood beside him, nodding with tears in her eyes.

"I told him before that he should have his heart checked again, but he said he was young and fine, and refused to go no matter what."

Qin Hai didn't answer, but dialed the number of the cardiology doctor on duty.

The phone rang three times before being answered, and the sound of a monitor could be heard in the background.

Qin Hai didn't stand on ceremony with him.

"Emergency observation bed 1, 27-year-old male. Chest tightness and numbness in his hands, had a follow-up examination tonight. Just found out two more things: he experienced dizziness after playing ball, and his father also suddenly collapsed and died while exercising."

He looked at the electrocardiogram on the table and continued, "The company's physical examination showed that the ventricular septum is slightly thickened. The electrocardiogram isn't conclusive at a glance, and the troponin is near the upper limit. The person can still speak, and the blood pressure and blood oxygen levels haven't dropped. Come over and check it again."

There was a pause on the other end of the phone.

"I'll be right there."

After hanging up the phone, Qin Hai looked at Lin Ye.

"Now you're finally good enough to make this call. If you send over all that information before, their first question will be, 'Why me?' Kobayashi, you still have a lot to learn."

Lin Ye nodded and carefully memorized it.

The blue text box at the edge of the field of vision lit up at that moment.

[Review conditions triggered.]

[The publicly available evidence has been supplemented.]

The blue text stops here, without providing any further answers.

Before long, the cardiologist on duty arrived, carrying a consultation kit.

Upon entering, he first looked at the electrocardiogram and test results, and then asked the nurse to repeat the bedside electrocardiogram.

The waveform that came out was similar to the one from before.

He squatted down by the bed and asked Meng Chi.

"How long did the blurred vision last? Did you experience chest pain or palpitations? Does anyone else in your family have had a heart condition when they were younger?"

This time, Meng Chi dared not be ambiguous.

"When my dad was young, he suddenly collapsed while playing ball and died when he was taken to the hospital. The doctor said it might be a heart problem, but in the end, they never got a clear diagnosis."

The cardiologist on duty closed the consultation clip halfway and lowered his voice.

"He experiences dizziness after exercise, and there's a family history of sudden death during exercise. We can't let this person go."

He looked at the screenshot of the physical examination again.

"The physical exam results showed a thickened ventricular septum. Hypertrophic cardiomyopathy cannot be diagnosed at this time, but myocardial damage, structural heart disease, and malignant arrhythmias must be ruled out. We'll keep him here tonight."

After he finished speaking, he looked at Qin Hai.

"I'll call Director Tang to report this."

Qin Hai nodded.

"Report the numerical values ​​and medical history clearly, so the doctor doesn't think it's another unfounded phone call."

The on-call cardiologist dialed Tang Zhendong's number.

The phone rang almost ten times before it was answered.

Tang Zhendong's voice was clearly sleepy, and he suppressed his anger from the very first sentence.

"What is it?"

The cardiologist on duty stood next to the nurses' station, one hand pressing down on the consultation clip, and first reported the most important items.

"Director Tang, bed number one in the emergency observation room. A 27-year-old male, experiencing chest tightness and numbness in his hands, and briefly went black after exercise. We just received news that his father died suddenly during exercise."

Tang Zhendong remained silent.

The on-duty doctor continued, "His company's physical examination report states that his interventricular septum is 13 millimeters. The follow-up ECG is not entirely the same as before, and his troponin is near the upper limit. His blood pressure and blood oxygen are currently manageable, but we dare not admit him. We want to categorize him as having myocardial injury, structural heart disease, or malignant arrhythmia. Please decide whether or not to admit him for monitoring."

There was a two-second silence on the other end of the phone.

Then Tang Zhendong's voice came through.

"Don't let him get out of bed yet, and don't put him back in the waiting room either."

He seemed to sit up, and most of the drowsiness in his voice dissipated.

"Connect the continuous ECG monitoring. Repeat the troponin and ECG tests as per procedure. Now perform a bedside echocardiogram in the emergency room, focusing on whether there is any obstruction in the interventricular septum and left ventricular outflow tract."

He paused, then added, "I'll call the cardiac intensive care unit to check bed availability. If the troponin level is high, or if there are problems with the ECG or ultrasound, don't delay in the ER; go straight to cardiac intensive care. You keep an eye on the patient; I'll call you back after I check bed availability."

The cardiologist on duty responded and hung up, then added a few lines to the consultation opinion.

Qin Hai glanced at the screen and simply nodded.

"Do as he says, connect the monitor, and do the bedside ultrasound first."

Nurse Zhao had already pushed the monitor to the bedside and quickly connected the leads to Meng Chi.

Heart rate 89, blood pressure 128/76, blood oxygen 99.

Meng Chi started to panic, clutching the bedsheets and asking, "Doctor, am I going to end up like my dad?"

Lin Ye didn't give any guarantees, only reminding him not to touch the lead wires.

"Cooperate with the examination first. It's better to have someone watching you now than to go home on your own."

The cardiology doctor on duty had just picked up the bedside ultrasound request form from the printer when the landline at the nurses' station suddenly rang.

Nurse Zhao answered the phone, but after saying "hello" once, she lowered her voice to say the rest of the sentence.

She looked at Qin Hai, her voice rising slightly.

"Director Qin, it's a call from the lab. Li Wencheng's digoxin result is in, 2.9."

The cardiologist on duty was about to walk to the observation station when he suddenly stopped.

Nurse Zhao covered the microphone and looked at Qin Hai.

Qin Hai did not answer the phone, but only gave instructions in a low voice.

"Make a note of 2.9. The family is asking when the last dose of medication was taken, so the lab will double-check the sample's time."

Nurse Zhao moved closer to the microphone.

"Don't call the lab yet, let's check the sample time again."

The cardiologist on duty glanced at the bedside ultrasound request form in his hand, and then at the monitor that Meng Chi had just connected.

"Director Tang will be going back to his bed later, so I'll keep an eye on this one. Call me immediately if there are any changes in Li Wencheng's electrocardiogram."