Chapter 247: Propranolol Experiment

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Li Yao is a professor-level figure. After hearing what Lu Chen said, she thought about it and knew what Lu Chen was up to.

"Lu Chen, are you talking about the propranolol experiment?"

Lu Chen nodded quickly: "Yes, teacher, I think I can give it a try."

Propranolol, a beta-receptor blocker, is also known as "propranolol".

The propranolol experiment is mainly used to distinguish nonspecific ST-T changes caused by autonomic dysfunction from ST-T changes caused by myocardial lesions.

Zhu Zhonghua also looked at the two doctors in front of him with expectation.

To be honest, he came from the county hospital below.

He has been to the best hospital in the county and the best tertiary hospital in the city, but no doctor can solve his problem of inverted T waves on his electrocardiogram.

It was because the electrocardiogram did not pass that the physical examination was stuck!

But he clearly did not have any disease!

All the doctors in the cardiology department of the county and city hospitals were helpless, and even told him clearly that this T wave would accompany him for life.

It will never stand upright!

Zhu Zhonghua almost gave up.

But this civil servant position is in Jinghua City, and the benefits are so good!

Zhu Zhonghua really can't bear to give up!

Jinghua Second Hospital is the best hospital in the province and the seventh-ranked hospital in China for cardiology.

So, this time Zhu Zhonghua came to Jinghua Second Hospital to try his luck.

If there is still no way, then he really gave up!

"Professor Li, what method are you talking about? Whether it works or not, I am willing to give it a try!" Zhu Zhonghua asked quickly.

Now he can grab a life-saving straw, so he must hold it desperately!

This is related to the direction of his entire life in the future.

Li Yao hesitated for a moment.

To put it bluntly, this Propranolol Laboratory is to distinguish whether the patient has autonomic nervous system disorder or is really sick.

But the specificity of this test is not strong.

So far, she has only seen a few patients with positive Propranolol, and they are all female patients!

But now it seems that there is no other way!

Li Yao glanced at Zhu Zhonghua. Slowly said: "The method we are talking about is to do a propranolol experiment."

After taking propranolol orally, record the 12-lead electrocardiogram 30min, 1h, and 2h after taking the medicine, and compare and analyze it with the 12-lead electrocardiogram before taking the medicine.

If after taking the medicine, the T wave changes from the inverted lead before taking the medicine to the upright one, the propranolol test is positive.

It suggests that the ST-T change before taking the medicine is caused by the hyperfunction of the autonomic nervous system.

After listening to Li Yao's description, Zhu Zhonghua seemed a little impatient.

"Isn't it just taking a medicine? I'll take it... By the way... Is this medicine expensive?"

"Not expensive, a box of 60 tablets, only twenty yuan, you only need to take two tablets." Li Yao said.

"Well, let me try this experiment!"

Li Yao did not prescribe medicine for Zhu Zhonghua immediately, but recorded all the conditions in detail in the medical record, and then prescribed a box of propranolol for Zhu Zhonghua.

Li Yao said, "I'll prescribe you a box of medicine first, and then write you an ECG application form. Remember to do an ECG half an hour after taking the medicine. Compare the two ECGs before and after. If the T wave is upright, it proves that it is effective!"

"Okay, no problem."

Zhu Zhonghua took the medicine collection form and the ECG application form and walked out of the outpatient clinic quickly.

Li Yao couldn't bear to disappoint him with his excitement.

...

After dealing with this patient, the subsequent registered patients finally came in.

"Hey, I've been waiting for a long time, and it's finally my turn!"

This time, the patient was a fat middle-aged man with a briefcase under his armpit.

As soon as he walked in, he started yelling, "I'm here for a physical examination. My blood sugar was high before, so I checked my blood sugar, blood lipids, liver and kidney function, and electrolytes. By the way, my uric acid was also high before, so I checked my uric acid again. I'm afraid I'll get gout in the future. How about another blood routine..."

Before Li Yao spoke, the fat man in front of him had already "diagnosed" himself.

"That's all for now."

After saying that, the fat man added another sentence.

Li Yao had a blank expression on his face and gestured to Lu Chen, asking him to prescribe all the items that the patient requested for examination.

"Okay, thank you then." The fat man left the clinic with his briefcase.

This man came in a hurry and left in a hurry.

Li Yao smiled and said, "Nowadays, many people can diagnose diseases. Even if they can't, they can use Baidu. Look at this patient. He has already diagnosed himself before I said a word."

"But the expert's appointment is 300 yuan each." Lu Chen curled his lips and said.

"Don't worry, they will still come to see me after their examination results come out."

Li Yao was right. The patient with chest pain before had already completed the cardiac ultrasound and returned to the clinic.

The results of the cardiac ultrasound showed that there was no obvious abnormality in the structure and function of the heart.

"Professor Li, you see my ultrasound results are also normal. What exactly is the chest pain?" The man looked very impatient.

He had already done a lot of examinations.

He had done cardiac ultrasounds four or five times, and each time there was nothing wrong, but he couldn't find out what the problem was!

This worried him!

Chest pain, this feeling is not pleasant!

However, after Li Yao looked at the cardiac ultrasound, a smile appeared on the corner of his mouth.

"Your chest pain may still be related to coronary heart disease!"

The man was about to interrupt Li Yao, because his blood vessels had been operated on and were not narrowed!

But Li Yao reached out to stop him: "Don't worry. First of all, you have to understand a concept. If the blood vessels are not narrowed, chest pain may still be caused by coronary heart disease."

"Our heart and blood vessels are like branches. In addition to large blood vessels, there are small blood vessels and even roots buried underground. The blood vessels examined by angiography are all large blood vessels and some small blood vessels. We cannot examine the roots buried in the ground."

"This kind of root is what we often call microcirculation. If the microcirculation disorder reaches a certain degree, the patient will have chest pain!"

The man looked quite panicked.

"You mean, I have a microcirculation disorder now?"

"It seems so now." Li Yao nodded.

"Microcirculation disorder... How to treat this disease?"

"I'll prescribe you a medicine called Nicorandil. You go back and take it for a while to see how it works. If it doesn't work, come back for a follow-up visit."

Li Yao immediately prescribed the man.

Lu Chen cooperated and typed it out on the computer. uukanshu.net

"Okay, thank you Professor Li."

The man went to many hospitals, but the problem of chest pain was not solved.

Now he can get a reason for chest pain, he is very satisfied.

He took the prescription and left the clinic.

...

For two hours, Li Yao saw more than ten patients in total.

Lu Chen followed Li Yao and learned a lot of communication methods and diagnosis and treatment skills.

But so far, they have not encountered any difficult patients.

At least in Lu Chen's opinion, they are all relatively easy to solve.

This may also be because Lu Chen has rich clinical experience and has seen many medical records, so he has this feeling.