Chapter 311: Encountering a Vampire Again

Second floor of the emergency department, in the observation room.

Although the hiccuping old man was sent to the CCU, Cheng Peng still couldn't figure it out.

Why does myocardial infarction cause persistent hiccups, while the patient has no obvious chest pain symptoms?

"I don't quite understand it either." Although Wang Xiaodong is a senior physician, he has actually just started working for a short time. He has not seen many such rare cases, so he naturally doesn't know the reason.

Cheng Peng thought about it and sent a WeChat message to Lu Chen to ask about the principle.

Lu Chen received the WeChat message and quickly replied.

"Myocardial infarction causes hiccups. I guess this may be because most elderly patients have varying degrees of cerebral arteriosclerosis and autonomic dysfunction (reduced sensitivity to pain)."

"Especially when the patient has diabetes, the pain and sensory nerves will be damaged, causing the necrotic myocardium to stimulate the vagus nerve, causing only hiccups without chest pain."

"In other words, it's not that there is no chest pain, but that the patient's pain sensation has subsided and can't feel the pain."

After reading Lu Chen's explanation, Cheng Peng finally understood a little.

"Myocardial infarction manifested as hiccups, this is really rare!" Cheng Peng exclaimed.

Lu Chen said: "In fact, in addition to hiccups, there are other uncommon symptoms that may also be manifestations of myocardial infarction. For example, toothache, headache, neck pain, frozen shoulder, and even worse, toe headache, which was finally diagnosed as myocardial infarction."

"In short, no matter what the main complaint is, detailed physical examination and medical history are very important, and there is also an electrocardiogram at admission. All these things are combined together, and finally we can unravel the mystery and make an accurate diagnosis."

...

After experiencing this somewhat rare patient, the emergency internal medicine clinic ushered in a short window period.

It was already ten o'clock in the evening.

In the night sky, the stars nodded.

There were fewer and fewer people on the street.

Except for the hospital not far away, which was still lit red, the surrounding area was dark.

Lu Chen sat in the emergency room.

Although the emergency department was very busy, he felt that he was just a tool.

As long as he listened to the superior doctor, he didn't need to use his brain at all.

This is not in line with Lu Chen's style at all.

He came to the emergency department to train.

If he doesn't see patients in person, he can't get gratitude points!

He has been a tool, but so many resources have been wasted.

"Teacher Wang, how about I do the patient's physical examination and consultation later?"

Lu Chen volunteered.

"Hmm?" Wang Xueyang raised her eyebrows.

This is the first time she has heard a student make such a request!

Wang Xueyang is eager for students to help her.

But the reality is that most students are not very reliable!

Let students check the body, auscultation of the heart and lungs is a problem.

It's better to come by yourself!

You know, the flow of patients in the emergency department is very large.

If you delay for a few minutes, the patients and their families may start to quarrel!

However, Wang Xueyang thought about it.

Lu Chen was able to make such a request himself, and considering his previous performance, he should not be that kind of unreliable student.

"How about this, you take the medical history and physical examination of the next two patients." Wang Xueyang said, "I'll take a look first."

Students with such ideas should be encouraged.

Besides, if Lu Chen can really replace her, then she can be much more relaxed this night!

"Okay." Lu Chen smiled.

Finally, I have the opportunity to contact patients.

It's only ten o'clock in the evening now. If the next patients are all treated by him.

Then his efficiency in earning gratitude points and improving system upgrades will definitely be improved!

...

Just as the two finished talking, a patient with abdominal pain walked into the emergency room.

Abdominal pain is also one of the most common types of patients in the emergency room.

This time, it was Lu Chen's turn to see the patient.

The patient was a middle-aged man in his thirties.

His face was flushed and he smelled of alcohol.

However, the man was now covering his hands and his face was full of painful expressions.

Lu Chen hurriedly helped the family members move the patient to the bed.

"Why do you feel uncomfortable?"

The middle-aged man pointed to his stomach, "It hurts... it hurts..."

Lu Chen asked about the medical history while starting the physical examination.

From the cause and trigger of abdominal pain, location, nature, whether there is metastatic pain, radiating pain, and the way to relieve it, everything is taken care of.

At the same time, Lu Chen was also checking the patient's abdominal signs, whether there was tenderness, rebound pain, etc.

Wang Xueyang, who was standing by, watched Lu Chen's actions and nodded with a smile.

This kid is really good!

Whether it is questioning or physical examination, he performed extremely perfectly.

This professional skill does not look like a first-year graduate student at all.

For example, questioning is the simplest clinical skill.

But many medical students don't pay much attention to it. They ask whatever they want to ask, or there is no rules, which makes it easy to miss a lot of things.

But Lu Chen is different. From the main symptoms to the accompanying symptoms, as well as the negative and positive of the differential diagnosis, he can ask clearly.

The most important thing is that there is no extra nonsense.

In the shortest time, he can master the patient's first-hand information.

"Teacher, the patient has tenderness under the xiphoid process, no rebound pain, and the rest of the physical examination is normal."

"What about the auscultation of the heart and lungs?"

"Both are normal."

……

After seeing two patients in a row, Wang Xueyang felt relieved.

Lu Chen could really do the physical examination on her behalf.

This is what Wang Xueyang dreams of.

With a student to help her, her night would be much easier.

"Lu Chen, next, you continue to see patients, I will be by your side, and I will give you hints when you encounter areas that you don't know how to do."

"Okay, thank you, Teacher Wang." Lu Chen smiled.

Through his own efforts, he was finally able to see patients in person.

However, the next patient made Lu Chen's expression change.

…

This is a woman wearing a black headscarf.

She was supported by a young man and slowly walked into the consulting room.

Her face was pale, the expression on her face was extremely painful, and she moaned in pain from time to time.

"Doctor, I keep complaining that my stomach hurts!" the young man shouted as he walked into the consulting room.

The middle-aged woman next to him was holding her stomach while reading a book.

"I have a stomachache, please give me pain relief!"

Lu Chen's pupils narrowed.

If he remembered correctly, this woman wearing a black headscarf seemed to be the "vampire" he met when he went to the temple to pray!

Wang Xueyang saw that this female patient was in a hurry and did not intend to let Lu Chen come to treat her. She wanted to come and treat her in person.

She quickly walked to the female patient.

But the first time she saw the patient, she was frightened.

This woman's whiteness is not the delicate whiteness of her skin, but a sickly whiteness!

There were large scars on her ears and nose, which looked like they had been corroded.

And her teeth are those kind of fangs!