Chapter 724 How About I Do It?

As the chief resident of the Department of Cardiology, Lu Chen is also responsible for all emergency consultations and rescue work in the Department of Cardiology.

Therefore, although he knew that the island medical team came to discuss this matter, he did not go to join in the fun.

However, the island medical team did not disturb him.

The emergency consultation of the emergency department came to him again!

The first hospital of Magic City, CCU lounge.

At this time, Lu Chen was in a dream.

A burst of urgent mobile phone alarms woke him up directly.

"General Manager Lu, emergency consultation in the emergency department!"

Wu Si no longer called the special phone of the chief resident, but directly called Lu Chen's private phone.

"Okay, I'll be there right away!"

Lu Chen held the phone in one hand and was busy putting on his white coat.

When he opened the door, there was a burst of noise outside the catheter room. He did not pay too much attention and hurried to the emergency department.

...

About five minutes, Lu Chen arrived at the emergency department.

On the bed, an old man with sweat all over his head and shortness of breath was sitting on the bed.

The head of the bed was shaken to a right angle of 90 degrees to the ground.

Wu Si, the attending physician of the emergency department, was organizing nurses to rescue the patient.

Seeing Lu Chen arrive, he felt a little relieved.

"Mr. Lu, this should be a patient with acute heart failure."

Lu Chen nodded, without any hesitation, picked up the stethoscope, and began to give the patient a simple physical examination.

Wu Si began to introduce the patient's condition to Lu Chen.

More than a month ago, the patient had difficulty breathing without obvious cause, accompanied by chest tightness and shortness of breath, which worsened in the supine position and could be relieved after sitting up. He went to the local hospital for treatment, and the symptoms improved after diuresis and improved circulation.

A day ago, the above symptoms worsened, and he coughed up pink foamy sputum and went to the local hospital again.

Diagnosed as "heart failure", nitroglycerin and sodium nitroprusside were given, but the effect was not good. After that, 7 "recombinant human brain natriuretic peptide for injection" were pumped in for 5 days, but the patient's condition still did not show significant improvement.

An hour ago, the patient was transferred to the emergency department of the First Hospital of Shanghai for further treatment.

"At present, heart failure is certain!" Lu Chen agreed with Wu Si's diagnosis.

Through physical examination, the patient was sitting and breathing, with moist rales in the lungs and edema in both lower limbs, which was obviously a symptom of acute heart failure.

And his life value was 47 (---), which was a symptom of an acute and critical illness, and the risk of sudden death was extremely high!

"Let's use furosemide first." Lu Chen said, "After stabilizing the patient's vital signs a little, transfer to the CCU."

"Okay." Wu Si nodded, and at this time, he took out another case.

It seems that it should be the patient's case information in the local hospital.

"Mr. Lu, take a look at this. The patient had a cardiac ultrasound at a local hospital, which showed severe aortic valve stenosis-mild insufficiency!"

Lu Chen raised his eyebrows slightly and immediately took the report in his hand.

From this cardiac ultrasound report, the patient's condition can be fully determined.

Chronic heart failure caused by heart valve disease, and acute onset!

In addition, patients with severe aortic stenosis are absolutely suitable for TAVR surgery!

After flipping through it, Lu Chen asked Wu Si to bring the emergency ultrasound machine for safety reasons.

He needs to recheck the patient's cardiac ultrasound.

Ultrasound is related to the operator's technique.

A small difference in technique is likely to cause huge errors!

...

Wu Si quickly asked the nurse to push the ultrasound machine.

After Lu Chen performed a cardiac ultrasound on the patient, he confirmed "severe aortic stenosis" again.

In addition, he also measured the patient's cardiac ejection fraction, which was only 38%!

Other data showed that the aorta was severely calcified.

Aortic valve: Vmax: 3.5m/s, PGmean: 26mmHg, valve area: 0.6cm2.

Left atrium, left ventricle, and ascending aorta are enlarged. The basal segment of the ventricular septum is thickened, and the ventricular wall pulsation is diffusely weakened.

"What is the result?" Wu Si asked curiously.

Cardiac ultrasound, unlike abdominal ultrasound, is difficult to understand if you don't know the anatomy.

"The local hospital is quite accurate." Lu Chen said in a deep voice, "There is indeed severe aortic stenosis. It is best to do an emergency TAVR operation immediately!"

Wu Si had no doubt about Lu Chen, "I will communicate with the patient's family?"

Lu Chen nodded, "If the family agrees to the operation, send it to the CCU immediately, and I will help contact the surgeon."

"Okay!" Wu Si heard this and quickly called the patient's family aside and started talking about emergency surgery.

Lu Chen stayed in the emergency room and continued to watch the patient's condition change.

...

Five minutes later, Wu Si finished the communication.

"The patient's family agreed!" Wu Si walked into the emergency room with a hospitalization certificate in his hand, "Mr. Lu, are we going to the CCU now?"

In fact, he almost guessed the result. The patient's family went to multiple hospitals and sent the patient to the First Hospital of Shanghai. They would definitely not give up easily.

"Wait a minute, I'll call the CCU first." Lu Chen said.

He wanted to ask the CCU doctor to prepare, and also to confirm that there was an empty operating room for the CCU catheter.

The call was connected immediately.

"Intracardiac CCU? This is Lu Chen."

"Mr. Lu, what's wrong?" It was Zhang Lulu, the CCU doctor, who answered the phone.

Lu Chen heard it right away and said quickly: "Sister Lulu, there is a patient with severe aortic valve stenosis in the emergency department. He has acute heart failure and may need emergency tavr surgery. I heard that the Japanese medical exchange group came to the catheterization room. Can they do surgery there now?"

"There is an empty operating room now, and emergency surgery can be done!" Zhang Lulu said immediately, "But Professor Zhang Shuqing and Professor Zhu Qingshan are both on the stage. If you want to do emergency tavr surgery, there may be no one."

Lu Chen frowned slightly, "No one?"

Currently, there are many people who can do tavr surgery in the First Hospital of Magic City, but the only doctors who can really perform the surgery and undertake this kind of emergency surgery are Zhang Shuqing and Zhu Qingshan!

Lu Chen hesitated for a moment and said slowly: "Why don't I do it!"

Zhang Lulu was slightly stunned. She knew that Lu Chen could independently lead tavr surgery and did a lot of it.

"But you are the chief resident now..." Zhang Lulu whispered.

"Sister Lulu, I am a cardiologist first, and then the chief resident." Lu Chen said, "If the patient needs emergency surgery, I will definitely do my duty. As for the chief resident's job, Sister Lulu, are you busy now?"

Zhang Lulu smiled helplessly, "You kid actually came to me! I happen to be off duty today, so I can help you with the chief resident's job for a while."

Seeing Zhang Lulu say this, Lu Chen showed a hint of joy on his face.

"That's great! Thank you Sister Lulu! I will ask the emergency department to bring the patient to the CCU right away."

After hanging up the phone, Lu Chen immediately informed Wu Si to pack up and prepare to transfer the patient to the CCU ward.

And Lu Chen went back to the CCU ward one step ahead and began preoperative preparations. 　　16377/10459484