Chapter 817: Trees Stand Out in the Forest

After dinner, everyone went home.

Lu Chen rested for a while in the apartment.

In the afternoon, he had to discuss difficult cases on behalf of Director Yan Wanfeng.

Nowadays, Yan Wanfeng basically doesn't care about clinical matters.

Most of the clinical matters in the department are all managed by Lu Chen.

Afternoon.

Oncology ward.

Demonstration room.

The directors or deputy directors of various major departments of Guanghai First Hospital came to participate in this difficult case.

The reason is that the patient's condition is critical and complicated.

Second, the patient's identity is special.

When he arrived at the Oncology Department, a graduate student immediately led Lu Chen to the demonstration room.

"Hey, Director Lu, you are here."

"Director Lu, the patient with congenital heart disease last time successfully gave birth to a child. This is a good case! We can study it well!"

"Director Lu, our department also has a troublesome case. If you have time, please go to our place to take a look."

Lu Chen is now familiar with the directors of other departments.

Everyone gradually became familiar with Lu Chen's identity, but ignored his age.

The main reason is that Lu Chen's ability is too outstanding.

Whether it is clinical ability or surgical ability.

"Okay, okay." Lu Chen smiled and greeted everyone one by one.

The Department of Oncology is a big and rich department!

The most important thing is that the conflicts between doctors and patients in the Department of Oncology are much less than those in other departments!

It is normal to diagnose a tumor but not cure it. Both patients and their families accept it!

If it is cured, it means that the medical skills are good.

Moreover, the drugs used in the Department of Oncology are very expensive.

Correspondingly, the benefits of the Department of Oncology are also very good.

Before Lu Chen chose the department, he even thought about the Department of Oncology for a while.

After ten minutes, all the staff arrived and the discussion of difficult cases began.

Director Tang of the Department of Oncology was the first to stand up and speak.

"Hello, directors. This time, we gathered together mainly to solve a case. The patient has a special identity, so our department has no choice but to brainstorm and see if we can come up with a good diagnosis and treatment method!"

Director Tang's words made everyone more curious about the identity of this patient.

However, the oncology department kept silent.

Everyone had to give up.

Then, the patient's attending physician gave a brief introduction to the patient's condition.

Everyone had a medical record form in their hands. With the introduction of the attending physician, everyone quickly learned the patient's basic situation.

The patient was diagnosed with rectal ca with liver and lung metastasis.

After the current targeted drug treatment, he recently developed dyspnea and decreased activity tolerance.

"Everyone knows the patient's situation." Director Tang said, "What we are most puzzled about is the reason why the patient has such symptoms. In addition, can he continue anti-tumor treatment?"

As soon as the voice fell.

A deputy chief physician of the respiratory department spoke first: "Excuse me, Director Tang, does the patient have a history of lung disease? For example, emphysema, etc."

"Yes." The attending physician nodded slightly, "The patient has a history of smoking for nearly 40 years, and has only started to quit smoking in the past year. He has a long history of chronic obstructive pulmonary disease."

"Then did you check your lung function before the tumor treatment?" The respiratory doctor said.

"No." The attending physician shook his head. "The patient's symptoms were very mild at the time, so I didn't pay attention to this problem."

"Well. I looked at the patient's medical records and felt that in terms of dyspnea, first of all, heart failure cannot be ruled out. In addition, the state of lung function, long-term emphysema, plus the metastasis of lung cancer, or the lung function must be poor."

The respiratory doctor talked freely.

After all, it is the top hospital in the province.

The resume of each director here is very good.

More than 90% of them have doctoral degrees and have the opportunity to study abroad.

There are even some directors who are industry masters.

Everyone expressed their opinions.

After a long while, the speeches ushered in a brief pause.

"Well, the opinions of all teachers are very valuable." Director Tang said, "Which department's teacher will continue to express his opinions?"

Under the stage, a doctor from the Department of Critical Care Medicine raised his hand.

Lu Chen knew him. He was the captain of the rescue team some time ago, Huang Xiaofeng.

"Director Tang, let me tell you my opinion." Huang Xiaofeng said.

"Okay, let's listen to Director Huang's opinion."

Everyone's eyes then turned to Huang Xiaofeng.

Huang Xiaofeng smiled gently, "I have consulted this patient before, and I noticed his electrocardiogram. I wonder if you have seen it?"

Then, three electrocardiograms taken after the patient was admitted to the hospital immediately appeared on the screen of the projector on the stage.

"Did you find any abnormalities?" Huang Xiaofeng said, "Although I am not a cardiologist, it is obvious that the AVR and ST segments of the first electrocardiogram are slightly elevated in the V1-V3 leads."

"The third electrocardiogram shows that the ST segments of the precordial leads and inferior wall leads are elevated."

"In addition, the patient's troponin is elevated. Do these all indicate that the patient has myocardial infarction?"

As soon as the voice fell, whispers rang out in the demonstration room.

Lu Chen did not speak.

In fact, he had noticed the patient's electrocardiogram a long time ago.

However, if it is really myocardial infarction and it is so easy to determine, then this patient does not need to undergo a general consultation in the hospital at all, right?

Sure enough, after Director Tang heard Huang Xiaofeng's opinion, he said, "Director Huang's opinion is very good. We have considered it before, so we performed a coronary CTA on the patient. You can take a look at the CTA results."

Coronary CTA is a non-invasive examination that, like coronary angiography, can diagnose coronary heart disease.

Subsequently, the bed doctor projected the patient's coronary CT image on the projector.

Lu Chen raised his head and looked attentively.

The patient's anterior descending artery has stenosis, but the degree of stenosis is not severe, only about 40% stenosis.

This degree of stenosis would never cause such severe symptoms!

Huang Xiaofeng obviously also saw this result. He was a little unwilling to give up and still asked: "The results of the angiography examination are normal, but it does not necessarily mean that there is no coronary heart disease! I remember that in the field of cardiology, if there is a disease, coronary microcirculation disorder is diagnosed. That is to say, the large main blood vessels may not be narrowed, but microcirculation disorder may also lead to heart failure.”

Microcirculation disorders cannot be detected by coronary angiography or CTA.

After saying this, Huang Xiaofeng glanced at Lu Chen and said, "Director Lu is an expert in this field. You know better than me. You should be talking like this."

Lu Chen smiled and nodded: "Director Huang, you are right, there is indeed such talk."

Seeing that Lu Chen had said this, everyone asked questions.

Could it be that the patient had heart failure caused by cardiac ischemia, as Director Huang Xiaofeng said?

Director Tang's attention was attracted by Lu Chen.

He suddenly said: "I have heard a long time ago that our Guanghai No. 1 Hospital has a very outstanding cardiologist. UU Reading www.uukanshu.net He is young and has won many honors and awards."

It was naturally Lu Chen who said this.

Everyone also turned their attention to Lu Chen, who was not far away.

Director Tang paused for a moment, then continued with a smile: "Director Lu is here in person to participate in the case discussion today. I think everyone is very interested in Director Lu's opinions on this patient, right?"

Lu Chen finally understood the difficult situation of a tree standing tall in the forest, but the wind would destroy it.

At this time, everyone present looked at him.

Maybe Director Tang didn't have any ill intentions.

But at this time, Lu Chen had to stand up and express his opinions and views.

If there is a slight mistake, he is likely to be labeled by everyone as "unqualified", "a scholar" and so on.

However, many doctors have already expressed their opinions. At the end of the day, Lu Chen, what new tricks can he come up with? ​16377/10590064