Chapter 818 Absolute Evidence!

Oncology Department.

Demonstration classroom.

At this time, everyone's attention was on Lu Chen.

Those who were familiar with Lu Chen and those who were not familiar with Lu Chen were all looking forward to what different opinions Lu Chen would say?

And Director Tang of the Oncology Department looked at Lu Chen with burning eyes.

No one knew that he and Professor Ouyang were actually good friends in private.

During the usual gatherings, Professor Ouyang Ming mentioned Lu Chen to him many times.

Director Tang was naturally very curious about this outstanding young man.

Today, he raised the question in public and let Lu Chen answer it last.

In addition to the test, it is more of a help!

Those present are all directors or deputy directors of various departments, showing their faces in front of everyone.

There are not many such opportunities!

Lu Chen naturally didn't know the hidden story behind this.

For him, no matter what the reason, he is willing to accept the challenge.

The condition of the tumor patient in front of him is just a small challenge for him.

What Lu Chen is least afraid of is diagnosis!

His system comes with a "diagnosis" function.

Only when the diagnosis is correct will the system pop up a prompt.

Therefore, in Lu Chen's mind, he had already thought about most of the possible diagnoses.

As long as the diagnosis of this patient exists in the current medical field, Lu Chen can diagnose it.

...

Lu Chen stood up and looked around at everyone.

"I am honored to be here today and share my views on this patient with you."

"Director Huang was right before. This patient can't be ruled out of coronary heart disease based on symptoms of dyspnea, electrocardiogram, troponin, etc.!"

Director Tang was a little disappointed.

He thought Lu Chen had some special opinions, but he didn't expect them to be the same!

At this time, Lu Chen changed the subject, "But my next opinion may be different from Director Huang's!"

"Hmm?" Director Tang raised his eyebrows and became interested.

In the demonstration room, other doctors also turned their eyes to Lu Chen again.

"The patient's coronary CTA shows that the anterior drop is only 40% narrowed." Lu Chen said slowly, "From the perspective of the mechanism of coronary heart disease, this degree of stenosis will definitely not cause serious symptoms, such as myocardial infarction, heart failure, etc."

"In this regard, Director Huang's opinion is that it is an obstacle to coronary microcirculation, but I think that for any disease, we must first start from the idea of ​​monism!"

In simple terms, medical monism is to use one disease to explain all symptoms and signs!

Huang Xiaofeng couldn't help interrupting after hearing this: "Director Lu, what is the relationship between tumors and heart disease? I think it is very likely that the patient had coronary heart disease before, but the symptoms were not obvious. After getting a tumor, the body suffered a trauma, which caused the coronary heart disease to worsen!"

Huang Xiaofeng's remarks are not without reason.

Many doctors present echoed and agreed with this view.

Lu Chen smiled, "I don't deny your idea, Director Huang. But I want to put forward some of my own opinions!"

"Okay, you talk, we all listen!"

Huang Xiaofeng looked at Lu Chen, wanting to see what other reasons this young man could come up with? !

Lu Chen no longer paid attention to Huang Xiaofeng, but walked onto the stage, came to the position of the attending physician, and operated the projector to show the PPT.

He first returned the PPT to the interface of the three electrocardiograms.

Everyone was a little puzzled. Didn't they just see this picture?

Why did they see it again?

Lu Chen said slowly: "All auxiliary examinations must be fully combined with clinical practice to be meaningful."

"Director Huang is right. These three electrocardiograms look very typical electrocardiograms of myocardial infarction. The first and second electrocardiograms show ST elevation in the AVR, V1-V3, and V3R-V5R leads, and the entire vector is biased to the right, which is very similar to left main trunk lesions."

"The third electrocardiogram shows extensive ST elevation in the precordial leads and inferior wall leads, which is also very similar to myocardial infarction."

"In the above two situations, if it is a myocardial infarction, it must be a very serious myocardial infarction. Then, the patient has no symptoms of progressive ischemia, no obvious chest pain, and no very dangerous clinical manifestations!"

Lu Chen paused, "In other words, the electrocardiogram is seriously inconsistent with the clinical symptoms! This shows that the diagnosis of coronary heart disease is wrong!"

After Lu Chen finished speaking, the whole audience was silent!

No one expected that this young Director Lu would directly overturn Director Huang Xiaofeng's diagnosis!

The diagnosis of coronary heart disease... is wrong!

This stunned everyone.

Director Tang of the Oncology Department was getting more and more excited as he listened.

Although Lu Chen did not finish, he could feel the confidence in Lu Chen's words.

This confidence was not possessed by anyone else present.

The person that Professor Ouyang Ming admired was indeed a master!

"Did you overlook something very important?" Lu Chen continued, "The patient is a tumor patient, and is undergoing targeted therapy and immunotherapy!"

"I guess this patient is likely to have myocarditis caused by immunotherapy!"

As soon as the voice fell, the system popped up a prompt.

"Congratulations, the system upgrade completion rate has increased!"

At the same time, everyone present was puzzled.

"Myocarditis caused by tumor immunotherapy?"

Everyone knows about myocarditis, but this myocarditis caused by immunotherapy...

This is beyond their cognition!

Even as an oncologist, they have never heard of it!

"Director Lu, can you explain this disease to everyone?" Director Tang said quickly.

"Okay, no problem." Lu Chen nodded slightly, and then took out his mobile phone.

Everyone was a little confused, and saw Lu Chen connected his mobile phone to the projector.

Lu Chen began to introduce: "This is a paper I read last month, published in the Lancet."

The paper was written in English, but everyone was a big shot in the medical industry, so it was naturally not difficult for them.

"This paper is about the side effects of immunotherapy. Immune myocarditis, as the name suggests, is a drug for tumor immunotherapy. While treating tumors, it will also damage the patient's myocardial cells!" Lu Chen picked out the key points of the paper, "Among the many adverse reactions, myocarditis caused by immunotherapy is a side effect that doctors are very reluctant to see."

The incidence of immune myocarditis is 0.06%-3.8%.

Although the incidence is relatively low, it has the characteristics of high lethality.

The mortality rate of immune myocarditis is as high as 39.7%-50%! Once it occurs, nearly half of the people will be in danger of death.

"After reading this article, let's read the second one!" Lu Chen switched to another article, "This paper is also published in the New England Journal of Medicine, a top journal in the cardiovascular field."

"Researchers warn patients using immunotherapy to be highly vigilant about the occurrence of immune myocarditis. Because the symptoms of this adverse reaction are not specific, it is easy to be ignored or mistaken for other underlying diseases!"

After reading the two articles, the demonstration room was silent.

It's not how great you are.

But after giving your reasons, you can still find corresponding evidence!

Compared with Lu Chen, Huang Xiaofeng's diagnosis seemed pale and powerless at this time. UU看书www.uukanshu.net

Director Tang smiled with relief, but he felt a little more disappointed in his heart.

The good news is that Lu Chen, this young man, is indeed extraordinary!

The sad thing is that China's research is still lagging behind foreign countries after all!

When will this situation be reversed?

Director Tang looked at Lu Chen in front of him, and felt a little more hope for no reason.

－－－－－－Digression－－－－－－

Myocarditis caused by immune check inhibitors has been mentioned in China in recent years.

The first domestic guideline was issued last year.

The content written in the article is partially lagging behind reality.

After all, I can't make up a new research field out of thin air.

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