Chapter 292 Feelings of Lingering Fears!

Doing an electrocardiogram is an ability that an emergency doctor or even every doctor must have.

After three years of training in the emergency room, Chen Cang is more familiar with the signs of lead 1 to 6 on the human body than the four keys of qwer on the computer keyboard when playing League of Legends in college!

Basically, as soon as you set up your body position, you can see at a glance where to put it, regardless of whether you are wearing clothes or not.

Because one of the most common diseases in the emergency department is myocardial infarction, this kind of patient has an acute onset and may occur at any time.

So after Chen Cang went to the Second Provincial Hospital, he spent half a year doing and reading electrocardiograms.

The ECG machine was standing by at this time, and it was obvious that the patient had just done another ECG.

At this moment, all three of them stared at the electrocardiogram machine slowly and steadily to highlight the report.

Meng Xi, on the other hand, kept thinking about the electrocardiogram just now in her mind. She always felt that she had seen it somewhere, but she couldn't remember it, and there were always some vague impressions.

Without ST elevation, it is not necessarily non-ST elevation acute coronary syndrome!

An electrocardiogram is a screening process. All diseases are screened through a single examination. After screening, further diagnosis and treatment can be carried out in a targeted manner.

In fact, sometimes the patient's disease is the same as doing an application problem with you, and you need to use logical thinking to judge.

If a patient comes with chest pain, all possible causes of chest pain should first appear in your mind.

Then verify or exclude them one by one through your experience, inspections, tests, imaging data, etc.

This is the current medical process of diagnosis and treatment.

Speaking of which, Western medicine is like this, so what is the diagnosis and treatment process of traditional Chinese medicine?

Maybe everyone thinks that Chinese medicine is mysterious, but in fact, Chinese medicine is also a kind of logical thinking ability, not so-called nonsense.

In ancient times, people didn’t know much about the inside of the human body, and the physiological and biochemical tests were immature. After all, in those days, there may be no disease, and the infection will disappear once the operation is performed...

This is normal.

Traditional Chinese medicine studies the relationship between internal diseases and external manifestations of the human body.

And his diagnosis and treatment process is to look, hear, and ask.

Knowing is called a god, which means that many famous doctors are experienced and well-informed, and a diagnosis can be obtained at a glance by seeing the patient's words, deeds, complexion, tongue, etc.

The ancients formed the diagnosis of traditional Chinese medicine after a variety of performances, and after hundreds of years of case summaries.

Through looking, smelling, asking, and checking to verify one by one, we have always obtained a suitable pathogenesis, so as to carry out diagnosis and treatment, and realize the purpose of seeing and knowing!

Sometimes, I have to feel the greatness of the ancients.

...

The electrocardiogram had just come out, and Chen Cang was about to give it to Meng Xi, but after holding it in his hand, he suddenly froze for a moment!

Because this electrocardiogram... is a little different!

The first is that the J point of the V1-6 leads of the chest is depressed by 1-3mm, the ST segment is inclined downward, and then the T wave is symmetrically high!

Second, the QRS complex is normal and not wide at all.

Finally, the patient had mild ST-segment elevation in lead aVR.

After Chen Cang carefully read it again, he suddenly thought of a possibility!

Could it be... Thinking of this, Chen Cang's expression changed!

Continue to think about it carefully, it is very likely!

After a few seconds! Chen Cang considered the patient's condition and age, etc., and thought of the possibility of the patient.

Turning around, Chen Cang hurriedly turned around and handed the electrocardiogram in his hand to Meng Xi.

Meng Xi took a look and couldn't help frowning, still not much different from just now.

Is it really NSTE-ACS (non-ST-segment elevation acute coronary syndrome)?

Chen Cang originally thought that Meng Xi, as a foreign female doctor, should know something, but looking at her like this, she seemed to be a little hesitant, and she was suddenly impatient.

Thinking of this, Chen Cang said directly: "Mr. Meng, I think the patient's ECG is very similar to de-winter syndrome! Further examinations must be arranged as soon as possible to facilitate further treatment!"

There is no hesitation, now is not the time to hesitate, because this ECG belongs to the hyperacute phase of ST-segment elevation myocardial infarction! Also known as: de-winter syndrome.

After Chen Cang said these words, the two of them were immediately blinded!

After Ge Huai heard the words, he also paused for a while, a little familiar!

Because this type of ECG is rarely summarized in China, de-winter et al., a cardiologist in Rotterdam, the Netherlands, retrospectively studied 1532 cases of acute coronary syndrome ECG with proximal left anterior descending artery occlusion, and found that 30 patients did not have typical st The segment was elevated, so after the research, several special ECG waveforms were discovered, which were subsequently published in the "New England Journal of Medicine" in the form of a paper.

This is called de-winter syndrome!

However, this syndrome has been around for a short period of time, and there may not be many references in the domestic literature, so many doctors do not know it very well.

And Meng Xi was reminded by Chen Cang, his face changed suddenly, de-winter?

right!

very similar!

Most likely it is!

Thinking of this, Meng Xi quickly took the ECG list and continued to compare it.

The more Meng Xi looked, the more frightened, the more frightened the more he looked.

Turning around to look at Ge Huai, he quickly said, "Doctor Ge, hurry up to make a doctor's order, complete the relevant examinations, and prepare to sign...as soon as possible..."

If it is diagnosed, then it is imperative to perform coronary intervention in time to open the infarct-related blood vessels and rescue the viable myocardium!

At present, the indications for thrombolysis in myocardial infarction are mainly defined according to the magnitude of ST segment elevation and whether there is a new complete left bundle branch block. Although de winter syndrome is a complete or subtotal occlusion of the proximal anterior branch, the ECG does not There were no indications for thrombolytic therapy.

In theory, thrombolytic therapy may have therapeutic effects, but it is still an "off-label" drug at this stage. Throughout the STEMI guidelines at home and abroad in recent years, such patients have not been mentioned.

What does it mean, any disease, when receiving treatment, needs to follow the indications for treatment.

And this kind of de-winter syndrome is not within the indication of thrombolytic therapy, so if there is a problem, it is the responsibility of the doctor.

But medical treatment is the development of traditional Chinese medicine, who can guarantee that there will be no problems?

As a doctor, you must exercise the scalpel in your hand rigorously!

As soon as Ge Huai heard this, he quickly got up and started various arrangements!

Time passed by, and Chen Cang followed Meng Xi and Ge Huai to get busy!

When the coronary angiography image data came down, the three of them suddenly looked solemn!

Sure enough!

Really de-winter syndrome!

Now that the diagnosis has been made, it is necessary to urgently arrange for interventional surgery.

Meng Xi quickly led the team to treat the patient without delay. At eleven o'clock, the patient finally finished the operation.

Surgery went well!

A fresh life received a perfect treatment in this way.

The three of them couldn't help but be filled with emotion!

At this time, Chen Cang rang in his ears:

【Ding! Meng Xi's favorability rating +15! 】