My medical skills add experience

Chapter 549 The second heart of the human body, secretly registered to see a doctor
The more inspection items he looked at, the tighter Zhou Can frowned.

On the X-ray examination of this patient, it can be seen that there is no obvious enlargement of the heart and pulmonary edema on the chest radiograph.Color Doppler echocardiography assessed that the size of the heart was within the normal range, the valve function was normal, and the left ventricular ejection fraction was below normal.

After carefully reading all the examinations of the patient one by one, he realized that the cause of this 17-year-old boy was far more complicated than imagined.

Usually, heart failure has at least one lesion in the heart.

However, the patient's heart is normal regardless of its size or myocardium, or the tricuspid valve, mitral valve, etc.It can be said that the patient's heart is normal except that the ejection fraction is not up to standard.

Of course, because of insufficient ejection ability, the heart rate has been much higher than normal.

This is not a disease, but a compensatory mechanism of the heart.

What causes the ejection fraction of the ventricle to be lower than normal?

It is impossible for a living person to open someone's chest to have a look.Can only rely on the results of various examinations, and then make a comprehensive assessment based on the doctor's diagnostic experience and medical knowledge learned.

At Zhou Can's level, the result of the evaluation would not be much different from the chest cavity examination.

Except for subtle lesions that are difficult to detect with some instruments.

For example, tumors with a diameter of less than 1 cm are difficult to detect through imaging, ultrasound and other means.MRI can be regarded as a major advancement in human medical examination. Tumors smaller than 1cm still have a chance to be detected.

However, if the tumor diameter is too small, or relatively hidden, it is still powerless.

In short, at Zhou Can's level, he is fully capable of making the evaluation results consistent with the results of the chest opening through the results of film readings, various biochemical tests, and auxiliary tests.

The invention and application of various inspection instruments is also to directly diagnose the real cause without harming the patient.

Otherwise, in order to find out a small cause, the patient needs to be prescribed five or six dollars, or even seven or eight dollars.

After opening the abdominal cavity, I found that the problem was not here. I suspected that there might be a disease in an organ in the chest cavity, and I had to open the chest again... that was unimaginable.

After Zhou Can finished all the examinations of the patient, he assessed that the patient's heart had no obvious pathological changes.

But one thing is worthy of vigilance, if the patient's heart rate is too high for a long time, it will cause very serious consequences.Such as heart enlargement, myocardial ischemia and necrosis, etc.So it's very harmful.

This young man has long-term heart failure, but it is controlled by drugs, coupled with his young age, full of vitality, and strong tolerance.

No particularly obvious changes have been found in his heart yet.

However, there are already signs of heart enlargement, but this enlargement is still within a reasonable range.

As for myocardial ischemic necrosis, it has not yet appeared.

Zhou Can frowned and thought hard, what is the cause of the patient?
Now he finally understands why so many top cardiologists in the imperial capital are helpless.

Because the cause of this young man is really difficult to find out.

Considering the poor ejection ability of the heart, a heart transplant is not the best solution, but it is worth trying.

It's like repairing an electrical product. The engineer checked for a long time and couldn't find any component that was broken. It may also be a problem with the integrated circuit board. In short, the electrical appliance cannot work normally now.According to experience and common sense, it can be determined that the problem lies in the main board.

What should I do if I really can't find the problem?
Replacing the motherboard is the easiest way to save trouble.

The experts in the imperial capital really had nothing to do, so they suggested a heart transplant for the young man.

"Your cause is very complicated. You will be hospitalized here for observation for two days first, and I will try my best to find the cause with other doctors in the hospital. But there is no way to guarantee it. If you have other neglected symptoms during the hospital observation period, or new symptoms Symptoms, or think of some important information in the course of the disease, you can tell the doctors and nurses in charge of the bed at any time."

Zhou Can can't find out the cause of the patient for the time being, so he can only arrange it like this.

There are many patients who cannot find out the etiology clinically.

Sometimes, doctors cure the disease without even knowing what caused it.

"Okay, thank you! Please take care of me!"

The patient expressed his gratitude to Zhou Can.

Zhou Can and Director Xueyan walked a few meters away, and heard the patient's family member say in a very disdainful tone, "I know that none of these so-called Internet celebrities are reliable, they are all hype. Such a young man, how high can he be?" go?"

"Based on my feeling, this Dr. Zhou is very honest. At least he has diagnosed me seriously just now, and if he comes, he will be at ease. Please wait patiently for two days and then see the situation!"

What the patient said to his family members made Zhou Can feel more comfortable listening.

……

A day passed in the blink of an eye.

As long as Zhou Can has time, he will try his best to find the cause of the 17-year-old boy.

There is no new information from the cardiothoracic surgery side.

This shows that the patient is still the same, and no other useful clues have been provided.

After get off work, Zhou Can frowned even while eating.

He traveled thousands of miles from the imperial capital to seek medical treatment, so he had to be worthy of this trust.

What is the cause of that young man surnamed Lan's heart failure?
The experts in Imperial Capital even checked the patient's ECG signal, and the result was normal.

To be honest, the cause of heart failure cannot be found out, even if the heart is replaced, it may not be effective.

With a new heart, it is still possible to have heart failure again.

For example, uremia can cause blindness in the eyes. Even if the technology is against the sky, it is useless to replace the entire vitreous.Because the cause is not in the eyes at all, but because of the loss of kidney function and the inability to excrete toxins.

"Do you still think about your 'national affairs' while eating?"

Su Qianqian asked him with a smile beside him.

"Hey, isn't it because I encountered a difficult case and failed to find out the cause! I do this job, so I have to be responsible for the patients. That young man is only 17 years old, and he is a very hard-working person. I really can't bear to just watch him like this." The pillars of a future country died young. Do you have some basis for saying that heaven is jealous of talents?"

Zhou Can really found that many idioms come from reality.

And it will repeat itself.

"How do you say that?"

Su Qianqian tilted her head and asked back.

"You see, you had kidney disease at that time, and you almost couldn't be cured. Now this young man is also very good, but he also has a strange disease that is difficult to cure. In clinical practice, I often meet some very sensible and intelligent children, young People, suffering from incurable diseases. It feels like God is jealous of them and deliberately sent disasters."

Zhou Can never believed in the way of heaven or fate before.

I have seen a lot in the clinic, and my understanding of fate seems to be a little deeper.

"Didn't the ancient Mencius say that if a man is assigned a great mission from heaven, he must first work hard and work hard! If a person wants to achieve something, he must endure more hardships and hardships than ordinary people! You continue to think The cause of that patient, I won't bother you anymore."

She likes to accompany Zhou Can quietly.

Zhou Can also enjoys her company.

"What are you doing staring at other people's legs? Many people are watching!"

Su Qianqian said shyly.

Although the two have been together for several years, she has always been as shy as a girl in public.Perhaps she is a traditional woman in her bones.

Zhou Can didn't respond, he didn't even eat, and just stared at her legs without blinking.

Seeing this scene, Su Qianqian realized that he might be thinking about something.

After a long time, Zhou Can's eyes brightened instantly.

Bright as the stars.

"I know what's wrong!"

Zhou Can said excitedly.

"Hey, work is work, you can't delay eating! Your body is the capital of the revolution. Only when your health is healthy can you heal others."

She grabbed Zhou Can and refused to let him go.

"All right, all right, I'll listen to my wife and go after dinner."

Zhou Can was really happy to be under her control.

"Hehe, I know you're talkative! You haven't married me yet!"

The title Madam is very useful to her.

What women care about sometimes is actually a man's heart.

There has never been a pledge of eternal love with Zhou Can, but there are two hearts colliding fiercely, and there are ordinary days.She gave Zhou Can her best years and lived with him. What was she planning?
Don't you just want a name?Isn't it that Zhou Can can value her, take her to heart, and love her all the time?

"Aren't you in a hurry? When I finish my work, I will accompany you back to your hometown. Let's fix the date of the wedding. At that time, the beautiful eight-carriage sedan will marry you and let you be my wife. wife."

Zhou Can made a promise to her.

"it is good!"

She was obviously satisfied with this answer, and looked at Zhou Can affectionately, her eyes were full of smiles, and the happiness on her face was about to overflow.

Zhou Can never makes promises easily, but as long as he promises, he has never broken his promise.

This kind of golden credit made her never doubt Zhou Can's words.

Including Zhou Can's subordinate Qiao Yu and others, and even senior doctors such as Dr. Xu and Director Xueyan also had great trust in Zhou Can.It is not easy to establish a person's credit. To destroy credit, one only needs to break one's credit once.

Adults with credit must be respected.

……

After eating and checking the inpatient wards in the emergency department, Zhou Can hurried to the cardiothoracic surgery department.

After arriving at the cardiothoracic surgery department, he went straight to the hospital bed where the young man was.

"Doctor Zhou, you are here!"

When the young man saw Zhou Can, he immediately greeted him politely.

It can be seen that he is very happy for Zhou Can's arrival.

He came here from the imperial capital to see a doctor, and he came here because of Zhou Can.Now that Zhou Can takes him seriously, it naturally makes him happy.

This is the two-way rush.

"Lan Ke, let me check your legs."

After saying hello, Zhou Can couldn't wait to examine the patient.

The middle-aged man standing beside the hospital bed still looked indifferent, watching Zhou Can do all this with a slightly contemptuous look.

It's obviously heart failure, why check your legs?
Even he, a non-professional, knows that legs have nothing to do with the heart.

"Hehehe... Ah... Hahaha... Can you stop touching my legs? I'm ticklish!"

The boy tried to dodge.

Zhou Can was pinching his legs, especially his calves.

"Doctor, I have to say a few words about you. We are here to treat diseases, not to play with you, let alone to be your guinea pigs. There is no relationship between your legs and your heart. You are here What are you playing around with? Other than making people think that your medical skills are muddled and muddled, it is useless for treating diseases.”

The middle-aged man pulled Zhou Can away, and said something to Zhou Can.

It can be felt that this person's strength is very great.

Intuitively, Zhou Can asked himself that he was no match for this person.

The other party also seemed to look him in surprise.

When Zhou Can was pulled away just now, there was actually a small contest between the two.

"I didn't expect to have some strength."

The man snorted.

Apart from a trace of surprise in his tone, it was more of contempt from the bottom of his bones.

Experts will know if there is any.

This man's force is indeed much stronger than Zhou Can's.

After all, practicing Sanda and boxing is just Zhou Can's hobby, and this man's hands are full of calluses, which is obviously a professional.

Zhou Can is a doctor by profession.

"Brother Wei, don't be rude to Dr. Zhou!"

The patient shouted to the middle-aged man.

His words were very effective, the middle-aged man immediately backed away two steps, and did not have any more physical contact with Zhou Can.

"Doctor Zhou, please don't take offense."

The patient apologized to Zhou Can.

"It's okay." Zhou Can waved his hand. "I may have found your cause."

It is Zhou Can's job to treat patients with heart failure.

"really?"

The patient's breathing became extremely short, his face was full of expectation, and his eyes were fixed on Zhou Can.

"Medicine is a very rigorous matter, and it is not yet certain. However, some experiments can be used to verify it. If you agree, I can apply for an echocardiogram for you now."

If you want to find out the cause of the patient, you need the cooperation of the patient.

"Agree, agree, please apply for me now! I dream of getting cured and going back to school as soon as possible."

The patient is obviously more anxious than Zhou Can, and is more eager to find out the cause and cure the disease.

The hardest thing about treating a disease is not being able to find out the cause.

You don't even know what caused it. Treating it is like shooting an arrow with your eyes blindfolded.Whether you can hit the rake's heart depends entirely on luck.

Of course, for the treatment of some special diseases, this drug has not yet been developed.Or the operation is too difficult, and it is also not easy to cure the disease.

"Hmph, the heart disease was detected in the leg, what a 'famous doctor'!"

Brother Wei sneered.

People are like this, the first impression is not good, and it is difficult to speak kindly later.

Brother Wei obviously has a lot of prejudice against Zhou Can.

"Brother Wei, my parents asked you to accompany me to take care of me, not to argue with the doctor. If you still respect me, please be polite to Dr. Zhou, otherwise I will be angry."

The patient is much more sensible than this brother Wei.

It is obviously not a wise move to offend the doctor in the hospital.

It is not difficult to hear from their dialogue that the two are not related by blood, but by employment.

Families that can afford bodyguards are basically not ordinary families.

Zhou Can has long discovered that this young man surnamed Lan has an aura that ordinary children don't have.That kind of extraordinary demeanor, the confidence and confidence in speaking, all show that he is not a child of ordinary people.

But since ancient times, the imperial capital has been the city of the emperor.

At the feet of the emperor, one is either an eunuch or an expensive one.

It is normal for this young man to have some power in his family.

Not to mention anything else, the original residents of the imperial capital, as long as they have a house, the value of the original residents will not be low.

If the family has a little foundation and some of the elders are officials, the offspring are more likely to be blessed.

"All right, all right, I won't talk anymore!"

Brother Wei was full of dissatisfaction.

But he didn't dare not listen to his employer's words.An expression of wanting to see if Zhou Can can find out the disease.

(End of this chapter)