The result of the cardiac color ultrasound was very direct, congestive heart failure, and also suggested that there was a large amount of pleural effusion in Zhou Xiufang's chest.
Luo Yiping, deputy director of the Department of Cardiology, was invited for consultation. He started joking as soon as he saw Sun Lien. "Boss Sun, do you have business to take care of us again? I heard from Director Wang that you invited him to dinner the day before yesterday."
"Director Luo, please take a look at the condition of this patient." Sun Lien ignored Luo Yiping's joke. He was not in the mood to joke with others now. He lowered his voice and said, "The patient is a relative of my teacher."
Luo Yiping put aside his relaxed look and glanced at the printed cardiac color ultrasound results, "Congestive heart failure is no problem, pleural effusion is one of the typical manifestations."
"How to deal with it?" Sun Lien asked, "Just give diuretics? I'm worried that the old man is too old and may have hypokalemia."
The kidney function of the elderly is generally poor, especially the reabsorption of potassium by the kidneys, which is much weaker than that of young people. Although the hasty use of diuretics to reduce body fluids can relieve heart pressure, it may cause symptoms of hypokalemia, leading to
More serious heart problems.
"Looking at it now, the benefits of using diuretics for the elderly are definitely greater than the risks." Luo Yiping thought about it and said firmly, "Look at the blood potassium level. As long as it is greater than 3mmol/l, give diuretics first." He suddenly paused.
"We also need to determine the causes of heart failure. Generally speaking, if an elderly person suddenly develops heart failure in winter, eight out of ten will be caused by lung infection."
"The blood samples have been sent out." Sun Lien nodded. Xu Yourong added, "The results should be available within half an hour."
Luo Yiping thought for a while and continued, "I suggest you simply do another CT scan to clarify the elderly man's pleural effusion. If the amount of pleural effusion is too large, you can consider asking for a chest drain."
There is some fluid accumulation in the human body's pleural cavity. The interlayer between the visceral layer and the parietal pleura is called the pleural cavity. There is usually about ten milliliters of fluid accumulation in it, which plays a lubricating role when a person breathes. The pleural cavity
Approximately 1000 ml of effusion is produced and absorbed every day. Increased fluid production or reduced absorption in the pleural cavity may lead to pleural effusion.
When congestive heart failure occurs, the patient's pulmonary capillary pressure will increase significantly, resulting in an increase in the production of pleural effusion. When the production exceeds the drainage capacity of the lymphatic system, pleural effusion will form.
Zhou Xiufang was lying on the hospital bed, her mind still a little unclear. She could occasionally respond to the nurse's calls, but she couldn't tell where she was or what her name was.
"Send the image." Sun Lien looked at the old man and sighed. When people get old, they are afraid of something wrong. A small illness or disaster may become fatal in an instant due to age.
The number of people queuing up in the imaging department is much smaller than the previous two days. As a pilot unit for major emergency departments, as long as the emergency room can be a little more relaxed, other departments will suddenly feel a lot more relaxed.
Video Brother Kroo had a day off today, and Zhou Jun personally pushed the old lady's gurney into the CT room. His father, Comrade Zhou, also took leave from work and came to the hospital to take care of his mother.
Comrade Zhou was an engineer at a local power company. He claimed that his biggest regret in life was not persuading his son to study medicine. Zhou Jun, who became a doctor, attached great importance to the health management of the old couple and forced Comrade Zhou to quit smoking for more than 20 years.
They have been addicted to smoking for years. At the same time, they also set a strict daily schedule and daily recipes for the old couple. Comrade Zhou was ordered to only eat half of the steamed sausages that he liked most every month. Sometimes he would eat them secretly when his son was not around.
Sausage has become Comrade Zhou's biggest hobby. Unfortunately, his wife has always been on the same side as his son. As long as he eats it secretly, he will be caught. Zhou Jun has a cold face and is so sarcastic that even Comrade Zhou
They are all a little bit too much.
"What's the matter with your grandma?" He and his son carried her into the CT machine. Comrade Zhou, who was fearless and fearless, finally panicked, "Is this an old illness recurring?"
"It's not coronary heart disease." Zhou Jun shook his head with an ugly expression, "The preliminary diagnosis is congestive heart failure complicated by pleural effusion."
"I've never heard you say that you have this problem before." Comrade Zhou's face turned ugly, "Is it new?"
Zhou Jun also had a cold face, "I don't know. It's such a cold day, why didn't you stop grandma from going for a walk?"
"I'm not a doctor!" Comrade Zhou called out to Chong Tianqu, "There are only two doctors in our family, one for you and one for your grandma. When have you ever heard of me?"
Zhou Jun shook his head, "Let's look at the results first. If the amount of pleural effusion is not large, drug treatment will be sufficient."
Lao Zhou sighed and said, "I hope there won't be any surgery. The Chinese New Year will be here in a blink of an eye. If the old lady gets a knife, she won't be able to celebrate this year anymore. Come to the hospital in turn to keep watch."
Comrade Lao Zhou was lingering outside the CT room, while Zhou Jun pulled Sun Lien aside and interrogated him about the situation.
"What do you think?" Zhou Jun still looked like a teacher, but he couldn't hide the anxious look on his face. "How serious is the situation?"
"The type of pleural effusion needs to be judged." Sun Lien thought for a moment and expressed his thoughts, "It would be okay if it was just a simple effusion caused by congestive heart failure. What I am worried about now is that the effusion may be caused by
Caused by infection.”
"No, the old lady has no signs of infection in the past few days." Zhou Jun had a different view on Sun Lien's judgment, "There is no fever and cough, so it doesn't look like infection."
Sun Lien shook his head and said, "Coronary heart disease, hypertension, and senile degenerative heart valve disease may all cause congestive heart failure. But it shouldn't happen so quickly."
"It's more likely to be caused by coronary heart disease." Zhou Jun frowned, "She has a history of coronary heart disease..."
"If the elderly do not have the habit of walking, this is indeed possible." Sun Lien understood that his teacher was really panicked, "Many elderly people have low exercise ability and habits, and grade three heart failure may not show up.
But the old lady goes out for a walk every day. If it is heart failure caused by coronary heart disease, the symptoms should have been there for a long time. The time is not right."
"Do you think it's an infection?" Sun Lien's reason was very strong, and Zhou Jun had to admit that his student's judgment was correct. "But there were no symptoms before..."
"I can only say that I hope it is caused by infection." Sun Lien sighed, "If it is not infection, it will be troublesome."
Pulmonary infections that can cause heart failure are fatal to young people, but Sun Lien is now secretly praying that the elderly person is really infected.
Low hemoglobin, elevated IgG antibodies, heart failure, and pleural effusion. If the combined answer to these four symptoms is not infection, it will lead the diagnosis to another terrifying conclusion.