Moreover, Bai Mingming has been deeply impressed by this disease recently.
The owner of the gym that Bai Mingming went to often thought he had this disease. At that time, the owner fell off the treadmill.
Bai Mingming's memory is still fresh.
This disease mainly affects young adults. In severe cases, it can cause heart failure and sudden death.
Bai Mingming had this idea and didn't dare to neglect it.
He immediately began to ask the patient's medical history carefully.
The patient soon gave back a piece of useful information. A week ago, he had a severe cold. It was quite serious at the time and he went to the community hospital for two days of intubation.
With this information.
Bai Mingming felt that the boy most likely had viral myocarditis.
The next step is to conduct necessary examinations and confirm the diagnosis.
Bai Mingming called the nurse and gave medical orders.
Ask the nurse to take the patient for an electrocardiogram and myocardial enzyme spectrum test.
These are two standard tests to diagnose viral myocarditis.
Of course, if the condition is confirmed and you want further examination, you can also do a cardiac color ultrasound, etc.
The electrocardiogram test is faster.
The nurse took me to the emergency room and there was no need to queue. It took ten minutes to check and two minutes to wait for the report. Including the distance there, it only took ten minutes to go back and forth.
Myocardial enzyme profile comparison takes time.
This examination is a routine biochemical examination and requires blood drawing.
The collected target blood will be placed in special testing equipment. Generally speaking, it will take at least two to three hours to get the results.
Of course, the actual device detection time takes less than an hour.
Because of efficiency considerations, hospitals collect a batch of specimens and then test them together.
Same, because of emergency.
The results of this test were greatly accelerated.
In less than half an hour, the test report of myocardial enzyme spectrum was also obtained.
The patient returns to the emergency room.
The nurse handed the two test reports to Bai Mingming.
For heart problems, of course the first step is to see an electrocardiogram.
When Bai Mingming saw it, he was a little dumbfounded.
Generally speaking, with viral myocarditis, the patient's heart rate will be abnormal, and there will be ST-T changes on the electrocardiogram. The most common ones are T wave inversion or decrease, and there may also be mild ST segment shift.
But this patient's electrocardiogram, the report says: st segment: no deviation. t wave: duration and amplitude are normal, no pathological deviation is found. Diagnosis: 1. Sinus rhythm. 2. Normal electrocardiogram.
What is this situation?
The electrocardiogram showed everything was normal.
Bai Mingming was a little panicked and quickly looked at the second myocardial enzyme spectrum report.
Let’s popularize the science here. It’s not surprising that electrocardiogram and CT can detect problems with heart problems. Why biochemical tests of blood can also detect problems. This also depends on the content of myocardial enzyme spectrum examination.
The five routine myocardial enzyme spectrum tests can detect acid dehydrogenase, creatine phosphate kinase, creatine kinase isoenzyme, aspartate aminotransferase, and alpha-hydroxybutyrate dehydrogenase.
These five enzymes are normal enzymes in cardiomyocytes.
In the blood of normal people, the levels of these five enzymes are very low. However, if the myocardium is damaged, these five enzymes will be released from the myocardial cells, and the levels of myocardial enzymes in the blood will increase.
Therefore, by detecting the levels of myocardial enzymes in the blood, the condition of the patient's myocardium can be judged.
Bai Mingming hurriedly picked up the myocardial enzyme spectrum report and took a look at it. Again, he was heartbroken. All five indicators were at normal levels.
I'm dizzy!
The test report was cruel. It was like a slap on Bai Mingming's face.
The possibility that the patient had viral myocarditis was completely ruled out.
The wall clock in the emergency room read ten fifty.
It has been almost an hour since the patient came to the emergency center. The cause of the disease has not yet been found.
The two tests I just did were completely useless.
Outside the emergency room, there were family members of the patients waiting anxiously.
Bai Mingming felt a little anxious at the moment.
But he is also an "old man" in the emergency center.
He knows very well that not panicking when faced with problems is an essential quality for an emergency doctor.
He took a deep breath, calmed down his emotions, and continued to investigate the cause.
On the other hand, Bai Mingming also knew that this patient's condition was not that simple.
He called a nurse next to him and said, "I'm going to see if Team Leader Zhou and Team Leader Liu are free. I told him that there is a difficult patient with chest pain in the emergency room."
The nurse heard the sound and moved.
Two or three minutes later, Liu Zhengqing followed the nurse.
Bai Mingming naturally hopes that Zhou Yisheng can come over. Firstly, judging from Bai Mingming's recent observations, Zhou Yisheng is currently much better at handling some difficult cases than Liu Zhengqing. Secondly, Bai Mingming and Zhou Yisheng
Our relationship is also getting better. Asking Zhou Yisheng for help does not put much psychological burden on me.
But Zhou Sheng didn't come. Bai Mingming estimated that it was probably because Zhou Sheng was busy. If Liu Zhengqing came, he could also help him solve some problems.
When a young doctor encounters an urgent condition, he always hopes to have a master beside him to take care of him. Even if Liu Zhengqing is not a master, with more than ten years of medical experience, in Bai Mingming's view, he is still quite reliable.
After Liu Zhengqing arrived.
I briefly asked Bai Mingming about the patient's condition.
He looked down at the patient on the bed, thoughtfully.
This patient is relatively young and thin, but quite tall. The hospital bed is two meters tall. He is lying on it, that is, he is almost in good health. It is estimated that this patient is at least 1.8 meters tall.
Liu Zhengqing instantly thought of a disease, spontaneous pneumothorax.
This disease mostly occurs in tall and thin men. Frequent colds and strenuous exercise are the triggers of the disease. When the disease occurs, patients will have difficulty breathing and chest pain.
Liu Zhengqing had an idea and immediately asked, "Could it be spontaneous pneumothorax?"
Sometimes, the authorities are confused and the observers are clear.
After Liu Zhengqing's advice, Bai Mingming felt that it was a bit reliable.
Spontaneous pneumothorax is also a common clinical disease.
Bai Mingming must also know the cause of this disease and its diagnosis and treatment methods.
Next, he no longer waited for Liu Zhengqing to remind him, he had already begun to determine whether the patient had this disease.
The first is of course a consultation.
Bai Mingming asked the patient: "Did you do any strenuous exercise during the day?"
The patient was lying on the bed and said feebly: "Before eating, I played basketball for more than an hour. The kind that played in the whole court was a bit more aggressive..."
There's drama!
Bai Mingming and Liu Zhengqing looked at each other.
Liu Zhengqing said: "Listen to your lungs."
Bai Mingming nodded and put on the stethoscope hanging around his neck.
In spontaneous pneumothorax, the breath sounds in the lung lobes may weaken or disappear upon auscultation.
Auscultation can quickly and easily determine the condition.
Bai Mingming knew this very well, and he immediately started to operate.