Chapter 2302

Back to the intervention department, Lin Yuan reported everything he knew to boss Zheng. I had an attack once before. I just took the medicine to treat facial paralysis, leaving no sequelae; Even the migraine that she thought was not important was reported to boss Zheng.

Speak for a long time, have more symptoms, and appear to be more serious.

She didn't emphasize that the patient had surgery, and she didn't get the first-hand information. Boss Zheng, it's useless to emphasize more. Lin Yuan knows it.

"Su Yun, what do you think?" Zheng Ren asked.

"Don't smoke, don't drink, why do you have such a good work and rest at a young age? It's fun to live. Do you want to go to a nightclub when you're old?" Su Yun nagged.

For him who smokes and drinks, Yang Lixin is a typical example of his opposite "evil".

"I didn't ask the medical history well. If sister Yue went, she would know more details." Before boss Zheng got angry, Lin Yuan reviewed himself and admitted his mistakes.

This way is very easy to use at home. Every time you meow, you expose everything. Although boss Zheng doesn't like this, Lin Yuan habitually calls out first.

Maybe in this case, boss Zheng can do it a little easier.

"You asked very well. The condition is basically clear." Zheng Ren smiled faintly.

"Er..."

This sentence is more unacceptable to Lin Yuan than being scolded.

Is the condition clear? Clear a wool! Where is it clear that you don't smoke, don't drink, and often stay up late? Or something else.

"Oh? Do you suspect patent foramen ovale?" Su Yun asked, "is it because of migraine, plus a suspected cerebral infarction, a cerebral infarction?"

"If one point, there is no way to diagnose. If the two points are combined, there is a great possibility of patent foramen ovale." Zheng Rendao.

Lin Yuan's mind flashed the diagnostic criteria and clinical symptoms of patent foramen ovale.

It is clearly written in the book - patent foramen ovale is mostly asymptomatic, it is difficult to hear noise, and the ECG and chest X-ray films are normal. Therefore, it is not easy to find and is not valued by people.

Lin Yuan even thought of the information written many years ago. Among the average 4-5 people, one person has patent foramen ovale.

Because most patients have no symptoms, it is very likely that they will not find this disease for a lifetime.

For a long time, it has been considered that patent foramen ovale generally does not cause two compartment shunt and has no effect on cardiac hemodynamics, so it is considered "insignificant".

Is that how boss Zheng diagnosed it?

Su Yun glanced at Zheng Ren. He frowned and said, "boss, did you start to doubt young people and cerebral infarction?"

"Almost. There must be a reason not." Zheng Rendao, "the probability of patent foramen ovale leading to migraine is very high. A considerable number of patients have migraine, but it is difficult to diagnose. It is all due to patent foramen ovale."

"Paradoxical cerebral infarction. It's what you've always suspected." Su Yun smiled, "so you asked XIAOLINZI to ask the medical history?"

"Well, as long as you have migraine, you can probably diagnose it as contradictory cerebral infarction. Do transesophageal ultrasound... It's still very difficult, and you may have to do a foaming test."

"Boss Zheng, wait a minute." Lin Yuan immediately stopped boss Zheng. If this goes on, he will even have how to treat it. The discussion of a case has come to an end.

But I don't have a clue.

Lin Yuan knows the contradictory cerebral infarction. Generally speaking, cerebral infarction is caused by arterial thrombosis. But some people have no embolus in the arterial system, but the embolus in his venous system can embolize the blood vessels in the head through the patent foramen ovale.

This is also a theoretical basis for the medical community to treat patent foramen ovale once contradictory cerebral infarction is found.

"Do you want to ask what is the relationship between migraine and patent foramen ovale?" Zheng Ren asked.

"Yes."

"Now there is no clinical explanation with theoretical basis." Zheng Ren smiled and said, "but there are several guesses. First, it is difficult to explain migraine. It may be that some neurotransmitters in the venous system bypass the pulmonary vascular inactivation and filtration function through this unclosed oval foramen, and directly go to the cerebral circulatory system. After binding with some receptors of some nerves, they produce the symptoms of migraine."

"Second, under the conditions of deep breathing, cough and exercise, the incomplete foramen ovale is open, and the small thrombus of the venous system enters the human brain circulation through the foramen ovale, aggravating the diffusion of cortical spreading inhibition, which is also the initial phenomenon of migraine."

Lin Yuan sighed in his heart. It seemed that he didn't learn diagnostics well enough.

"When encountering unexplained cerebral infarction, the recent theory tends to check the heart." Zheng Ren continued, "patent foramen ovale is also a predisposing factor."

Cerebral infarction, to check the color Doppler ultrasound of the heart, is also related to migraine... Lin Yuan sighed deeply again.

They all say that you can't treat your head and feet with headache. I didn't expect to be taught another lesson today.

Su Yun said, "do you want to do a B-ultrasound yourself?"

"No." Zheng Ren said, "do you know anyone in neurology?"

"I've always been in hospital before, but do you know people in internal medicine? They don't have deep contact." Su Yun said, "should I remind you?"

"Well, do an transesophageal echocardiography, or do a foaming test. In short, how convenient and how to check the situation of patent foramen ovale. If there is any, there is a high probability of recurrence in the future. Find an interventional doctor in the circulatory department to block it directly."

"Look at the delay of intervention. It used to be the work of mind." Su Yun glanced at his boss, and all his complaints piled on him.

"The circulatory department is now mainly engaged in cardiac interventional surgery. Who do you blame for this?" Zheng Ren said.

"I'll ask people whether they have checked it. Don't let's be warm here. The neurology department has already prepared to finish the operation for examination. It's so embarrassing." Su Yun turned the topic aside and changed direction.

"That's OK, as long as you don't miss it. If you have one attack after another and don't open it once, the patient will be miserable in the future." Zheng Ren doesn't care, he said casually.

It's good to fool it over. Su Yun reminded the patient of the diagnosis that the patient might be ignored. There was no doubt. Lin Yuan did a good job.

Well, after a few days, rich son left. I have to teach her the operation. If there is anything wrong, knock it with hemostatic pliers.

Lin Yuan didn't know that he got boss Zheng's "attention" because of a migraine.