Chapter 291： : Worrying!

Electrocardiogram is a capability that an emergency doctor or even every doctor must have.

After three years of training in the emergency department, Chen Cang's familiarity with the human lead 1 to 6 leads is more familiar than the qwer four keys of the computer keyboard when playing League of Legends in college!

Basically, once you are in a good posture, you can see where to put it at a glance, regardless of whether you wear clothes or not.

Because one of the most common diseases in the emergency department is myocardial infarction, this kind of patient is very ill and may happen at any time.

After Chen Cang went to the Second Provincial Hospital, he had done ECG for half a year and read ECG.

At this time, the electrocardiogram machine is being set aside, and it is obvious that the patient has just made another electrocardiogram.

At this moment, all three are staring at the ECG machine slowly and stably to highlight the report.

And Meng Xi kept thinking about the electrocardiogram just now. She always felt that she had seen it somewhere, but she couldn't remember it. There was always a faint impression.

If there is no elevation of st, it is not necessarily the non-st elevation acute coronary syndrome!

The electrocardiogram is a screening. All diseases are screened through a test. After screening, further diagnosis and treatment can be carried out.

In fact, sometimes the patient's disease is just like you do an application problem, which requires logical thinking to judge.

If there is a patient with chest pain, you should first see all the causes that may cause chest pain.

Then verify or exclude them one by one through your experience, inspections, assays, image data, and so on.

This is the current process of diagnosis and treatment in medicine.

Speaking of which, Western medicine is like this, so how does Chinese medicine diagnose and treat?

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

In ancient times, people did n’t know much about the inside of the human body, and physiological and biochemical tests were not mature. You ca n’t do surgery when you come to a patient! After all, in that era, it was probably not sick, and the infection was gone as soon as the surgery was performed ...

This is normal.

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

And the process of his diagnosis and treatment is nothing but eagerness.

Looking at what is known as God, this means that many famous doctors are experienced and knowledgeable, and a diagnosis can be obtained at a glance when the patient's words and behaviors are complex and morphological.

The ancients have formed a diagnosis of traditional Chinese medicine after a series of hundreds of years of case summary.

Through looking, smelling, asking, and cutting to verify one by one, I have never been able to get a pathogenesis, and then diagnose and treat, to achieve a purpose of seeing little knowledge!

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

Uh ...

The ECG just came out, Chen Cang was about to give it to Meng Xi, but after holding it in his hand, he suddenly stunned!

Because of this electrocardiogram ... something different!

First of all, the lead V1-6 of the chest moves up and down, and then the T wave is symmetrical and pointed!

Secondly, the QRS wave is normal and not wide at all.

In the end, the patient's segment lifted up slightly.

After looking at it carefully again, Chen Cang suddenly thought of a possibility!

Isn't it ... thinking here, Chen Cang's face changed!

Continue to think carefully, it is likely to be!

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

He turned around, and Chen Cang quickly turned his hand to the electrocardiogram and handed it to Meng Xi.

Xun Mengxi took a look and couldn't help frowning, but it was still not too different from the previous one.

Is it really elevated acute coronary syndrome)?

沧 Chen Cang originally thought that Meng Xi as a female doctor abroad should have some understanding, but looking at her like this seemed to be a little hesitant and suddenly anxious.

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

Without any hesitation, this is not the time to hesitate, because this ECG belongs to the super-acute manifestation of ST segment elevation myocardial infarction! It is also called: de-winter syndrome.

After Chen Cang said this sentence, the two suddenly lost sight of it!

After hearing this word, Ge Gehuai paused for a while, and was familiar with it!

Because this kind of ECG is rarely summarized in China, it is a retrospective study of 1532 cases of left anterior descending coronary proximal occlusion of ECG by de-winter and other cardiac physicians in Rotterdam, Netherlands. It was found that 30 patients did not show typical st Duan elevated, so after research, he found several special ECG waveforms, and then published them in a paper to the New England Journal of Medicine.

This is the so-called de-winter syndrome!

However, the appearance of this syndrome is still short, and not many of them may be consulted in domestic literature, so many doctors are not very familiar with it.

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

Correct!

I'm alike!

Most likely!

Thought of this, Meng Xi quickly took the list of ECG and continued to look at it.

Mengxi became more and more frightened when she looked, and became more flustered when she looked.

He turned and looked at Ge Huai, and said quickly: "Doctor Ge, quickly get a doctor's order, improve the relevant examinations, prepare to sign ... Do coronary angiography as soon as possible ..."

If the diagnosis is confirmed, then it is necessary to perform coronary intervention in time to open the infarct-related blood vessels and rescue the surviving myocardium is imperative!

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

In theory, thrombolytic therapy may have a therapeutic effect, but it is still a "super indication" drug at this stage ~ www.novelhall.com ~ In recent years, the STEMI guidelines at home and abroad have not mentioned such patients.

What do you mean, any disease needs to be treated according to the instructions when receiving treatment.

这种 And this kind of de-winter syndrome is not within the indications of thrombolytic therapy, so what goes wrong is the responsibility of the doctor.

But medical treatment is originally developing Chinese medicine, who can guarantee that there will be no problems?

As a doctor, you must exercise your scalpel carefully!

Ge Huai heard this, and quickly got up and started various arrangements!

After a minute and a second passed, Chen Cang followed Meng Xi and Ge Huai to get busy!

After the image data of coronary angiography came down, the three of them suddenly looked grim!

I really do!

Really de-winter syndrome!

Now that the diagnosis is confirmed, the next step is to urgently arrange for interventional surgery.

Mengxi quickly and quickly led the team to treat the patient. There was no delay in one minute and one minute. At eleven o'clock, the patient finally finished the operation.

The operation went smoothly!

A living life, and just got a perfect treatment.

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

At this time, Chen Cang rang:

【Ding! Meng Xi favors +15! 】