On Thursday night, Chen Cang's night shift.
An old man walked in crookedly, "Doctor, I want to buy a medicine."
Chen Cang immediately hesitated, and quickly got up: "What medicine?"
The old man was a little breathless and had a short breath.
"Ah ... Ah ... spirin enteric-coated tablets!"
The old man thought for a long time, and then he said this sentence.
After speaking, the old man continued to say, "By the way, I still want to make an electrocardiogram. I have been flustered recently."
Chen Cang looked at the old man's face, and suddenly hesitated!
The old man is tall, but he is also relatively fat, and he is not very stable when he walks. It is more troublesome to move step by step.
However, this is not the most critical. The most important thing is that the old man is yellow and puffy, and his cheeks are dark red!
This may not be a typical symptom to others.
However, Chen Cang watched the old man speak shortly, thinking of his desire to make an electrocardiogram, and frowned suddenly!
Look at his lips again and again, his tongue is dark ...
A name is just around the corner!
Wind heart disease!
That is rheumatic heart disease. The face of the elderly is a typical mitral valve face, also known as rheumatic heart disease.
Chen Cang hurried to Xiaolin: "Xiaolin, help me go in with the old man."
Kobayashi put down the work in his hand, nodded quickly, and helped the old man into the rescue room.
The old man was relieved when he was lying in bed.
Chen Cang couldn't help asking: "Old man, have you ever had any illness before?"
The old man gasped for a few breaths, and Kobayashi was very eye-catching and quickly brought oxygen.
That said: "I ... I have heart disease, rheumatic heart disease, for many years."
When Chen Cang heard it, it was so.
Subsequently, Chen Cang quickly picked up the stethoscope and put it on the apex of the old man to listen to the heart beat.
I saw heartbeats flickering, heart sounds varying in strength.
Suddenly Chen Cang frowned, the elderly may have atrial fibrillation.
Not only atrial fibrillation, but Chen Cang can hear progressive rumbling murmurs at the end of the heart, which is a typical auscultation of mitral stenosis.
Later, at this time, Kobayashi pushed the ECG machine over.
An electrocardiogram was pulled out.
Chen Cang frowned as he looked at the electrocardiogram.
This situation is not very good, let alone talk about the problem of rheumatic heart disease, this atrial fibrillation may at any time cause serious illness and induce complications.
Thinking of this, Chen Cang quickly said to the old man: "Are there any diseases such as high blood pressure and hyperlipidemia ..."
The old man nodded: "Yes, there are ... But I have been taking the medicine, and the control is OK. I have been hospitalized in the fall, a cerebral infarction. After being discharged, I have been taking medicine to maintain, what aspirin ..."
The old man's consciousness is very clear. When he speaks, it is slow but methodical.
This is a good thing!
The blood pressure was normal, but Chen Cang felt that the old man should be reminded.
However, after buying the medicine, the old man decided to go home and staggered home.
Chen Cang looked at the old man, worried.
And Kobayashi said with a worried expression: "Doctor Chen ... will he be in trouble?"
Chen Cang frowned: "It's hard to say."
At about 9 o'clock, the emergency phone rang suddenly.
"An elderly person in Anju District 9012 suddenly had an unfavorable speech and was unable to move. He needed timely rescue."
Chen Cang nodded quickly, and Kobayashi didn't pause at all. He quickly got up and went out.
Second-line duty staff also hurried up to watch the class for Chen Cang.
According to the patient's situation, Chen Cang's diagnosis should be cerebral infarction, but bleeding cannot be ruled out. As long as the cerebral infarction is not a large vessel obstruction in the brain stem, it is generally not life-threatening, but bleeding is not necessarily.
After the car arrived, Chen Cang went upstairs with Xiaolin and driver Lao Yang.
When Chen Cang and Xiaolin saw the old man, they suddenly froze!
Isn't this ... the old man who just came to the emergency department to buy medicine?
His wife was panicked, and after Chen Cang soothed, he quickly rushed back to the hospital.
Just sent to the hospital, Chen Cang suddenly heard the system prompt sounded.
【Ding! Serial Missions-Truth Triggered!
The final link: save the elderly, explore the cause, and get rich rewards after completing the task! 】
When Chen Cang heard it, he suddenly hesitated.
Is this the final task?
To this day, Chen Cang has considered not only rich copy rewards, but also what the truth is!
Is VOLB cough water the key cause ~ www.novelhall.com ~?
This time the clues are very straightforward. The possibility of cerebral infarction in patients is 70 to 80%, and high blood pressure, rheumatic heart disease ... so many original diseases, the possibility is too great.
Because of this, it is even more difficult to judge, because even if there is no cough water, the elderly are also very likely to get sick.
However, now is not the time to tangle this, after Chen Cang hurriedly sent the old man.
Directly sent to shoot NMR.
The results showed multiple intracranial ischemic lesions, but these were old, but there was a new acute cerebral infarction in the right frontal lobe!
In general, brain MRI is the first to be performed for suspected cerebral infarction (MRI). Cranial brain CT is preferred for suspected bleeding. These tests are more targeted for diagnosis.
Chen Cang called the doctor in the neurology department for consultation. At the same time of treatment, he must find the cause of the disease.
When it was learned that the elderly had mitral stenosis in rheumatic heart disease, Dr. An frowned.
The patient's elderly wife was directly told: "The blood flow in the normal heart is smooth and unobstructed, and when the mitral valve is narrow, blood cannot flow from the left atrium into the left ventricle at a normal speed, and blood accumulates and rotates in the enlarged left atrium. Slowing the flow can create tiny blood clots that can bury the risk of a stroke. "
"At the same time, long mitral stenosis can lead to changes in the structure of the heart, such as enlargement of the left atrium, which is closely related to atrial fibrillation, which is the most common cardiogenic embolism. s reason."
Now the truth seems to be out.
The patients themselves have these reactions of blood stickiness. When the mitral valve is narrowed, thrombus is easy to form, and the onset of atrial fibrillation directly leaves the emboli in place.
Everything is very reasonable explanation!
At this time, Dr. An suddenly looked at Chen Cang and said, "Director Chen, it should not be considered an acute cerebral infarction at present, as long as the cerebral infarction can improve blood circulation in the ischemic area as soon as possible, anticoagulation and thrombolysis can be performed at the same time. . "
"But ... the most important thing is the mitral valve."
"The patient's mitral valve stenosis is not treated, the primary disease is not controlled, and this cerebral infarction will occur, and it is not one or two attacks."
When Chen Cang heard it, he nodded. Indeed, according to the old man, autumn has now had two cerebral infarctions.