Chapter 147 Aortic Dissection
Doctor Yang saw that the patient's condition was very critical and made a prompt decision.
"I'll order an electrocardiogram for you to find out the cause of the disease!"
"Okay, okay! Doctor, please hurry up!"
The patient's son stamped his feet anxiously. Saving lives is like putting out a fire, and every minute and every second is extremely precious.
Li Quan has been staring at the patient. His visual diagnosis skills have now reached a minor level of success. Even if he cannot compare with a high-tech electrocardiogram, he is not far behind.
Through observation, he did not find any facial features of myocardial infarction in the patient.
If the patient has had a myocardial infarction, the blood oxygen exchange will definitely be extremely poor or even blocked. You should be able to see a dark purple color due to lack of oxygen on the face, or a lighter dark red color.
There are also other physical features of the patient that are inconsistent with myocardial infarction.
However, his visual diagnosis skills revealed that the patient's disease was roughly located in the heart and chest.
What is the reason that can cause patients to experience a knife-like pain in their chest?
Li Quan was thinking hard.
Although the possibility of myocardial infarction had been ruled out, Yang Yu, the attending physician, was on the scene making the diagnosis, so it was naturally not his turn as an intern to interrupt.
Due to the urgency of the condition, the patient's family immediately took the examination application form and took the patient to have an electrocardiogram.
After hesitating for a while, Li Quan decided to ask Dr. Yang for advice.
After all, Dr. Yang has far more experience in diagnosis and treatment than him, and has encountered more cases.
"Doctor Yang, if the patient just now did not have a heart attack, what other disease do you think could cause the patient to have severe chest pain?"
"Not a heart attack?"
Doctor Yang Yu handed the medical record to him to write.
Writing medical records and writing medical orders are very time-consuming, so senior doctors usually delegate such tasks to trusted interns or resident doctors.
"If it's not a heart attack, pneumonia, bronchitis, pulmonary embolism, gastric ulcers... can all cause chest pain. In addition, in rare cases, nerve tingling in the chest area, chest muscle spasms, etc. can also cause chest pain. However, in this patient's case, the possibility of a heart attack is very high. We'll know after the electrocardiogram comes out."
Dr. Yang Yu is indeed experienced and listed a long list of diseases that may cause chest pain.
Not long after, the patient came back after taking an electrocardiogram.
Critically ill patients like this will definitely be given priority for examination.
"Uh... this, how is this possible? It's not a myocardial infarction, and there's no myocardial necrosis. There's not even myocardial ischemia." After receiving the examination form, Doctor Yang Yu broke out in a cold sweat .
The more unknown and confusing the disease is, the more dangerous it is.
What kind of disease could it be?
Seeing that the patient was in so much pain that he was almost in shock, Doctor Yang Yu was very anxious.
Emergency department work is not easy, as you will encounter all kinds of difficult patients. If you are not careful, you may miss the best time to rescue the patient due to misjudgment and the patient may die.
He suddenly remembered the question Li Quan had just asked him.
"If it's not a heart attack, what other diseases can cause chest pain?"
Could it be that this guy had already discovered that the patient was not suffering from a myocardial infarction?
Doctor Yang Yu suddenly turned around and looked at Li Quan.
But he unexpectedly found that Li Quan was staring at the patient lying on the emergency bed with a focused look on his face.
"Doctor Li, have you found anything?" Yang Yu no longer cared about the attending physician's face at this time and quickly asked Li Quan for his opinion.
"I..." Li Quan hesitated.
"Just speak freely. It's okay even if you say something wrong. Because in order to confirm the diagnosis, further tests will definitely be needed. If you find anything, it can help me diagnose the patient's condition in advance and buy time for rescue."
Doctor Yang Yu spoke sincerely and took the initiative to dispel Li Quan's concerns.
"Can I take the patient's pulse first?" Li Quan asked. "It won't take more than two minutes at most."
He added one more sentence.
This is also to gain the consent of the family members.
"Can!"
Doctor Yang Yu nodded in agreement.
"Traditional Chinese medicine has great advantages in diagnosing this disease by taking the pulse. If the lesion can be found, it can buy a lot of precious time for rescuing the patient."
The latter part of the sentence was obviously meant for the family members to hear.
Communication between doctors and patients is also a very profound science.
As long as communication is effective, the understanding and support of family members can be gained, reducing many unnecessary medical disputes.
Both family members looked at Li Quan eagerly.
They found that the young doctor had a serious face, a focused expression, and a very steady posture when taking the patient's pulse, which faintly revealed a kind of master's demeanor.
They couldn't help but increase their trust in Li Quan a little.
"The pulse is like a sobbing sound, intermittent, rapid and fierce. I suggest measuring the patient's blood pressure immediately. The lesion is initially located near the heart in the front chest."
Li Quan's visual diagnosis technique has already locked down the approximate area of the lesion.
Now, using the pulse diagnosis technique to check the pulse, he found that the pulse near the heart was obviously abnormal. It was like a hole in the embankment of a big river, and the river water was pouring out.
It seems like a dam is about to burst.
Therefore, he became more certain that the lesion was located in the heart.
Doctor Yang has measured the patient's blood pressure immediately.
The patient's blood pressure is 200/120 mmHg.
Obviously higher.
Considering the patient's history of hypertension, it is expected that the blood pressure is high. If it is simply high blood pressure, it is impossible to cause chest cramps like a knife.
"Doctor Yang, try measuring the blood pressure with the other arm," Li Quan suggested.
At first, Doctor Yang Yu did not understand Li Quan's intention and just did as he was told instinctively.
The blood pressure in this arm is 120/80 mmHg.
Blood pressure is normal.
"Oh no, this patient may be suffering from the extremely rare aortic dissection!"
Dr. Yang Yu could no longer maintain the composure of a attending physician because the disease was extremely serious.
"Li Quan, take the patient to do a chest CT scan immediately. I will notify Director Zhang to come for consultation and prepare for rescue." Doctor Yang Yu quickly wrote a medical examination application form. He then looked at the patient's family and said, "If the patient is diagnosed with aortic dissection, surgery is required immediately. The cost will be very high, so you family members should prepare immediately."
Upon hearing this, the patient's wife asked sadly, "Doctor, how much money do you need to prepare?"
"It will cost at least 250,000 yuan, and it may be as high as 300,000 yuan. In addition, the mortality rate of this disease is very high. Our hospital will do its best to save the patient, but the operation is extremely risky and he may not be saved. Your family members should think carefully as soon as possible."
Doctor Yang Yu said with a serious expression.
"So much money... How can our family afford so much money... Oh my God..."
The patient's wife collapsed and squatted on the ground crying with her face covered.
In this situation, doctors are helpless.
Money is not everything, but without money, nothing is possible.
Sometimes, the cost of rescuing a patient is very high, and it is not certain that the patient can be saved. The family can only choose to save or give up.
Li Quan took the patient to do a chest CT scan immediately.
The results are out.
It was really aortic dissection and heavy bleeding.
At this moment, Director Zhang has already rushed over to participate in the consultation.
The patient was sent directly to the emergency room.
The patient has been equipped with various monitoring devices, and the anesthesiologist has also arrived to prepare.
At this moment, the patient's heart began to fail and the life monitor began to beep.
"Tell the family that the patient is in critical condition, in critical condition!"
Doctor Yang Yu shouted.
The family members have not yet made up their minds. If they rescue the patient, they may lose both the life and the money. If they don't rescue the patient, there will be no chance at all.
I can only watch my loved ones pass away.
This scene is cruel, but it happens every day in hospitals.
"You family members must make a decision immediately: save the patient or not? If you perform surgery right away, there is still hope. If you don't save the patient, there is no hope at all."
The patient's wife collapsed on the ground and cried loudly.
