Chapter 178
To put it more bluntly, as long as her heart is beating, she will have shortness of breath and hypoxia.
However, I saw that her ventricular wall is not particularly thick. Let's do an examination first, and then start using the correct medicine. "
Then the woman named Xiaoling looked up at Wang Xiaomian.
Then she looked at Zhang Yi:
"Doctor, please give me a definite answer. Can my mother's disease be cured?"
Zhang Yi nodded happily:
"Yes, of course not. Look at the degree of ventricular wall hypertrophy. If the pressure difference between the ventricle and the outflow tract is too large, the ventricular wall is too thick.
The only option is to surgically remove the hypertrophic ventricular wall.
Of course, it is best not to have surgery if you can avoid it.
Because the heart is different from other organs, the entire ventricular wall is muscle.
There are many nerve conduction techniques inside, and these nerves and muscles are connected together, so the heart will beat again and again.
If the hypertrophic ventricular wall is removed, it will definitely affect the entire heart function.
It may cause arrhythmia, that is, a part of the muscle is suddenly cut off, and the heart conduction is cut off.
Then the heart rate will definitely be unstable.
Another example is acute heart failure, a part of the ventricle is cut off, and the recovery is very poor after suturing, the myocardium is damaged and the heart can't beat.
Then it may cause heart failure of the whole heart.
But don't worry too much, it can definitely be cured, but any surgery has risks.
I hope your family members can understand more. ”
It is best if the pressure difference between the outflow tract and the ventricular inflow tract does not exceed 50-60 mmHg.
The drug can stabilize it.
Once the pressure difference is too large, even above 100 or 150, it is very serious.
Despite the serious complications, this resection surgery had to be performed.
The family looked at Zhang Yi again, and then left the doctor's office worriedly.
At this time, the sky had gradually darkened.
Zhang Yi was waiting for the patient's latest pressure difference results.
An hour later, the result came out.
Pressure difference 110!!
Looking at this result, Zhang Yi also looked worried.
"Director Wang, I saw that the pressure difference shown in your previous admission examination was more than 70.
This time it reached 110. I guess it must be related to the use of drugs such as dopamine and sodium nitroprusside.
How about this, I suggest using verapamil and metoprolol to control the patient's myocardial contractility first.
After slowing down the speed, do another examination and see. "
Listening to Zhang Yi's suggestion, Wang Xiaomian nodded again.
Today, Zhang Yi is the boss here~!
Listen to him~!
In the ward.
Wang Xiaomian is instructing the nurse to give the patient medication.
Behind him, several younger attending physicians following him couldn't help asking:
"Director Wang, do you trust that doctor so much? What if... he is wrong?"
Wang Xiaomian glanced at him and scolded:
"I can see that you rarely read books and rarely take the initiative to learn!
After get off work, check the various symptoms of obstructive hypertrophic cardiomyopathy!
Write me an article about the main symptoms, simulated diagnosis and treatment plan of obstructive hypertrophic cardiomyopathy within two days!"
"Ah? ! "
The people behind him all widened their eyes.
No way...
We are just asking...nothing else!
Two hours later.
After taking the correct medication, the old lady's symptoms improved a lot.
The shortness of breath was significantly relieved, and the oxygen saturation index also went up.
At this time, I arranged for a hemodynamic test.
Looking at the result again, 73 mmHg.
"Isn't that right? This is not that much worse." Zhang Yi looked at the check list and said.
Wang Xiaomian finally showed a little relief and said:
"Yes, it means that the medicine is used correctly. Alas...I really thank you for today. I'm so sorry that you are still working overtime in the capital so late.
Oh, no, it's my fault. Doctor Zhang, you haven't had dinner yet, right?
Let's go to the cafeteria to eat something now?
We have a midnight snack cafeteria in Ping An Hospital. "
Don't say it.
Zhang Yi is really a little hungry at this time.
"Okay, then I'll trouble Director Wang. "
Wang Xiaomian waved his hands quickly:
"Doctor Zhang, please don't be polite to me. You helped us so much today. I don't know how to thank you!
Hey, I think there seems to be a classmate of yours in our department, right?
Lu Gao? Where's Lu Gao?"
Wang Xiaomian said as he looked around the department.
But he didn't see Lu Gao.
"Maybe Lu Gao has already gone off work, but I have something to tell you, Doctor Zhang.
Don't think that you are from the same school and are classmates.
If you ask me, he is really not as good as you! ”
They are in the same class and taught by the same teacher.
See, the difference is so big.
Zhang Yi diagnosed such a rare disease after just a few glances at the examination list.
And Lu Gao could only follow the attending physician and make peace with him!
Alas!
What a pity.
Why doesn’t Zhang Yi work in our hospital?
(Lu Gao: Woohoo… Director, do you dislike me??)
The two were about to get up and go to the hospital cafeteria to eat something.
Suddenly.
Wang Xiaomian’s cell phone rang.
It was Liu Xiongwu calling.
"Director Liu?" Wang Xiaomian picked up the phone.
In the afternoon, the patient's condition was difficult, and Wang Xiaomian called Liu Xiongwu, wanting them to come and take a look.
"Yes, there is indeed such a patient, left heart failure and pulmonary edema."
"Yes, but..."
Wang Xiaomian said and glanced at Zhang Yi sitting next to him.
"But it has been solved! The patient's condition is getting better!"
On the other end of the phone, Liu Xiongwu frowned and asked:
"Huh? Didn't you say that the patient's condition was very dangerous in the afternoon? And that the cause of the disease could not be found? I also specifically asked Professor Jin of Union Hospital about the situation."