When a doctor opened a plug-in

Doing an electrocardiogram is an ability that an emergency doctor or even every doctor must possess.

After three years of exercise in the emergency room, Chen Cang is more familiar with the signs of the human body from 1 to 6 leads than the four keys of qwer on the computer keyboard when he was playing League of Legends in college!

Basically, as soon as you put yourself in your position, you can see where to post 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 patients is acutely onset and may appear at any time.

So after Chen Cang went to the Second Provincial Hospital, he spent half a year doing electrocardiograms and reading electrocardiograms.

The ECG machine was standing aside at this time, and it was obvious that the patient had just taken another ECG.

At this moment, the three of them all stared at the ECG machine slowly stabilizing the prominent report.

On the other hand, Meng Xi kept thinking about the ECG just now in her mind. She always felt like she had seen it before, but she couldn't remember it. There was always a vague impression.

Without st elevation, it is not necessarily non-st-segment elevation acute coronary syndrome!

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

In fact, sometimes the patient’s disease is just like you do a word problem, and you need to use logical thinking to judge.

If there is a patient with chest pain, all possible causes of chest pain should appear in your mind first.

Then verify or exclude one by one through your experience, inspection, laboratory test, image data, etc.

This is a diagnosis and treatment process in current medicine.

Having said that, Western medicine is like this, so what is the diagnosis and treatment process of Chinese medicine?

Perhaps everyone thinks that Chinese medicine is mysterious and mysterious. In fact, Chinese medicine is also a kind of logical thinking ability, not so-called nonsense.

In ancient times, people didn't know much about the internals of the human body, and the physiological and biochemical tests were not mature.After all, in those days, there was probably no disease, and the infection disappeared after the operation...

This is normal.

However, Chinese medicine uses the external manifestations of the human body to study the relationship with internal diseases.

And his diagnosis and treatment process is to see, hear and ask.

It is known as the god, which means that many famous doctors are experienced and knowledgeable. You can get a diagnosis by seeing the patient's words, deeds, complexion, tongue, etc.

The ancients, through various observations, hearings and inquiries, after hundreds of years of case summary, formed the Chinese medicine diagnostics.

Through seeing, smelling, questioning, and cutting to verify one by one, we have always obtained a suitable pathogenesis, so that we can diagnose and treat, and realize the purpose of seeing the slightest knowledge!

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

...

The electrocardiogram had just come out, and Chen Cang was about to show it to Meng Xi, but after holding it in his hand, he was suddenly taken aback!

Because of this electrocardiogram...something is different!

The first is that the J point of leads V1-6 on the chest is lowered by 1-3mm, and the ST segment moves upward and downward, and then the T wave is symmetrical and sharp!

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

Finally, the patient's ST segment in lead aVR is slightly elevated.

After Chen Cang read it carefully again, he suddenly thought of a possibility!

Could it be... Chen Cang's expression changed when he thought of this!

Continue to think about it carefully, it is very likely to be!

A few seconds later!Chen Cang comprehensively considered the patient's condition and age, and thought about the possibility of the patient.

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

Meng Xi took a look and frowned, still not much different from just now.

Is it really NSTE-ACS (non-ST-segment elevation acute coronary syndrome)?

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

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

There is no hesitation, now is not the time to hesitate, because this kind of electrocardiogram is a hyperacute manifestation of ST-segment elevation myocardial infarction!Also known as: de-winter syndrome.

After Chen Cang said these words, the two of them were immediately blindfolded!

After Ge Huai heard this word, he paused for a while, a bit familiar!

Because this kind of electrocardiogram is rarely summarized in China, the cardiologist de-winter in Rotterdam, the Netherlands, retrospectively studied 1532 cases of acute coronary syndrome with proximal left anterior descending artery occlusion, and found that 30 patients did not have typical st Duan Gao, so after research, found several special ECG waveforms, and then published in the "New England Journal of Medicine" in the form of a paper.

This is the so-called de-winter syndrome!

However, the appearance of this syndrome is still short, and there may not be many in the domestic literature, so many doctors do not know it well.

And when Meng Xi was reminded by Chen Cang, his expression suddenly changed, de-winter?

Correct!

Very similar!

Probably it is!

Thinking of this, Meng Xi quickly took the ECG list and continued to compare it.

Meng Xi became more frightened as she watched, and frightened as she watched.

Turning to look at Ge Huai, he quickly said: "Doctor Ge, hurry up to give the doctor's order, complete the relevant examination, and prepare to sign... as soon as possible..."

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

The current indications for thrombolysis of myocardial infarction are mainly defined according to the extent of ST-segment elevation and whether there is a new complete left bundle branch block. Although dewinter syndrome is complete or subtotal occlusion of the proximal branch of the anterior branch, the ECG does not Meet the indications for thrombolytic therapy.

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

What does it mean? When receiving treatment for any disease, you need to follow the indications for treatment.

And this kind of de-winter syndrome is not in the indications of thrombolytic therapy, so if something goes wrong, it is the responsibility of the doctor.

However, medical treatment is originally developing traditional Chinese medicine. Who can guarantee that there will be no problems?

As a doctor, you must use your scalpel carefully!

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

As time passed by, Chen Cang followed Meng Xi and Ge Huai to get busy!

When the coronary angiography image data came down, the three of them suddenly became serious!

Sure enough!

It's really de-winter syndrome!

Now that the diagnosis is confirmed, interventional surgery needs to be arranged urgently next.

Meng Xi Fenghuohuo led the team to quickly start the treatment of the patient. There was no delay in one minute and one second. At eleven o'clock, the patient finally completed the operation.

The operation went well!

A fresh life, in this way, received a perfect cure.

The three can't help feeling full of emotions!

At this time, Chen Cang heard:

Ding!Meng Xi favorability degree +15!