When a doctor opened a plug-in

On Thursday night, Chen Cang's night shift.

An old man walked in obliquely: "Doctor, I want to buy a medicine."

Chen Cang was taken aback for a moment, and quickly got up: "What medicine?"

The old man gasped a little while speaking, and his breathing was a little short.

"A...a...spirin enteric-coated tablets!"

The old man thought for a long time before he said this sentence.

After speaking, the old man continued: "By the way, I still want to have an electrocardiogram. I'm so flustered recently."

Chen Cang looked at the old man's face and was taken aback!

The old man is tall, but he is also relatively obese. It is not safe to walk around. It is troublesome to move step by step.

However, this is not the most important thing. The most important thing is that the old man's complexion is yellow and swollen, and his cheeks are dull red!

This may not be considered a typical symptom to others.

However, Chen Cang frowned when he saw the old man talk short of breath and thought he wanted to do an electrocardiogram!

Look at his blue lips and dark tongue...

A name is ready to come out!

Rheumatic heart disease!

It is rheumatic heart disease. The face of the elderly is a typical mitral face, also called rheumatic heart disease.

Chen Cang greeted Xiao Lin quickly: "Xiao Lin, help the old man in with me."

Xiao Lin 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 on the bed.

Chen Cang couldn't help asking: "Old man, have you had any disease before?"

The old man took a few breaths, Xiao Lin was very eye-catching, and quickly brought oxygen.

Then he said: "I... I have heart disease, rheumatic heart disease, for many years."

When Chen Cang heard it, it really happened.

Afterwards, Chen Cang quickly picked up the stethoscope and placed it on the apex of the old man's heart to listen to the heartbeat.

I saw the heartbeat fluctuates quickly and slowly, and the heart sounds vary in strength.

Suddenly Chen Cang frowned, and the old man might have atrial fibrillation.

Not only there is atrial fibrillation, but Chen Cang can hear progressively increasing rumbling murmurs in the late diastole at the apex, which is a typical auscultation manifestation of mitral stenosis.

Later, at this time, Kobayashi also 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 the problem of rheumatic heart disease, this atrial fibrillation may be serious at any time and induce complications.

Thinking of this, Chen Cang hurriedly said to the old man: "Are there any diseases such as high blood pressure and hyperlipidemia..."

The old man nodded: "Yes, both... But I have been taking medicine, and the control is okay. I was hospitalized in the autumn and it was a cerebral infarction. After I was discharged from the hospital, I have been taking medicine to maintain it. What aspirin..."

The old man's consciousness is very clear. When he speaks it slowly, but it is methodical.

This is a good thing!

The blood pressure was normal, but Chen Cang felt that he should remind the elderly.

But after the old man bought the medicine, he was determined to go home, staggeringly home.

Chen Cang looked at the old man, worried.

And Xiao Lin said with a worried expression: "Doctor Chen... will something happen to him?"

Chen Cang frowned: "It's hard to tell."

At about 9 o'clock, the emergency phone rang suddenly.

"An old man in Anju Community 9012 suddenly spoke unfavorably and was inconvenient to move, so he needed timely rescue.

Chen Cang nodded quickly, Xiao Lin didn't pause at all, got up quickly, and left.

The second-line staff on duty also quickly got up to watch the shift for Chen Cang.

According to the patient's situation, Chen Cang's diagnosis should be cerebral infarction, but hemorrhage cannot be ruled out. As long as cerebral infarction is not a large blood vessel obstruction in the brainstem, it is generally not life-threatening, but bleeding is not necessarily.

After the car arrived, Chen Cang went upstairs with Xiaolin and the driver Lao Yang.

After Chen Cang and Xiao Lin saw the old man, they were stunned!

Isn't this... the old man who came to the emergency room just now to buy medicine?

His wife was panicked, and after Chen Cang calmed down, he hurried back to the hospital with him.

Just when he was sent to the hospital, Chen Cang suddenly heard the system beep.

Ding!Serial mission-the truth is triggered!

The final link: save the elderly, explore the cause, and get rich rewards after the task is completed!

Chen Cang was stunned when he heard it.

Is this the final task?

By now, Chen Cang has not only considered the rich copy rewards, but also what the truth is!

Is VOLB cough water the key cause?

This time the clue is very straightforward. The possibility of a patient with a cerebral infarction is 70 to 80%, and hypertension, rheumatic heart disease... so many primitive diseases are too likely.

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 struggle with this, after Chen Cang hurriedly sent the old man.

Send it directly to the nuclear magnetic field.

The results showed that the patient had multiple ischemic foci in the skull, but these were old, but there was a new acute cerebral infarction in the right frontal lobe!

Generally speaking, brain MRI (nuclear magnetic field) is the first for suspected cerebral infarction, and brain CT is preferred for suspected bleeding. These examinations are more targeted for diagnosis.

Chen Cang called Dr. An from the Department of Neurology for a consultation. At the same time of treatment, he had to look for the cause of the disease.

When he learned that the elderly had rheumatic heart disease and mitral stenosis, Dr. An also frowned.

Tell the patient’s wife directly: “The blood flow in the normal heart is smooth and unobstructed, but when the mitral valve is stenosis, the blood cannot flow from the left atrium into the left ventricle at a normal speed, and the blood will accumulate and rotate in the enlarged left atrium. If the flow rate slows down, small blood clots may form, which may bury the hidden danger of stroke."

"At the same time, mitral valve stenosis takes a long time, which can lead to changes in the structure of the heart, such as the enlargement of the left atrium. The enlargement of the left atrium is closely related to atrial fibrillation, and atrial fibrillation is the most common cardiogenic embolism. s reason."

Now the truth seems to be revealed.

The patient itself has the reaction of thick blood. When mitral valve stenosis, thrombus is easy to form, and the onset of atrial fibrillation directly makes the embolus go away.

Everything is a very reasonable explanation!

At this time, Dr. An suddenly looked at Chen Cang and said, "Dr. Chen, what we are thinking about now is not acute cerebral infarction. As long as cerebral infarction improves the 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 problem of the mitral valve."

"If the patient's mitral valve stenosis is not treated, the original disease is not controlled, and this cerebral infarction will have an attack, and it will not happen once or twice."

When Chen Cang heard this, he nodded. Indeed, according to the old man's words, he has had two cerebral infarctions since autumn.