Chapter 234 How About I Give It a Try?

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Sun Guoguo has a relatively stable personality. When dissection cannot be completely ruled out, she will not easily let the patient undergo interventional surgery.

"Let's do it at the same time!"

After considering for a few minutes, Sun Guoguo decided to contact the catheterization room and prepare for the interventional surgery.

On the other hand, she contacted the CT room and said that the patient with chest pain needs to undergo chest CT enhanced scan to rule out the possibility of aortic dissection.

"Lu Chen, you will push the patient to do enhanced CT first. If the result is fine, then don't go back to the ward, and push the patient directly to the catheterization room."

"Okay, senior sister." Lu Chen nodded.

This is the safest way at present.

However, it is an enhanced CT and an interventional surgery. The patient and his family were a little scared by this posture.

Sun Guoguo communicated the condition with the patient and his family directly, obtained informed consent for all operations, and signed it.

Afterwards, Lu Chen pushed the patient to the CT room.

...

The patient's brows were frowning all the way.

When he arrived at the door of the CT room, the patient's chest pain worsened again!

"Just push a morphine injection." Lu Chen said to the accompanying patient.

"Okay." The nurse nodded.

A morphine injection was prepared in the rescue box in advance, and the nurse directly injected 4mg of morphine intravenously for analgesia.

Morphine injection is a strictly controlled anesthetic drug.

Whether the patient has myocardial infarction or aortic dissection, excessive pain is not conducive to disease recovery.

In particular, it may increase the oxygen consumption of the heart, so Lu Chen decided to push the morphine injection.

Because I had communicated with the CT in advance, as soon as I arrived at the CT room, I got the needle for angiography and arranged the examination immediately.

The enhanced CT scan was completed quickly.

Lu Chen took a rough look and found that there was no obvious dissection of the thoracic and abdominal aorta, so the chest pain should not be caused by aortic dissection.

The only thing left is acute myocardial infarction!

In the ward, when the enhanced CT was completed, the imaging results were directly uploaded to the medical record system.

In the ward, Sun Guoguo had also seen the CT images.

"If you don't see the dissection, just push it directly into the catheterization room. I'll contact the doctor in the catheterization room." Sun Guoguo also called Lu Chen and asked him to send the patient directly to the catheterization room for emergency interventional surgery.

Lu Chen was completely relieved now, and he stepped up to push the patient directly to the catheterization room.

...

It took less than 10 minutes.

Lu Chen handed the patient to the doctor in the catheterization room of the cardiology department.

The catheterization room sent a doctor out to communicate with the family again.

There is no such thing as too much communication during surgery. Only when communication is in place can medical disputes after surgery be avoided as much as possible.

The doctor in the catheterization room spoke very quickly, and regardless of whether the family understood it, he directly put the consent form in front of her.

"Sign it."

The patient's wife also listened to the general idea. The overall meaning was that this stent was effective, but expensive.

And there might be problems, but if you don't do it, you're dead.

"Then there's nothing to say. I'll sign it." The patient's wife picked up the pen, gritted her teeth, and her fingers were shaking.

After signing the surgical communication, the operation began.

But...

The accident came as expected.

…

In the catheterization room of the Department of Cardiology.

Ren Feng, an interventional cardiologist, stared at the screen and repeatedly used X-rays, but he didn't see any obvious stenosis or obstruction of the coronary artery.

Several large blood vessels are still very smooth!

What's going on?

Ren Feng on the stage was sweating on his forehead and began to curse, "Damn, there was no abnormality in the chest CTA."

After stepping down, Ren Feng brought out the CT film he had just taken.

After repeated inspections, there was indeed no aortic dissection!

Combined with the current coronary angiography, there was no myocardial infarction.

None!

The patient had severe chest pain, which was obviously a problem!

But no problem was found, this is not a joke.

Fortunately, the patient's chest pain seemed to have improved at this time, and his brows relaxed a little.

Otherwise, the interventional doctors in the catheterization room would really be anxious to death.

"Let's end the operation." Ren Feng said to the assistant and nurse beside him, "Tell the family that the patient is not suffering from acute myocardial infarction or coronary heart disease. There is no coronary heart disease at all."

Although the coronary artery is a little narrow, it is far from causing myocardial ischemia and hypoxia, and frequent angina attacks.

The patient was quickly pushed back to the eighth zone of the heart.

...

At this time, the eighth zone of the heart.

Lu Chen, Sun Guoguo and others have seen the results of coronary angiography.

Everyone was a little confused.

It's not aortic dissection, nor is it acute myocardial infarction!

At this time, the patient's wife walked into the doctor's office.

"Doctor Sun, what exactly causes the chest pain? Isn't it coronary heart disease? It has always been treated according to coronary heart disease. Nitroglycerin can also relieve chest pain before. Isn't it said that nitroglycerin is a special medicine for coronary heart disease?"

The patient's wife insisted on the "coronary heart disease" this time.

She had no choice but to worry.

This is not it, that is not it, what disease is it? There must be an explanation!

"The chest pain I just had was really scary. I felt like I was going to die."

Sun Guoguo was also very depressed, but being depressed couldn't solve the problem.

However, she immediately thought of a way to remedy the situation.

From the severity of the patient's chest pain, it must be related to the condition of the heart, lungs or large blood vessels.

Since coronary angiography and chest CTA did not find obvious problems, it is very necessary to do a cardiac color Doppler ultrasound next!

The human heart is like a house, with walls, water pipes, and circuits.

The electrocardiogram looks at the circuit (cardiac conduction system), coronary angiography looks at the water pipes (coronary arteries), and the cardiac color Doppler ultrasound looks at the walls, doors and windows.

If there is a problem with the circuit and water pipes of the house, it will cause chest pain.

If the walls (myocardium) and doors and windows (valves) are broken, it will also cause chest pain. So this cardiac color Doppler ultrasound must be done.

Originally, patients with coronary heart disease routinely need to do cardiac color Doppler ultrasound.

But just now it was too urgent, and I rushed to the stage in a hurry.

Sun Guoguo also felt that the cardiac color Doppler ultrasound might be an unnecessary examination at the time.

But now thinking back, the cardiac color Doppler ultrasound is still necessary.

The family members certainly agreed to do it. She just needed to find the cause of the disease, and she couldn't be so confused.

Besides, she had already done the dangerous and expensive coronary angiography, so she didn't need a cardiac ultrasound.

…

Sun Guoguo returned to the ward and listened to the patient's heart again. She seemed to find some murmurs, but they were not too obvious.

"Brother Wei, please ask for a bedside cardiac ultrasound for the patient." Sun Guoguo said.

"Okay!" Wei Zhongwen nodded.

However, in less than two minutes, he returned to the ward.

"Sister, the teacher in the ultrasound room is doing an ultrasound in the CCU on the fourth floor. It may take more than ten minutes!" Wei Zhongwen said.

Cardiac ultrasound is not a routine emergency examination. Some small hospitals don't even have bedside emergency ultrasound.

"Okay, then we can only wait!" Sun Guoguo frowned.

The patient has repeated chest pain, so a cardiac ultrasound is imperative!

At this time, Lu Chen on the side suddenly said, "Sister, how about I try the ultrasound?"