Chapter 573: The Feeling of Near Death

Remember [New] in one second!     The first step in admitting a patient is to ask about the patient's medical history and conduct a physical examination.

Lu Chen handed all these tasks over to the female intern Su Rui.

She is worthy of being a student of Kyoto University Medical School. The questioning and physical examination are very methodical, so Lu Chen can't find any problems at all.

Patient Li Wenqian, 28 years old this year.

A few months ago, she began to feel flustered occasionally.

"It's just that the heart will suddenly beat violently, accompanied by a sense of chest pressure." Li Wenqian added. .

Lu Chen nodded slightly, "In our medical professional terms, it is called palpitations and chest tightness."

The patient initially thought that he had a bad heart.

"I'm not even 30 years old! My heart is not good!" Li Wenqian was scared to death when she thought about it.

After all, heart disease is not a trivial matter, and even the smallest heart problem can make people miserable.

Severe heart disease can even cause sudden death, how can we not worry?

"I went to the hospital right away!" Li Wenqian recalled, "The cardiologist at our hospital listened to my heart and did an electrocardiogram. He didn't find any problems, except that my heart rate was a little bit fast."

Lu Chen was puzzled. A fast heart rate doesn't mean anything.

Some people have a faster heart rate when they see a doctor, which is caused by physiological tension.

The patient's life value is 74 (-), so it seems that there shouldn't be too many problems.

"Did you take any medication later?" Lu Chen asked.

"Yes." Li Wenqian nodded, "I still remember that the doctor prescribed me metoprolol tartrate tablets."

Metoprolol tartrate is a beta-receptor blocker. There are many beta-receptors in the heart. Once blocked, the heart activity will be inhibited. Therefore, it can be used to treat tachycardia and heart failure.

Many patients with arrhythmia and hypertension take this medicine. It is a very common and widely used medicine.

"Has the heart discomfort improved?"

"It has improved. Later, I was busy with work and didn't take it to heart." Li Wenqian said, "But two months later, the symptoms came back! That familiar heart discomfort, it came suddenly, as if I was shocked, and then my heart beat wildly for a few minutes, 5-6 times a day, and the situation was even worse than before."

"Will taking metoprolol tartrate work?" Lu Chen asked in confusion. Listening to the patient's description, it really looks like some kind of paroxysmal arrhythmia.

"It doesn't work." Li Wenqian sighed, "This kind of heart discomfort has seriously affected my daily life and work. Later, I went to the hospital again and chose to do a heart ultrasound and electrocardiogram when I was most uncomfortable, but still no problems were found."

Su Rui, a female intern next to her, said: "It may be that the arrhythmia attack is short-lived and suddenly stops. Although you still feel uncomfortable, the arrhythmia has actually passed, so the electrocardiogram did not find any problems."

Many arrhythmias are sudden and stop suddenly. Ordinary electrocardiograms cannot just hit that point, so there is no way to find abnormalities.

"Oh, that feeling is really too uncomfortable, it's really like the feeling of dying again." Li Wenqian said helplessly.

In clinical practice, there is a professional medical term called near-death feeling.

"Later, the doctor at the local hospital changed a medicine for me." Li Wenqian took out another box of medicine from her bag, metoprolol succinate tablets.

Metoprolol succinate tablets and metoprolol tartrate tablets are drugs with the same ingredient.

However, the latter is a short-acting drug, one pill can only last for a few hours; the former is a long-acting drug, one pill can last for about a day.

"Oh, there is another drug..." Li Wenqian took out a porcelain bottle of medicine from her bag, the Quick-Acting Heart Pill.

The Quick-Acting Heart Pill is used for coronary heart disease, not arrhythmia, but people will curse when they are anxious, so bring it with you just in case.

"Have the symptoms been relieved?"

"No..." Li Wenqian smiled bitterly, "All the drugs combined have no effect, no effect at all, I still feel uncomfortable, and I still feel like I'm dying."

Lu Chen frowned.

According to the patient's description of the symptoms, it seems like some kind of arrhythmia.

And judging from the life value of 74 (-) on her head, there should be no fatal disease, otherwise the trend of change cannot be a minus sign.

"Have you done a 24-hour dynamic electrocardiogram?" Lu Chen said.

24-hour dynamic electrocardiogram, as the name suggests, requires the electrocardiogram box to be worn for 24 hours.

As long as there is an arrhythmia within 24 hours, it can catch it.

"I have done it, more than once, but it didn't work."

Li Wenqian took out a few more checklists from her bag.

Lu Chen took them and looked at them.

There were three dynamic electrocardiogram test results in total. Except for the occasional fast heart rate, no abnormal problems were found.

"I have been to many hospitals, but now there is really no way." Li Wenqian sighed helplessly, "I can only come to your hospital."

If the cardiology department of Kyoto University First Hospital can't solve it, then she is really desperate!

Lu Chen has basically understood the condition, and he gave the patient a more detailed physical examination.

Auscultation of the heart and lungs did not find any problems.

"Brother Lu, do you think it is possible that it is autonomic nervous system disorder?" Su Rui suddenly said.

Lu Chen nodded slightly, Su Rui's suspicion was correct.

Autonomic nervous system dysfunction can also cause symptoms such as palpitations.

The so-called autonomic nerves may not be well understood by everyone.

To put it simply, it means some autonomic nerves that control the internal organs, including sympathetic nerves and parasympathetic nerves.

If there is something wrong with them, the internal organs will feel and move poorly, so it is possible that autonomic nerve disorders may cause heart palpitations.

However, Li Wenqian interrupted: "I checked the information on the Internet. Some people said that it was an autonomic nervous system disorder, and they told me to take some B-group vitamins, oryzanol, etc., but it didn't work for me."

Lu Chen discovered that these people who came to Kyoto Hospital for medical treatment had a thorough understanding of their own conditions and often looked up information online.

Su Rui frowned slightly. If it wasn't autonomic nerve disorder, what else could it be? She ran through other possibilities in her mind.

At this time, Lu Chen said: "If there is really no way to detect arrhythmia, we can do electrophysiological examination."

Arrhythmia is like a thief. The thief always waits until the night is dark and windy, and the lights are dim to commit crimes.

After he got it, he quickly hid it and the police couldn't do anything to him (similar to an ordinary electrocardiogram).

Okay, then step up patrols, and there will be 24-hour guard patrols (24-hour dynamic electrocardiogram).

But even so, thieves still have ways to evade police patrols and attack behind the scenes.

What can we do in the end?

There is only one way, UU Reading www.uukanshu.net If you want to find out the thief, you can only go door to door to register and visit.

This is called taking the initiative, which is like a cardiac electrophysiological examination. It is directly close to the heart and stimulates the heart (knocking on the door to register). If there is a problem, it will be induced.

"How should this electrophysiological examination be done?" Li Wenqian asked immediately.

"It's a minimally invasive surgery." Lu Chen explained, "Use electrodes directly deep into the esophagus to stimulate the heart near the esophagus to see if it can induce arrhythmia. If it can, then find a way to perform radiofrequency ablation surgery to burn away the lesions. "

Lu Chen's description was very straightforward.

Li Wenqian was a little frightened when she heard this.

It's so scary to operate a knife on your heart!

"I, I..." Li Wenqian swallowed, "This... I'll think about it first. Doctor, please let the director come and see me first..."

Lu Chen shrugged his shoulders. He couldn't help it. These patients didn't quite believe him, so they still had to let Deputy Director Xiao Shikang do the rounds.