Chapter 629 No Need for Electric Shock

Internal heart area II.

In the ward.

"Doctor Lu, are you sure you want to use amiodarone?" the nurse asked.

Lu Chen frowned. The nurses in this magic city are too long-winded!

How many times have they asked the same question?

"I'm sure!" Lu Chen said in a deep voice.

"Oh, that's good." The nurse curled her lips and put amiodarone in the infusion pump, ready to give it to the patient.

The nurse has the responsibility to help the doctor check the correctness of the doctor's order, but if Lu Chen insists, she won't ask any more questions.

At this time, Yu Bin and Yan Shuming walked into the ward quickly.

"Lu Chen, what's the patient's condition?" Yu Bin asked.

The nurse who was dispensing medicine on the side saw this situation and immediately stopped what she was doing.

Lu Chen explained: "Brother, the patient has a panic attack. This is her electrocardiogram. I'm going to use amiodarone for cardioversion."

Yu Bin was slightly startled. He didn't say anything immediately, but reached out to take the electrocardiogram.

"Isn't this ventricular tachycardia? Why use amiodarone? Is there any special purpose?"

Yu Bin's words were very implicit, and he did not directly refute Lu Chen.

Besides what he said, why not use cardioversion?

The first measure for ventricular tachycardia is cardioversion.

Aside, the nurse Yan Shuming raised the corner of her mouth.

She wanted to see how this new young doctor would handle this matter.

"This Lu Chen didn't listen to my advice. Fortunately, Yu Bin was found. What if the doctor's order was wrong, wouldn't it harm the patient?"

In clinical practice, many nurses are even more experienced than young doctors.

Yan Shuming thought to herself that she would have to give suggestions to the director in the future. These new doctors have too little clinical experience. They still need to study in the department for a period of time before they can be independent.

Otherwise, the risk is too high!

Lu Chen's face did not change at all. He glanced at Yu Bin, and then slowly said: "Because... this is not ventricular tachycardia!"

As soon as the voice fell.

The whole ward, whether doctors or nurses, all stared at Lu Chen in disbelief.

Yu Bin was a little unhappy.

How could he believe what Lu Chen said!

He looked down at the electrocardiogram in his hand. Wide QRS wave tachycardia, this is ventricular tachycardia!

Moreover, the patient had relapsed many times before, and each time the diagnosis was ventricular tachycardia, and electrical cardioversion was used.

The three students under Lu Chen also opened their mouths.

Especially the female graduate student Ji Yingying, she had always emphasized to Lu Chen that this patient was supraventricular tachycardia.

At this time, Lu Chen smiled and said slowly: "Brother Yu, let me ask you a question, why didn't the blood pressure of patients with such frequent ventricular tachycardia drop?"

Blood pressure, this is also one of the "suspicious points" that Lu Chen noticed!

Normally, malignant arrhythmias such as ventricular tachycardia and ventricular fibrillation will basically cause a drop in blood pressure.

Yu Bin was also stunned. In his subconscious, the patient was a patient with ventricular tachycardia, who just needed electrical cardioversion, and he never paid attention to the problem of blood pressure.

"The patient's blood pressure is very low?"

"Yes." Lu Chen nodded.

He flipped through the patient's previous medical records.

The patient's cardiac ultrasound and coronary angiography showed no organic heart disease.

The electrocardiogram did not show long QT, Brugada syndrome, etc.

The electrocardiogram of the patient during the attack did not meet the electrocardiogram characteristics of the left posterior or left anterior fascicle VT (ventricular tachycardia).

The most important thing is that the patient's life value is 72 (-)!

If it is really a ventricular tachycardia, this kind of serious arrhythmia will definitely have more than one minus trend in the change of life value. Gu Mei

It doesn't seem very scientific to diagnose it as ventricular tachycardia!

"This..."

Yu Bin frowned, and he was a little undecided for a while.

What Lu Chen said seemed to make some sense!

If the patient really had a ventricular tachycardia, why was the hemodynamics so stable?

Why was there only some discomfort and panic, and no other symptoms at all?

Yu Bin picked up the patient's electrocardiogram and read it carefully again.

He didn't want to miss any clues.

"Is the patient really not having ventricular tachycardia?"

...

Seeing Yu Bin in a daze, Lu Chen hurriedly urged the nurse, "Hurry up and use the amiodarone."

Yan Shuming glanced at Yu Bin and saw that he had no reaction. She gritted her teeth and gave the patient amiodarone.

"Okay, pay attention to the speed of amiodarone pumping and monitor heart rate changes."

Lu Chen breathed a sigh of relief when he saw the nurse using the medicine.

Yu Bin, who was standing by, swallowed his saliva, glanced at Lu Chen, and asked in a low voice, "Lu Chen, if the patient is not ventricular tachycardia, then what is it?"

Lu Chen smiled slightly, "Supraventricular tachycardia?"

"Ah?" Yu Bin looked at the electrocardiogram repeatedly, frowning all the time, and muttered, "I really can't tell where it is supraventricular tachycardia..."

The differential diagnosis of wide QRS wave tachycardia is a topic that will never go out of date in cardiology.

Ventricular tachycardia and supraventricular tachycardia are often difficult to distinguish.

Ventricular tachycardia is a malignant arrhythmia, which often means a more dangerous condition and requires a more radical treatment strategy.

Supraventricular tachycardia is an arrhythmia with a relatively good prognosis.

Especially in some emergency cases, if you can quickly distinguish between ventricular tachycardia and supraventricular tachycardia, you can buy a lot of rescue time for rescue.

…

"Lu… Doctor Lu, are you sure you don't need electric shock?"

The man stood at the door of the ward and looked inside.

When he saw the nurse give his wife medicine instead of "electric shock", he was quite excited.

At this time, his attitude towards Lu Chen was no longer as arrogant as before.

In the past, his wife came to the hospital for electric shock every time she had a panic attack.

As a result, the two of them had a deep fear of this "electric shock".

"No need for electric shock." Lu Chen said slowly, "We have temporarily used an anti-arrhythmic drug for the patient. Now we just need to monitor the changes in heart rate at any time."

"But..." The man frowned, "When will my wife's heart rate drop?"

"It depends on the specific condition and the patient's sensitivity to the drug." Lu Chen said, "Some people take half an hour, some people take three hours, and some people may need one or two days."

"Will this medicine... be useless!" The man said with some worry.

Although electric shock is terrifying, it is really effective!

After each electric shock, UU reading www. uukanshu.nｅt his wife's heart rate returned to normal.

If the medication is ineffective, wouldn't it delay the treatment time?

Lu Chen saw the man's worry at a glance.

"Uncle, don't worry, we will evaluate the patient's condition at any time. Don't use electric cardioversion for the time being, and don't use electric cardioversion!"

The man wanted to say something, but the patient on the bed immediately said, "I will listen to Dr. Lu. I won't use electric shock for the time being. I want to try medication. Even if it takes a day or two, I am willing to try!"

The man seemed to underestimate his wife's determination not to use "electric shock".

After experiencing the torture of "electric shock", the patient suddenly heard that electric shock was not needed, and the whole person was very excited.

"Okay, Dr. Lu, we will follow your arrangement." The man said.

Lu Chen nodded slightly, told the nurse to pay attention to the patient's heart rate changes, and then left the ward.

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