Chapter 740: Lu Chen Can’t Rest

It took Lu Chen about 20 minutes to walk back to the single talent apartment.

He is now an associate chief physician, and he does not need to stay in the department all the time.

He has more freedom in his work and commuting time.

If it was during his doctoral study, it would take him 20 minutes to go home at noon, and he would not have to go back at all.

He would have to go back and forth for less than ten minutes before he had to go to the hospital again.

Now Lu Chen can go back to the apartment boldly, and even enjoy the scenery on the way.

Back to the community, it was peaceful. I think most people did not come back, and they were all taking a lunch break at work.

Lu Chen returned to the apartment alone, and he seemed very leisurely.

It was quiet across the street and upstairs, and they should not have come back.

Lu Chen made a cup of tea, found the latest papers and documents, and began to read them.

Keeping a certain amount of reading every day is a habit that Lu Chen has developed over time.

And, whether it is from the Department of Cardiology or not, he would take a look.

He did not lie back in the bedroom until he was tired of reading, ready to take a half-hour lunch break, and then go to work.

Lu Chen smiled slightly. Did he live the life of a retired director in advance?

...

Afternoon.

Lu Chen came to the second area of ​​cardiology.

This surprised Jin Miao, because the senior doctors of other groups had not come yet.

The senior doctors of other groups would not be so punctual. They might stay in the department for a while and then leave.

Lu Chen was one of the early ones.

After returning to the lounge and putting on his white coat, he sat steadily in front of the computer and continued to familiarize himself with the hospital's medical records and medical order system.

He would be out of the clinic tomorrow, so Lu Chen had to familiarize himself as soon as possible.

Jin Miao didn't pay much attention to Ling Chen. He had a lot to do!

Not only did he have to admit new patients, but he also had to adjust the treatment plan for old patients. This was not an ordinary busy schedule.

However, Jin Miao had many students under him, including regular trainees, graduate students, and interns. With these free labors, he could handle it.

In addition, Jin Miao also made an appointment for a cardiac MRI examination for the patient with elevated "myocardial enzymes".

When the results are reported, it can be determined whether the patient has myocarditis.

Lu Chen can occasionally guide Jin Miao and earn a small amount of gratitude points.

However, in the current system mall, the gratitude points required to redeem skill cards are often tens of thousands or hundreds of thousands.

The gratitude points obtained from students are already insignificant.

On the other hand, Lu Chen is now an associate chief physician. Most medical students who encounter problems they don’t understand will first consider asking the attending doctors.

Therefore, except for Jin Miao occasionally discussing a few issues with Lu Chen, there are very few students who come to ask Lu Chen questions.

This channel for obtaining gratitude points has been blocked!

This makes Lu Chen quite melancholy!

...

However, Lu Chen can’t be idle after all.

At three o’clock in the afternoon, Lu Chen was familiar with the medical record system. When he was about to rest, Jin Miao ran into the doctor’s office.

He came to Lu Chen and said, "Director Lu, a patient who came this morning had a myocardial infarction!"

He took an electrocardiogram in his hand and handed it to Lu Chen.

Lu Chen looked down.

This electrocardiogram is indeed problematic.

The ST segment of the anterior septal lead is elevated, indicating myocardial infarction.

For ordinary patients, Jin Miao will not take the initiative to find Lu Chen.

Unless the patient is seriously ill or the condition is complicated, he will take the initiative to find a senior doctor.

And the patient in front of him belongs to the category of serious illness.

Even if he can treat the patient, he still has to fulfill his obligation to inform.

"What are the symptoms of the patient?" Lu Chen asked.

"It's mainly chest tightness, no obvious chest pain." Jin Miao thought for a while and briefly described the patient's condition.

The patient is a 60-year-old woman who has had chest tightness for 4 days. She feels uncomfortable when she walks, and she will be fine after sitting down and resting for a few minutes.

The children at home are busy, so she didn't take it seriously at first, but she didn't expect it to get worse and worse.

Now she feels stuffy and suffocated when she lies down, and she also coughs and doesn't like to eat.

Only then did she agree to let her husband at home take her to the hospital for a check-up.

"The patient said he had gastritis, bile reflux, and chronic cold legs before, and he usually took some painkillers to get better, but he never had heart disease."

Lu Chen nodded slightly, "What about other risk factors for coronary heart disease?"

Jin Miao answered fluently: "Except for age, hypertension, diabetes, dyslipidemia, obesity, smoking, drinking, family history, etc. are not related to her. The heart examination is generally normal, and there are a few rales on auscultation of the lungs."

While listening to the story, Lu Chen looked through the patient's examination and test results.

Routine blood test: white blood cells 11.13×109/l, neutrophil percentage 86.5%, absolute neutrophil value 9.63×109/l, hemoglobin 131g/l.

Myocardial injury markers: troponin T (T) 42.2ng/l (0-14ng/l).

Brain natriuretic peptide (BNP): 12723pg/ml (<100pg/ml).

There were no obvious abnormalities in biochemistry, coagulation function, and thyroid function.

Jin Miao continued, "The increase in troponin T was not as high as expected, but the increase in BNP was particularly obvious."

Lu Chen thought for a while and said, "Severe heart failure can also cause a slight increase in troponin, which may be ischemic cardiomyopathy. First, basic treatment for coronary heart disease should be carried out to improve heart function, and then cardiac ultrasound and elective coronary angiography should be arranged."

Even if acute myocardial infarction is considered, the patient has missed the best time for surgery - within 12 hours of onset, the patient's heart is now extremely fragile, like a ball of tofu dregs.

If a coronary intervention is performed now, it is easy to puncture the heart.

So, we can only wait for the patient's heart function to recover and make the heart stronger before performing coronary intervention.

Jin Miao agreed with Lu Chen's opinion, "I will communicate with the patient's family."

...

Just when Lu Chen thought everything was in place, the patient's condition suddenly took a sharp turn for the worse.

The patient suddenly felt nausea and vomiting at around 4 pm. The vomitus looked like coffee grounds, and the occult blood test of the vomitus was positive.

Lu Chen immediately asked Jin Miao to recheck the blood routine.

The patient's hemoglobin dropped from 125g/l to 100g/l.

Could it be upper gastrointestinal bleeding?

"This is a big trouble!" Jin Miao ran to Lu Chen.

Lu Chen frowned. UU Reading www.uukanshu.net

Be careful not to use force, fasting and rehydration, taking into account heart function, and stopping antiplatelet drugs.

Coronary heart disease is caused by thrombus, which is contradictory to the treatment of gastrointestinal bleeding!

Coronary angiography has become a distant prospect!

Lu Chen recalled that he had seen cases of gastrointestinal bleeding after taking aspirin before, but most of them had the basis of gastrointestinal tumors and gastrointestinal ulcers.

"He used to have gastritis, bile reflux, and old cold legs..."

Lu Chen suddenly remembered what Jin Miao said when he explained the medical history.

The digestive system foundation is indeed not good, and then there is "old cold legs", which is another "folk diagnosis".

However, no matter how small the details are, they cannot be missed.

Lu Chen looked at Jin Miao and said, "I'll go with you to see the patient again." 16377/10479391