Chapter 837 Misunderstanding

I can see the life value of the main volume Chapter 837 Misunderstandings Case Discussion Meeting began.

Lu Chen sat behind the Kebed team.

He estimated that there were seven cardiology teams in the entire demonstration room, with a total of about 17 people.

On the podium, the attending physician of this case began to introduce the patient's basic situation to everyone.

This model is similar to that in China.

After the attending physician introduced the condition, he asked questions.

Then the doctors continued to discuss and analyze the answers.

"Patient, male, 18 years old."

"Because the electrocardiogram was found to be obviously abnormal after exercise. The patient did not have any uncomfortable symptoms."

"He was previously healthy and denied a family history of cardiomyopathy or unexplained sudden death."

The patient's medical history was very simple, just a few simple sentences.

But then, the examinations and tests released by the attending physician were not simple!

There were many electrocardiograms in total.

Lu Chen picked out the most typical ones.

As soon as he opened the electrocardiogram, Lu Chen immediately interpreted the results.

This is a typical asymmetric T wave, and the ST in the chest lead is still depressed.

Obviously, this is an electrocardiogram of cardiomyopathy.

For example, the most common disease is hypertrophic cardiomyopathy.

Sure enough, as soon as this picture came out.

Everyone began to discuss it, and at the same time they were all confused.

Everyone is a top doctor in the world, and this basic electrocardiogram can be recognized.

The doctor in charge smiled and asked everyone to be patient and continue to check the patient's other information.

Next.

The doctor in charge took out the patient's electrocardiogram, cardiac ultrasound, and cardiac magnetic resonance.

The patient's cardiac ultrasound and cardiac magnetic resonance all confirmed the diagnosis of "cardiomyopathy".

The results of cardiac ultrasound showed: myocardial hypertrophy at the apex, with a maximum thickness of 24mm, normal left ventricular size and contractile function, and no blood outflow obstruction.

Cardiac magnetic resonance examination showed that the thickness of the apex and anterior septum were 25mm and 13mm respectively.

At the apex, delayed enhancement of contrast agent can be seen.

In addition, the patient has also undergone genetic testing.

Genetic examination showed that the patient's MYH7 coding and β-MHC gene mutations!

However, the patient's parents and siblings were all negative.

All these results confirmed the possibility that the patient had "hypertrophic cardiomyopathy"!

Since no sudden death risk markers were found in this examination, there is no indication for ICD implantation for the time being.

...

Seeing this, Lu Chen frowned.

At first glance, this case is too simple.

No matter how you look at it, no matter what you say, this is hypertrophic cardiomyopathy!

Such an obvious disease, can't the doctors at Mayo diagnose it?

This is absolutely impossible!

Lu Chen continued to read below.

The following medical records slowly dispelled Lu Chen's doubts.

After being discharged from the hospital, the patient stopped strenuous training as prescribed by the doctor, but he still maintained an exercise lifestyle.

One year later, the patient was re-examined.

The re-examination of the heart MRI showed that the left ventricular hypertrophy had eased!

The maximum thickness of the apex was 10mm.

The re-examination of the electrocardiogram showed that the ST segment depression was significantly improved compared to the first visit!

As soon as the result came out, everyone in the demonstration room fell silent.

The patient did not receive any treatment, and the symptoms were miraculously cured!

Kebed, who was beside Lu Chen, frowned and whispered: "It looks like hypertrophic cardiomyopathy, but the hypertrophy was relieved after the exercise stopped, which looks like physiological myocardial hypertrophy!"

Lu Chen also frowned.

Kebed was right, pathological myocardial hypertrophy is impossible to reverse.

Only physiological myocardial hypertrophy can be reversed after stopping exercise.

However, the patient had a genetic test before, and the gene for hypertrophic cardiomyopathy was indeed found.

This seems to be contradictory!

Lu Chen's heart sank, it is worthy of being a case that can appear in Mayo!

There is absolutely no such disease that can be easily diagnosed.

"Lu, what do you think of this case?" Kebed looked at Lu Chen on the side.

Lu Chen shook his head, "I don't have any idea for now."

Kebed touched his chin and said slowly: "Lu, I have an idea. This patient's myocardial hypertrophy relieved itself after stopping training, and the genetic tests of family members were all negative, so I think it may be necessary to check the genetic test again to rule out the possibility of false positives in the initial test."

Kebed's idea is very simple.

He thinks the first genetic test is wrong!

His opinion is to re-test the gene.

After Kebed finished speaking of this idea, other Mayo cardiologists also raised this possibility.

This 18-year-old athlete is likely to have simple physiological myocardial hypertrophy.

Lu Chen frowned, because when he considered this diagnosis.

The system did not pop up any prompts.

That is, "physiological myocardial hypertrophy" is wrong!

For a while, everyone's opinions were not quite unified.

Some doctors said it was "physiological myocardial hypertrophy", and some doctors said it was "genetic pathological hypertrophic cardiomyopathy"!

Everyone has their own opinions, and no one can convince anyone.

...

Lu Chen has been silent.

Because he found something very strange.

When he thought of "physiological cardiac hypertrophy," the system did not pop up a prompt.

When he thought of "pathological hypertrophic cardiomyopathy", the system also did not pop up a prompt.

Doesn’t this patient have “cardiomyopathy” at all?

This idea came to Lu Chen's mind.

Everyone has been arguing for a long time, but in fact it is not cardiomyopathy at all? !

This is too ridiculous...

Lu Chen reorganized the patient's examination.

Whether it is from electrocardiogram, cardiac ultrasound, cardiac magnetic resonance, or even genetic testing, it has been confirmed that the patient has cardiomyopathy!

There is no other possibility.

"Is it possible that the system is down again?"

But since Lu Chen owned the system until now, the system has always been reliable.

There has never been a system bug!

…

While Lu Chen was thinking, the entire Mayo Cardiology Classroom was mainly divided into two factions.

One party believes that it is physiological myocardial hypertrophy. The main reason is that after stopping exercise, the patient's myocardial hypertrophy has recovered compared to before.

On the other hand, they thought it was pathological hereditary cardiomyopathy because the result of the genetic test was positive!

Any other test may not be as accurate as genetic testing.

Kebed continued to say to Lu Chen: "Lu, everyone is holding different opinions now. We can only look at conducting genetic testing again and wait for the results before we can make a judgment."

At this moment, an idea suddenly flashed in Lu Chen's mind.

Everyone seems to have entered a misunderstanding.

Why do everyone think it is either physiological or pathological?

Can't both situations exist at the same time?

Just when Lu Chen thought of this, the system immediately popped up a long-awaited notification sound.

"Congratulations, the system upgrade completion rate has increased!"

"Brother Shen!"

"Um!"

When Shen Changqing walks on the road, whenever he meets someone he knows, he will say hello or nod to each other.

But no matter who it is.

There was no unnecessary expression on everyone's face, as if they were indifferent to everything.

To this.

Shen Changqing has become accustomed to it.

Because this is the Demon Suppression Division, an organization that maintains the stability of the Qin Dynasty. Its main responsibility is to kill monsters and monsters. Of course, there are also some other side jobs.

It can be said.

Everyone in the Demon Suppression Division has a lot of blood on their hands.

When a person is used to seeing life and death, he will become indifferent to many things.

When he first came to this world, Shen Changqing was a little uncomfortable, but he got used to it over time.

The Demon-Suppressing Division is huge.

Those who can stay in the Demon Suppressing Division are all powerful masters, or those who have the potential to become masters.

Shen Changqing belongs to the latter.

Among them, the Demon Suppressor Division is divided into two professions, one is the Guardian Envoy and the other is the Demon Slayer.

Anyone who enters the Demon Suppression Department starts from the lowest level as a demon slayer.

Then he will be promoted step by step, and he is expected to eventually become a guardian envoy.

Shen Changqing's predecessor was a trainee demon slayer in the Demon Suppression Division, and he was also the lowest level among the demon slayers.

Possessing the memory of a previous life.

He is also very familiar with the environment of the Demon Suppression Division.

It didn't take long for Shen Changqing to stop in front of a loft.

Unlike other places in the Demon Suppressing Division that were full of chills, the attic here seemed to stand out from the crowd, showing a different kind of tranquility in the bloody Demon Suppressing Division.

At this time, the attic door was open, and occasionally people came in and out.

Shen Changqing only hesitated for a moment before stepping in.

Enter the attic.

The environment changes in vain.

The fragrance of ink mixed with the faint smell of blood hit his face, making him frown instinctively, but then relaxed it quickly.

There is almost no way to cleanse away the smell of blood on everyone in the Demon-Suppressing Division.