Chapter 897 It Must Be Done

In the ward.

The 18-year-old girl stared blankly at the ceiling.

A month ago, she and her classmates were in the classroom, looking forward to the future.

Maybe tomorrow, or the day after tomorrow, she will meet her prince charming.

However, the misfortune of life is so sudden.

Dizziness, fatigue, and then fainting.

This made such an 18-year-old girl at a loss.

The doctor said that her heart beat too slowly.

As the most important organ in the human body, once the heart stops beating, it will be dangerous.

Only by implanting a pacemaker to help the heart beat can she avoid this danger.

However, she has not been in love yet.

She still has many interesting things to do, but she has not had time to do them.

"Dad, do I have to put in a pacemaker?"

The girl turned her head and looked at her father.

During this month, the man looked for doctors everywhere and could only fall asleep late at night every day.

When he got up the next morning, he had to continue looking for a hospital for his daughter.

In a month, his hair turned a little gray.

"How could that be?" The man forced a smile, "Didn't you hear what Director Lu said today? Your electrocardiogram may have other diagnoses."

"And I'm talking to you. There was a boy who also had a slow heart rate before. Other experts said he needed a pacemaker. But when he came to Director Lu, he was cured without a pacemaker!"

The girl smiled.

She also had a glimmer of hope in her heart.

But she didn't know when it started.

Outside the ward window, dark clouds gathered.

The wind was blowing hard, and the windows were whistling.

Looking at it, a storm was about to hit.

……

Demonstration room of the Department of Cardiology.

Lu Chen stood on the stage.

Behind him, on the projector, were the girl's three electrocardiograms.

"Let me ask a question. Among these three electrocardiograms, only high-degree atrioventricular block is there?"

Lu Chen looked around and finally stopped his sight on Gu Xinyue.

Everyone started to discuss non-stop

"Do you think there are other possibilities of block?"

Lu Chen gave some reminders.

Gu Xinyue has been following Lu Chen for a long time.

He knows that every step of Lu Chen is meaningful.

Could it be that this patient really has other diagnoses and may not have a pacemaker?

Gu Xinyue frowned deeply, not missing any details of the electrocardiogram.

This time, he really saw something.

"Director Lu, I know!" Gu Xinyue suddenly stood up, "This patient has first-degree atrioventricular block, complete right bundle branch block, and left posterior fascicular block. Consider the existence of three-branch block!"

As soon as Gu Xinyue said this, Jin Miao's eyes lit up.

When he looked at the electrocardiogram again, he saw these three types of conduction blocks.

This old Gu is really good.

On the stage, Lu Chen smiled and nodded.

"Doctor Gu is right. This patient has a combination of three blocks. Do you know where the blocked part is?"

Lu Chen looked at Gu Xinyue.

Gu Xinyue looked at the electrocardiogram again, frowned, and then said slowly.

"I think the atrioventricular node or the His-Purkinje system are both possible."

Lu Chen did not deny this answer, but looked at the others.

"What do you think?"

Jin Miao stood up, "I think the blockage is in the His-Purkinje system, right?"

Gu Xinyue asked in confusion, "Why can't it be the atrioventricular node?"

Jin Miao scratched his head, "It's just a feeling. As for the specific reason, I can only understand it myself, and I really can't tell it."

Everyone smiled when they heard Jin Miao's words.

However, Lu Chen gave Jin Miao a thumbs up, "Your sixth sense is really accurate. The blockage is in the His-Purkinje system."

"Director, what is the reason?"

Another deputy chief physician asked.

"As far as I know, this kind of blockage is possible in clinical practice. We haven't done electrophysiological examination yet, so we definitely can't tell it apart."

Lu Chen smiled.

"You only know one thing, but not the other."

"If the patient is older, there is a possibility of atrioventricular node block."

"But for this 18-year-old girl, the atrioventricular node is not so prone to problems, and for patients with ventricular septal defect, surgery mainly affects the bundle branch conduction system."

"The reason is also very simple. The ventricular septum is between the left and right ventricles. Surgery generally affects the bundle branch conduction system. The atrioventricular node is quite far away from there and generally cannot be affected."

This statement is very simple to say.

But it is quite difficult to connect it to reality.

"Director, but you said so much, but you didn't say how to treat this patient?" Gu Xinyue asked in confusion, "Does the next treatment require a pacemaker?"

"Or, according to your meaning, this is a coexistence of three types of block, shouldn't a pacemaker be placed?"

Gu Xinyue's question is also what everyone wants to ask.

After analyzing for most of the day, Lu Chen revised the diagnosis of the electrocardiogram, but the general direction did not change.

This kind of multiple block electrocardiogram is indeed an indication for implanting a pacemaker.

At this time, Lu Chen said seriously: "I don't think I said that this patient doesn't need a pacemaker?"

"Ah?"

Everyone was stunned when they heard it.

Especially Gu Xinyue, whose eyes were wide open.

The doctors in the department thought that Lu Chen had other insights.

At this time, Lu Chen continued: "For an 18-year-old girl, the occurrence of three-branch block is definitely not physiological, but pathological. The following four possibilities should be considered."

"First, acute viral myocarditis; second, progressive cardiac conduction obstruction; third, cardiomyopathy; fourth, damage to the conduction bundle system after ventricular septum surgery."

Acute viral myocarditis, the patient did not have any prodromal symptoms of infection, and after admission, the myocardial injury markers and pro-BNP were completely normal.

The patient did not have any symptoms of chest tightness, chest pain, or dyspnea, and the possibility of acute viral myocarditis was very small.

As for progressive cardiac conduction obstruction, this type of disease is a disease without obvious organic disease and conduction bundle system involvement. The course of the disease is migratory, progressively aggravated, and develops into high or third degree atrioventricular conduction block.

This type of disease is mostly middle-aged and elderly, and there is a family history.

In addition, from the perspective of cardiac color Doppler ultrasound, there is no evidence of cardiomyopathy. From the electrocardiogram, there is no evidence of cardiomyopathy, so the possibility of cardiomyopathy is not high.

Lu Chen's remarks are very convincing.

There are four possibilities, and only the last one remains.

"That is the last possibility, the conduction bundle system is damaged after ventricular septum surgery!"

A very common complication of ventricular septum surgery is atrioventricular block, and most of them involve the His-Purkinje system, so this patient can almost be locked in the cause of atrioventricular block.

"Director, I have another question." Gu Xinyue continued, "The patient has been postoperative for 13 years. Why didn't he have the disease when he was a child, but he still has this situation now?"

Lu Chen thought about it and said, "The only reasonable explanation is that the patient had surgery when he was a child. As he got older, the heart conduction bundle system was also developing, and it may be affected by the traction of the patch."

"In this case, is a pacemaker necessary?" Gu Xinyue asked tentatively, hoping to get a different answer from Lu Chen.

After all, this is an 18-year-old girl!

But unfortunately, reality is always cruel.

Not every disease can be cured perfectly.

Lu Chen's eyes were deep, and he said slowly: "It must be done!"

I don't know when, it has been raining outside the window.

The dark clouds are pressing down on the city.

A very depressing atmosphere shrouds everyone's heart.

"Brother Shen!"

"Yeah!"

Shen Changqing walked on the road, and if he met someone familiar, he would say hello or nod to each other.

But no matter who it was.

Everyone's face had no extra expression, as if they were indifferent to everything.

In this regard.

Shen Changqing has become accustomed to it.

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

It can be said that.

In the Demon Suppression Division, everyone's hands are stained with a lot of blood.

When a person is used to 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 Suppression Division is very large.

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

Shen Changqing belongs to the latter.

The Demon Suppression Division is divided into two professions, one is the Guardian and the other is the Exorcist.

Anyone who enters the Demon Suppression Division starts from the lowest level of the Exorcist,

and then is promoted step by step, and finally has the hope of becoming a Guardian.

Shen Changqing's predecessor was an apprentice Exorcist in the Demon Suppression Division, and also the lowest level of the Exorcist.

He has the memory of his predecessor.

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

It didn't take too long for Shen Changqing to stop in front of an attic.

Unlike other places in the Demon Suppression Division that are full of killing, this attic seems to stand out from the crowd, showing a different tranquility in the bloody Demon Suppression Division.

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

Shen Changqing just hesitated for a moment and stepped in.

Enter the attic.

The environment suddenly changed.

A scent of ink mixed with a faint smell of blood hit him in the face, causing him to frown instinctively, but then he relaxed quickly.

The bloody smell on everyone in the Demon Suppression Division was almost impossible to clean.

:,!