Chapter 1468 It’s Just a Headache Treatment, Can We Not Do a Heart Attack?

"You say it, you say it! I will do whatever you say!"

Hearing Grete ask for his opinion, the old dwarf nodded quickly. Just kidding, if the adults from Dragon's Nest are willing to treat him, they are giving him great dignity and asking him to do a check-up. Is there anything he can't do?

And so far, I have just brushed strange light on him (doing electrocardiogram, measuring blood pressure, measuring blood oxygen, etc.);

Ask him to stand on a board and rotate, hold his breath and exhale as required (do head and neck CT, head and neck MRI);

Draw a little blood from him (to measure blood sugar, blood lipids, etc.), hey, this little bit of blood is nothing!

Grete smiled. He directed the old dwarf to lie down, unbutton his shirt, and expose his chest. Then, he couldn't help but said "Alas":

By the way, I can understand that savages have thick chest hair;

I can understand giants having thick chest hair;

Even those knights in Nevis all have dark, thick and long chest hair that needs to be shaved before they can do an echocardiogram. I can understand that;

But you are a dwarf! dwarf! You're playing with your brains, not your physical strength. What's the point of having such thick chest hair?

Well... I have married 4 wives, a total of 12 women, and have given birth to more than 30 children. It is not surprising to have such thick chest hair...

"You shaved your chest hair first..." He stroked his forehead and waved his fingers. Alas, that’s all for the hair on other parts of the body. For the hair that protects the heart, it’s better to shave it off if you can.

What a waste of time if it comes time to do a cardiac ultrasound!

"What?!"

The old dwarf subconsciously crossed his arms. Before he could protest, two middle-aged dwarfs swarmed up to him, stretched his arms, poured water, applied soap, waved the razor, brush, brush, brush...

With decisive movements, quick handling, and light and precise movements, he is worthy of being a dwarf known for his exquisite craftsmanship.

Grete estimated that if a barbarian was asked to shave his chest hair, he would probably be pasted with a lump of beeswax, and then wait for the beeswax to dry, and then tear it off directly, right?

Before Grete could react, large piles of black and white fur fell to the ground. He only blinked a few times, and the old dwarf's chest was clean and flat, with all the stubble shaved off...

Well, with a chest like this, it would be more comfortable to do an echocardiogram. Gretel applied glycerin, pressed his palms, and activated the B-ultrasound magic with ease. The eyes are slightly closed, the blood flowing from the heart is vividly present.

Well, there are microbubbles in the left atrium. Judging from the location, it should be at the interatrial septum and fossa ovale, with a small right-to-left shunt. The bubbles are very small and the defects are not large. If you don't pay attention, they are almost impossible to see.

Gretel narrowed his eyes subconsciously. Stop for a moment and give the command softly:

"Listen to my words clearly, follow the order, and do a set of actions.

——First take two deep breaths, then close your throat tightly and listen to me count five times. After counting, exhale forcefully, but still close your throat tightly to prevent the breath from actually exhaling. Understand? "

If this order were to be carried out by barbarians or ogres, most of them would probably have to blink their eyes, exhale, and hold their breath.

The old dwarf thought about it carefully, then took two deep breaths, raised his fingers on the bed, and counted five times in a row. Then exhale forcefully, say "Oops" again, and start over again...

After trying it back and forth twice, I nodded lightly on the bed and whispered, "I understand."

Gretel was very pleased and asked him to do it again. It felt like there was no air leaking out near his mouth and nose when he exhaled, so he had obviously learned it.

He paused for a moment to let the old dwarf relax and restore the oxygen content in his blood. Seeing that his face recovered, he began to order:

"Breathe deeply!—Breathe deeply!—Five, four, three, two, one, exhale!"

Bang, bang, bang. After completing this set of movements, within three cardiac cycles, the microbubbles in the left atrium were particularly obvious!

"Patent foramen ovale, diameter, 3mm..." Grete thought silently in his mind.

He opened his eyes and quickly looked at the old dwarf's figure. Based on the size of the heart seen in the echocardiogram, he calculated the ratio of the dwarf's heart to that of a human, and the diameter of the foramen ovale was equivalent to the size of a human:

"Well...it's almost 4mm...it's a relatively big one..."

This was really a flash of inspiration. In his previous life, while chatting with colleagues before a certain meeting, he once heard a colleague from Shinai talk about such a case:

There was an old patient who had recurring headaches and could not find the cause.

Later, he came across an academic paper, which pointed out that there is sometimes a correlation between patent foramen ovale and migraines, and that sealing the foramen ovale can help treat migraines...

Treating a dead horse as a live doctor, this colleague asked for help from the cardiology department, diagnosed the symptoms of patent foramen ovale, and persuaded (fooled) the patient to undergo a closure operation.

Later, the patient’s migraine actually got better! In his excitement, the patient actually gave him a "Miracle Rejuvenation" banner. He never thought about the relationship between heart surgery and headaches...

"Well, I may have found the cause of your headache." Gretel clapped his hands. But he found it. He used his secret vision to look at the whole body of the old dwarf, especially his brain, to make sure there was no energy accumulation:

He is really not good at energy conflict!

In a comfortable mood, he didn't mind giving away a handful of spells for free, and waved his hand with satisfaction. A cleaning technique passed by, and the glycerin on the old dwarf's chest disappeared instantly——

This looks much better than the scumbag behavior of throwing a pile of straw paper at him and telling him to "wipe it yourself." Moreover, it is very efficient and clean, which makes people feel comfortable.

The old dwarf immediately opened his eyes wide. Although Gretel said it was "possible to find it", his tone and attitude all revealed that "I am very sure". He asked with some trepidation:

"Found it?...What's the reason?"

"Well, your heart is a little bit undeveloped." Gretel pointed at his heart, and then showed him the shadow of the heart:

"It's a gap here. It should have grown ten days and a half after birth, but it didn't completely grow. When the heart beats, blood will leak through it, which will cause you a headache. …”

The old dwarf half-understood what he said, but seeing Grete's confident look, he couldn't refute. After struggling for a long time, I asked carefully:

"But my heart is leaking a little blood...why do I have a headache?"

This is quite far away!

Even if it leaks, it's still leaking in the chest, so it won't hurt my head anyway!

Well……

Well, there is a story. The specific mechanism by which patent foramen ovale causes migraines is indeed unclear. Of course, there is speculation.

Most researchers believe that under conditions of increased right heart pressure such as breath holding and coughing, certain neurohumoral substances that can cause headaches directly enter the systemic circulation through the unclosed foramen ovale, causing migraine symptoms.

If the foramen ovale is closed normally, they should be directly metabolized and degraded in the pulmonary circulation.

But to explain this in detail, we need to explain what is pulmonary circulation and what is systemic circulation; what are those substances, for example, what other substances are there besides 5-hydroxytryptamine, and their degradation and metabolism processes...

"Research reports show that migraines are closely related to patent foramen ovale." Looking back now, Grete still remembers the way his colleague from Shinuchi grabbed the journal and showed off to him proudly:

“Especially for migraine with aura, the probability of migraine with aura in patients with patent foramen ovale is as high as 46.3% to 88.0%, and the probability of migraine with non-aura is 16.2% to 34.9%. (1)

There is also increasing data showing that some ischemic strokes that were once considered to be of unknown cause were later confirmed to be related to patent foramen ovale.

——I am considering suggesting to the superiors that in the future, when I see unexplained headaches, I will send everyone to have a cardiac color Doppler ultrasound! "

Now that heaven and man are separated, he has no choice but to silently recall the voice, appearance, and appearance of his divine colleague in his mind—no, he is the one who traveled through time, and it should be others who recall his voice, appearance, and appearance...

Gretel smiled helplessly to himself. I couldn't explain clearly, and I had to convince the patient, so I had to keep a straight face and pretend to be dignified:

"According to my rich medical experience, your headache is most likely related to heart problems. As long as you perform a small treatment and close the gap, there is a high probability that your problem will be solved."

"...Do I need to cut my heart open?" The old dwarf's face turned pale. He subconsciously crossed his arms and tightly protected his chest.

Thinking about it, something felt wrong. The master of Dragon Nest wanted to cut his heart open. Could he still resist? I'm afraid that if I lie down and let others slaughter me, I can still keep the whole tribe safe, but if I struggle to resist, it will bring harm to the whole tribe!

Feeling discouraged at this thought, he let go of his arms and lay back like a salted fish, with only one pair of eyes staring sadly at Gretel, expecting him to change his mind.

Gretel sighed and said warmly:

"There is no need to cut open the heart. In fact, unless it is absolutely necessary, we try not to open the heart and cause too much damage to the patient. If we can use other methods, use other methods."

He didn't say it was okay, but said, "Unless it's absolutely necessary, try not to cut open the chest." The old dwarf shivered more and more, and sweat oozed from his forehead, cheeks, and chest that had just been shaved.

Unless it is absolutely necessary, try not to betray your heart. Does that mean that you will still betray your heart when it is absolutely necessary? !

No! ! !

Although when I had a headache, I kept saying "Cut my head in half", but now that the pain is gone, I still don't want to die! ! !

"This, this can..." Can it not be cured?

"I'm afraid it still needs treatment." Grete sighed:

"There is a defect in the heart. If you leave it alone, big problems will occur in the future. For example... the congestion will flow to the brain and block the blood vessels in the brain, which will lead to paralysis and death."

(1) Lip P Z, Lip G Y, "Patent foramen ovale and migraine attacks: a systematic review": "American Journal of Medicine", 2014, 127 (5): pp. 411-420