Not myocardial infarction

Everyone felt incredulous when they heard Yun Tian's words. One Stroke Pavilion More Good

Such a typical patient with myocardial infarction, Yuntian actually said that it was not myocardial infarction

"What are you kidding, the patient is in such a serious condition and needs to be intervened immediately, such a typical symptom, which one do you use to tell that the patient is not having a myocardial infarction?"

Vice Dean Xia was furious

What the hell is this kid going on?

"You yourself are not sure that the operation will be done, and you dare to say in front of so many of us that the patient is not an emergency patient with myocardial infarction, and the rescue time is racing against time, how can you be allowed to mess around like this"

"Director Shao, Director Zhang, I didn't expect that your 913 Hospital would be so careless about human life"

Vice President Xia was very angry

How can there be such a doctor in the world

The leaders of the major hospitals who came to visit were also in an uproar.

"Director Shao, Dr. Yun is just an intern, it is inevitable that he is inexperienced, such a typical myocardial infarction situation, I am afraid it is safer to perform surgery immediately"

Several people who had a good relationship with Director Shao also began to persuade on the side.

"Yes, Director Shao, I believe in Yuntian's surgical level, but in the patient's condition, it is safer to do angiography first."

At this time, even Director Zhang stood up

The patient's condition is typical.

In terms of interventional surgery, he is not as good as Yuntian, Director Zhang fully admitted.

However, he has more than 20 years of clinical experience in cardiology, and in terms of disease diagnosis, Director Zhang believes that his experience should be richer.

Yun Tian has just graduated, such a typical myocardial infarction, Yun Tian can't see it, it seems that everyone has strengths and weaknesses.

"I believe in Xiaoyun" Director Shao, shaking his head, looked at Yuntian and said firmly.

"Do you believe that most of the interns present are cardiologists from the entire imperial capital and even the whole country, and we can't diagnose such a typical myocardial infarction?"

"So far, this doctor Yun who makes you believe has not even said his own diagnosis, you are so foolish, I am going to go to the Health Bureau to complain about you 913 now"

Vice Dean Xia was furious.

Very angry.

rushed to Director Shao, stretched out a finger, and pointed at Director Shao angrily.

"The patient is not a myocardial infarction, but has extensive left lower extremity coronary spasm"

The little nurse had already taken nitroglycerin, Yun Tian opened the patient's mouth, put nitroglycerin under the patient's tongue, and instructed the patient to take it, before raising her head and saying to Vice President Xia.

"Extensive left lower limb spasm, what joke is just coronary spasm, how can there be such a severe troponin elevation"

Vice Dean Xia snorted coldly and scoffed at Yun Tian's diagnosis.

Even most of the doctors present didn't quite believe what Yun Tian said.

Although ischemia caused by extensive spasm of the coronary arteries can also cause myocardial damage and elevated troponin, the patient's current condition is 10 typical.

Not only is troponin elevated, but left anterior wall movement is also impaired on ultrasound

Plus ST-segment elevation on ECG.

Even if it is suspected that it is a generalized spasm of the left lower branch, I am afraid that no one dares to be as sure as Yun Tian.

It is important to know that both have typical myocardial ischemia.

The clinical manifestations are almost identical and difficult to distinguish.

It is impossible to distinguish just by some auxiliary tests and symptoms.

The main clinical means of differentiating these two diseases is coronary angiography.

Whether it is a spasm or blockage, the best way is to go to the operating table for coronary angiography.

See it at a glance.

And it doesn't delay the patient's treatment.

Coronary angiography alone is not very damaging to the patient.

In the case of spasms, repeated administration of nitroglycerin will improve the patient's condition.

No surgery is required.

After the imaging, the device can be withdrawn.

The damage to the patient is not significant.

But if it's an infarction.

It will not delay the patient's rescue time.

So I listened to Yuntian's words.

All the doctors present had some emotion.

Sure enough, it was a young doctor, and the newborn calf was not afraid of tigers, so he dared to take such a big risk.

So sure.

In case of error of judgment, the patient, if it is an infarction.

If the rescue time is delayed, a life will be lost.

Relative to life, coronary angiography will not leave any irreversible damage to the patient.

It will also not affect the patient's condition.

Although there are some minor damages, they are almost insignificant compared to life.

"Whether it's spasm or infarction, it's better to have a coronary angiogram first, which is more secure and in line with the diagnosis procedure. ”

Director Zhang, who is a Buddha nature, this time, stood up bravely.

After all, even if Yuntian's diagnosis is correct, the risk is too great.

At least that's what 913 Cardiology can't afford right now.

Therefore, although Director Zhang said it carefully, he still stood up bravely and opposed Yun Tian and Director Shao's approach.

Director Zhang is the master of the 913 Department of Cardiology.

Since Director Zhang has said so, Yuntian can't insist anymore.

"Dr. Liu, push the patient in and do a coronary angiogram first"

Director Zhang didn't dare to hand over the operation to Yuntian at this time.

Moreover, looking at the appearance of the clouds, I completely disagree with the coronary angiography.

Therefore, Director Zhang said to a doctor in his thirties in the crowd of onlookers.

"Good. The doctor, who was in his thirties, didn't say much, answered, and pushed the patient to prepare for the operation.

"Coronary spasms and blockages can be calculated if you look carefully at the scale of the data, the extent of the impact, and the patient's pain level and time of onset. ”

"This patient, apparently vasospasm, repeated use of nitroglycerin can relieve the symptoms, a coronary angiography, is a damage to the patient, there is no need for this"

Yuntian stood aside, and it was rare to say much.

It's just that almost all the top cardiology leaders in the imperial capital were present at this time.

And Yun Tian looked like an old man preaching, and everyone was extremely uncomfortable listening to it.

Usually, these words are said by the people present when they teach young doctors.

When, it was the turn of an intern to speak to everyone in such a tone.

"Dr. Yun, I have been working in cardiology for decades, and I really haven't heard of the calculation method you mentioned. I don't know which professor came from such an advanced and magical method."

Vice Dean Xia snorted coldly and asked with a sneer.

Vice President Xia was very sure that Yun Tian was talking nonsense at all.

If such research results were published, it would be impossible that I would never have heard of them.

Although the international cardiology circle is very large, it is big and small.

If such a study is discovered, it will definitely be the first to appear in several top journals.

I have never heard of it for decades, so such a theory must be nonsense in some small magazine.

"Well, this method is something I have recently summed up by myself," Yun Tian showed an embarrassed look for the first time, scratched his head and said.