Chest pain, tightness, and rapid heart rate.

Viral myocarditis is also possible.

And for this disease, Bai Mingming has been deeply impressed recently.

The owner of the gym that Bai Mingming often went to, thought that this was the disease he had in the first place. At that time, the boss fell straight off the treadmill.

Bai Mingming remembers it vividly.

The age group of onset of this disease is also mainly young adults. In severe cases, it can cause heart failure and sudden death.

Bai Mingming had this idea and didn't dare to slack off.

He immediately began to take a careful history of the patient.

Soon the patient gave back a useful piece of information, a week ago, he had a bad cold, which was quite serious, and he went to the community hospital to hang up the water for two days.

With this message.

Bai Mingming felt that the boy was most likely suffering from viral myocarditis.

The next step is to check the necessary tests to confirm the diagnosis.

Bai Mingming called the nurse and gave a doctor's order.

Have the nurse take the patient for an electrocardiogram and cardiac enzyme study.

These are two standard tests to determine viral myocarditis.

Of course, if the condition is confirmed, if you want further examination, you can also do cardiac ultrasound and so on.

The ECG is relatively fast.

The nurse took it to the emergency department, and there was no need to queue, ten minutes for examination, and two minutes for the report. Coupled with the distance to go, it only took ten minutes to go back and forth.

Cardiac enzyme palette compares time.

This test is a routine biochemical test that involves drawing blood.

The collected blood of interest is placed in a special testing device. Generally, it takes at least two or three hours for results to be available.

Of course, in reality, the device inspection time takes less than an hour.

Because of the efficiency considerations, a batch of specimens are collected in the hospital and then tested together.

Again, because of the emergency department.

The results of this test were greatly accelerated.

In less than half an hour, the test report of cardiac enzyme spectrum was also obtained.

The patient returned to the emergency room.

The nurse handed over the two test reports in her hand to Bai Mingming.

For heart problems, of course, the first step is to look at an electrocardiogram.

When Bai Mingming saw it, he was a little dumbfounded.

In general, in viral myocarditis, the patient's heart rate will be abnormal, and there will be ST-T changes on the ECG, the common T wave is inverted or decreased, and there may also be a slight shift in the ST segment.

But in this patient's ECG, the report reads: ST segment: no shift seen. T wave: the time limit and amplitude were normal, and no pathological deviation was observed. Diagnosis: 1. Sinus rhythm. 2. Normal electrocardiogram.

What the hell is going on?

The ECG shows that everything is normal.

Bai Mingming was a little panicked, and hurriedly took a look at the second cardiac enzyme report.

Here's a bit of popular science, it's not surprising that ECG and CT scans can detect problems with heart problems. Why do you do a biochemical test of the blood can also show the problem. This also depends on the content of the cardiac enzyme spectrum.

Routine cardiac enzyme spectrum five tests can detect acid dehydrogenase, phosphocreatine kinase, creatine kinase isoenzyme, aspartate aminotransferase, and α-hydroxybutyrate dehydrogenase.

These five enzymes are normal enzymes in cardiomyocytes.

In the blood of normal people, the levels of these five enzymes are very low. However, if the heart muscle is damaged, these five types of enzymes are released from the heart muscle cells, and the level of cardiac enzymes in the blood increases.

Therefore, the patient's myocardial condition can be judged by measuring the content of muscle enzymes in the center of the blood.

Besides, Bai Mingming hurriedly picked up the report of the cardiac enzyme spectrum and took a look. Again, it is cold in the heart. All five indicators are normal.

I'm dizzy!

The test report is brutal. It was like a slap on Bai Mingming's face.

The possibility that the patient had viral myocarditis was completely ruled out.

The wall clock in the emergency room came to 10:50.

It's been almost an hour since the patient came to the emergency center. No cause has been identified.

The two tests I did just now were completely busy.

Outside the emergency room, there are also family members of patients who are waiting anxiously.

Bai Mingming was a little anxious at the moment.

But he's also an "old man" in an emergency center.

He knows that not panicking in case of trouble is a necessary quality for an emergency doctor.

He took a deep breath, stabilized his emotions, and continued to investigate the cause.

On the other hand, Bai Mingming also knew that the patient's condition was not so simple.

He called a nurse next to him and said, "Go and see if Team Leader Zhou and Team Leader Liu have time, just say that there is a tricky patient with chest pain in the emergency room." ”

The nurse moved.

Two or three minutes later, Liu Zhengqing came with the nurse.

Bai Mingming naturally hoped that he could come over on Monday. First, judging from Bai Mingming's recent observations, Zhou Ming is much more powerful than Liu Zhengqing in dealing with some difficult cases. Second, the relationship between Bai Mingming and Zhou Yisheng is also better. Ask for advice on Monday, and there is not much psychological burden.

But Zhou Ming didn't come, Bai Mingming estimated that it was mostly because Zhou Zhou was busy. Liu Zhengqing can come, and he can also help him solve some problems.

When a young doctor encounters an urgent illness, he always hopes that there will be a great god by his side. Even if this Liu Zhengqing is not a god, with more than ten years of medical qualifications, in Bai Mingming's opinion, it is still quite reliable.

After Liu Zhengqing arrived.

Briefly asked Bai Mingming about the patient's condition.

He looked down at the patient on the hospital bed, thoughtful.

This patient is relatively young and thin, but he is quite tall, and the bed is two meters, and he lies on it, that is, he will be fine. It is estimated that the patient is at least 1.8 meters.

Liu Zhengqing instantly thought of a condition, spontaneous pneumothorax.

This condition is more common in tall and thin men. Frequent colds and strenuous exercise are a trigger for the onset of illness. At the onset of the disease, the patient will have difficulty breathing and chest pain.

Liu Zhengqing had an idea and immediately brought it up, "Could it be a spontaneous pneumothorax?" ”

Sometimes, it is the authorities who are confused, and the spectators are clear.

After Liu Zhengqing's order, Bai Mingming felt a little reliable.

Spontaneous pneumothorax is also considered a common clinical condition.

The cause of this disease and its diagnosis and treatment methods must also be known to Bai Mingming.

Next, no longer waiting for Liu Zhengqing to remind, he has begun to determine whether the patient is this disease.

The first is of course a consultation.

Bai Mingming asked the patient, "Have you ever exercised vigorously during the day?"

The patient lay on the bed and said weakly: "Before eating, I played basketball for more than an hour. The kind of people in the audience, who ran a little more fiercely......"

There's a play!

Bai Mingming and Liu Zhengqing glanced at each other.

Liu Zhengqing said: "Listen to the lungs." ”

Bai Mingming nodded and took the stethoscope around his neck with him.

Spontaneous pneumothorax, auscultation of the lobes of the lungs, will show signs of weakening and disappearing.

Auscultation allows for a quick and simple diagnosis of the condition.

Bai Mingming knew this very well, and he immediately started to operate.

……