"Yes. Zhao Yunlong said.

He immediately picked up his mobile phone and sent a WeChat message to the doctor on duty, asking him to send the echocardiogram pictures and reports.

A few minutes later, the phone rang, he glanced at it and handed it to Jung In.

According to the CDFI report, the patient's tricuspid regurgitation tract area is greater than 8 square centimeters, which is a severe tricuspid regurgitation.

However, pulmonary artery pressure and other indicators are abnormal, but they are not consistent with tricuspid regurgitation.

This is indeed a bit strange.

Generally speaking, the heart valve is like the door bow of the old house, and when opened, it is pulled back to prevent blood from regurgitating.

In this case, it is most common in the elderly to have weak valve closure due to muscle atrophy and weakness, and the aging of the portal arch.

If you are young, it is common to have congenital heart disease, infections, intravenous drug use, etc.

Zheng Ren asked about the patient's medical history, and there was no such medical history. This is also Zhao Yunlong's strange point, so I plan to discuss it within the department tomorrow.

If you don't understand the disease, you can't go directly to the stage.

Once on the operating table, if there is a disease that is not detected, the surgeon will face more trouble. As an old surgeon, Zhao Yunlong will not fail to understand this.

It is better not to go to power, but also to find out all the circumstances.

So, he behaved very cautiously.

Su Yun also looked at it twice, and countless questions lingered in his heart, this patient was really abnormal.

I don't want Zhao Yunlong to refuse to drink more, if Zhao Yunlong is hangover and talks like a doctor during the ward rounds and internal consultations in the department tomorrow, it will be strange that he will not be scolded to death by the director.

"Are the other test sheets coming out?" Zheng Rentuo pondered and suddenly asked.

"I asked the other side to pass all the pictures. Zhao Yunlong said.

This time, Zhao Yunlong directly set up a group and asked the doctor on duty to send the picture to the group.

Looking at the test sheet, Zheng Ren and Su Yun were finally honest.

Especially Su Yun, the black hair on his forehead was faintly moving without wind, as if his brain was running at high speed, causing a slight change in the air flow.

Zheng Ren looked at the reports one by one, and immediately found the problem.

The patient not only has changes in cardiac steatosis, but also severe fatty liver, and the liver is larger than that of a normal person on B-ultrasound.

That's weird.

The patient is only in his thirties, and even if he drinks too much alcohol and eats a lot of fatty meat, it is difficult to develop severe fatty liver disease, which also causes the liver to become larger.

This, like tricuspid regurgitation, is not a problem that should occur in young people of this age.

Zheng Ren pondered for a while, compared various data, and after ten minutes, he said slowly: "Check a blood acylcarnitine spectrum test tomorrow." ”

"Huh?" Zhao Yunlong was stunned.

"Based on the patient's test values and the clinical symptoms you said, I suspect primary carnitine deficiency. Zheng Ren said: "Cardiomyopathy, lipid-deposition myopathy, fatty liver, and the patient's blood sugar is only 3mmol/L, which can be approximately judged. ”

Zhao Yunlong was a little confused, he knew about this disease, but he had never seen it clinically.

Su Yun thought for a few seconds, and then asked, "Can SLC22A5 allele test be done in the hospital?"

"Yes, but it will take time. ”

"Is there anyone else in the patient's family who is in a similar situation?"

"When the medical history was asked, the patient's description was unknown, and I have asked the patient's father and mother to rush over and ask me in person tomorrow. "Zhao Yunlong's clinical work is meticulous, Su Yun can think of it, he can also think of it, and it has been arranged a long time ago.

"The boss is right, considering that it is primary carnitine deficiency, surgery is not recommended, and it is okay to give a levoka intravenously for a period of time, and then it can be taken orally all the time. yes, boss. Su Yun asked.

"Hmm. Zheng Ren nodded.

It is a fatal disease, but as long as it is detected in time, supplemented by diet and levocarnitine, the quality of life will not be affected.

"Free carnitine is significantly reduced, if it is less than 10 μmol/L, plus a variety of acyl carnitine decreases, it can be basically judged. Zheng Ren said: "When the genetic test returns, start to supplement the Zolka, and the symptoms will be alleviated." ”

Listening to Zheng Ren and Su Yun solve the doubts in Zhao Yunlong's heart one by one, Fang Lin was a little emotional.

The star of tomorrow in cardiothoracic surgery in the imperial capital, that is not called in vain. Su Yun was able to diagnose, and he was not surprised. But this diagnosis was given by Mr. Zheng first, and then Su Yun reversed it and found a few evidences.

Mr. Zheng is indeed very strong.

Whether it's right or wrong, it's enough to be able to come up with the next step that needs to be checked, and it's enough to try and make mistakes step by step. Many people, including myself, look at these test sheets, and they are all dewed.

"Lao Zhao, I'll go to Yizang in a while, do you still drink?" Su Yun asked.

"There's something wrong with Ming'er. Zhao Yunlong insisted.

"Cut, spoiled. ”

"Who knew that such a patient would be accepted today. Zhao Yunlong didn't care about Su Yun's contempt at all, it seemed that he was used to it. He was pondering the patient's condition, and the more he thought about it, the more correct Zheng Ren said.

It is very likely that primary carnitine deficiency is used, and after the use of levocarnitine, the symptoms of tricuspid regurgitation will be relieved, and there is no need for surgery at all.

This is detected early, if it is a few years or ten years later, or the patient has an acute outbreak, metabolic acidosis and hyperammonemia, it is possible that the person will disappear directly.

Even if it is not, it is unlikely that it will be cured if it is treated later.

This condition is similar to diabetes and requires long-term medication. However, compared to complications, long-term use of levocarnitine does not seem to be a big deal.

After eating for a while, after a "banquet consultation", everyone's interest also decreased. Especially when Zhao Yunlong refused to go to Yizang to drink, Su Yun felt even more bored, chatted lightly for a while, and then dispersed.

They each hailed a ride home.

The night was shrouded and the lights were dim, Zheng Ren sat in the car and took out his mobile phone and reported to Xiao Yiren that he was ready to go back.

The Shay and Chang Yue were already lying down, in the water.

Chu Yanran was on duty tonight, and Haicheng received a car accident injury and was being rescued in an emergency surgery. She didn't have time to water the group, it was Chu Yanzhi who told everyone.

"Boss, how many people do you think will come to see you for TIPS surgery tomorrow?" Su Yun suddenly asked.

"Who knows. "Zheng Ren doesn't care.

"I expect someone will invite you to give a lecture tomorrow, are you ready?"

"I don't need it at all, just go if I need it. On your side, it's true to have the agreement ready. ”

"The agreement is fine, the lecture fee and the money for the throwing knife, what do you think?"

"Uh......" Speaking of money, Zheng Ren is really not ready to ask for it. But he knows that free things are generally not cherished.

I want to promote the learning of TIPS surgery as soon as possible, but there are still a few nodes on my side that have not been opened. Then we must take detailed measures to improve the motivation of doctors in other hospitals, so that they can apply TIPS surgery to clinical practice as soon as possible.