The place where the doctor needs to get this needle to reach is the coronary artery. To put it simply, the coronary artery is a melon, the femoral artery, the abdominal aorta, the thoracic aorta, the aortic arch and so on are all vines.

After the guidewire enters the coronary artery, the catheter is inserted along the guidewire, and then the contrast agent is injected into the catheter, and once the contrast agent enters the coronary artery, X-rays can be taken, so that the direction of the contrast agent can be clearly seen.

You can't see the thrombus on X-ray, but you can see the contrast agent, and if the contrast agent stops abruptly somewhere, it means that the place is blocked, and it is likely that it is blocked by the blood clot, and the blood can't pass, and the contrast agent naturally can't pass.

The principle of coronography is like this, and it is not very complicated.

Mu Chun looked at the results of the coronary angiography and was completely stunned.

Sometimes chest pain can be related to other conditions, and pulmonary embolism can also present with symptoms similar to acute myocardial infarction, especially chest pain.

Those who study medicine know that the heart and lungs are not separated, and sometimes lung diseases will also affect the heart, and it is possible to have changes in the electrocardiogram.

Although troponin is specific to heart muscle cells, an increase in troponin usually indicates the rupture and necrosis of myocardial cells, but it is not necessarily 100% an increase caused by coronary artery occlusion and ischemia necrosis, and it may also be the destruction of myocardial cells caused by other diseases, such as myocarditis.

The differential diagnosis of myocardial ischemia and myocardial infarction is sometimes necessary clinically.

If the heart is compared to a house, the coronary arteries are the water pipes of the house, the electrocardiogram conduction system is the wires of the house, and the cardiomyocytes are the walls of the house. Now there is a problem in the house and it is impossible to live in it, it may be that the water is cut off due to rust and blockage, it may be that the power is cut off due to a short circuit in the wires, or it is possible that the walls are cracked and leaking......

In order to rule out other conditions, Qiu Tong had completed a chest CT scan + enhancement when he was sent to the intensive care unit, and the results showed that everything was normal, ruling out the problem of embolism in the lungs.

Qiu Tong's vital signs were still in a critical state, but the experienced Deng Li was hesitant.

"Doctor Mu Chun, what's going on?"

In the middle of the night, in the emergency room, Nurse Ding Feng and Dr. Deng Li were all a little confused.

Or immediately find a doctor for consultation, but Deng Li himself is the director of the cardiology department, who to consult?

The interventional surgery was definitely not possible, Qiu Tong's blood pressure was still not stable, her heart rate continued to be between 115 and 120 per minute, and if the blood test was done, the troponin value might be even higher than before.

"Doctor Mu Chun."

If Qiu Tong dies like this, who should be responsible for this matter?

Public opinion may say that Qiu Tong is innocent of death, but after the police restore the facts, who will sympathize with Qiu Tong?

Why do you want to do this? What kind of strange means are used to make the girls become instruments of hatred.

"Now I can only continue to observe, do some conservative treatment, try to stabilize the patient's condition, not myocardial infarction, then what will it be?"

Deng Li scratched his hair, his dinner was still on the table in the emergency room, from the outpatient clinic to the emergency department, until the middle of the night Deng Li had no time to eat, when he received a call from the ambulance center saying that a patient had been delivered within fifteen minutes, Deng Li had just opened the takeaway bag.

He ordered an eel beef rice, and now the eel was completely cool, and the beef was no longer warm.

Deng Li is used to it, doctor, how can anyone complain about not having time to eat, this has been used to it during the training period.

It's Mu Chun, he originally wanted to talk to Mu Chun about some questions, but now is not the time at all.

Mu Chun looked at Qiu Tong's painful appearance, and his heart was mixed, more anger and pain.

But he knew that it was useless to think about it now, and the most important thing now was to figure out what happened to Qiu Tong?

Back in the custody room, Deng Li saw Mu Chun's painful expression and patted him on the shoulder, "Is it your patient?" ”

Mu Chun shook his head.

Qiu Tong is not his patient, Li Mu is.

Thinking of this, Mu Chun suddenly felt a severe chest pain, couldn't help bending down, and sat on the ground against the wall.

"What's wrong with you?" Deng Li saw the situation and was nervous.

While checking Mu Chun's condition, he shouted outside the door, "Ding Feng, Nurse Ding Feng." ”

The nurse hurried to see why another person had fallen to the ground.

This night shift is really too much to do, and the patients can't solve it without saying anything. If there are two myocardial infarctions in one night, Director Deng Li will not be able to keep busy even if he has three heads and six arms.

"I'm fine."

In about half a minute, Mu Chun's pain gradually disappeared, he stood up, walked to Qiu Tong's side, and checked the cardiopulmonary monitor again.

"I know why."

Look directly at the blood pressure, heart rate, and other values on the display.

"Is it okay to have another ECG?"

Although Deng Li didn't understand what Mu Chun meant, he acted immediately, and the ECG quickly typed out new drawings.

"Although, I don't know if Qiu Tong has a history of heart disease, since it is not found in the medical insurance record, I can rule out a history of heart disease for the time being, but one thing can be 100% certain." Mu Chun looked at Qiu Tong with a firm look in his eyes and said slowly, "What is certain is that Qiu Tong experienced a very significant external incident before the chest pain occurred. ”

"External event strikes? What does Dr. Mu Chun mean? ”

Seeking medical treatment, Mu Chun did not have time or special reason to describe the matter between Qiu Tong and Li Mu to Director Deng Li in detail for the time being.

"I'm talking about patients who are extremely sad or angry because of a major external event, which leads to chest pain, breathlessness, shortness of breath and other symptoms similar to heart disease."

"I seem to understand, but it's not common in clinical practice, so I didn't think about it in that direction at all."

"Well, it seems likely that this is the reason for this at the moment—[Broken Heart Syndrome]."

Broken heart syndrome (also known as takotsubo cardiomyopathy) refers to chest pain, breathlessness, shortness of breath and other symptoms similar to heart disease caused by extreme sadness or anger caused by a major external event, but there is no myocardial damage or blockage of the heart arteries, as long as the patient overcomes the acute phase that can be life-threatening, usually recovers within a few days or weeks.

In about 1 in 10 cases, people with broken heart syndrome develop cardiogenic shock, in which the heart suddenly can't pump enough blood to meet the body's needs.

Mu Chun judged that Qiu Tong was in this situation now.

"It does look like Dr. Mu Chun said [broken heart syndrome]." Deng Li's hanging heart relaxed a little.

"The symptoms [of broken heart syndrome] look very similar to myocardial infarction, and there is also an increase in troponin on blood tests."

The sound of the instruments in the care room made a regular sound, and the white sheets were lifeless.

Suddenly, Deng Li called Ding Feng, "Nurse Ding, prepare mechanical support, Doctor Mu can help together, there are not enough people in the emergency department at night." ”

"No problem."

Mu Chun agreed, completely obeying Deng Li's orders. e

After a few minutes, Qiutong's blood pressure returned to normal and her breathing became smooth.

There was finally a strong anger on the white sheets, and the sound from the equipment in the intensive care room sounded more and more pleasant.

"It would have been nice if I had thought about it earlier, but fortunately, the medicine just now still had some effect, now as long as I continue to promote blood flow, I will wait for her to slowly recover on her own."

Mu Chun took off his gloves, and Deng Li, who finally rescued the patient, stood beside Mu Chun and smirked.

Deng Li is about forty-five years old, but he looks very young, he belongs to the relatively silent kind of doctor in Sumichuan Medical College, he has a good relationship with everyone, and his medical skills are also excellent, but he has a strange nickname.

Behind his back, everyone called Deng Li "the little prince of the night." ”

The two walked to the emergency room, Deng Li glanced at the lunch box, turned around and asked Mu Chun, "Do you want to eat some?" ”

"No, I've had dinner. Eat it, I'll be able to help you if you need anything. ”

After Mu Chun finished speaking, he pulled a chair and sat down.

Deng Li opened the drawer and took out a box of nuts from it, "Eat some of this, I often work night shifts, and I eat a little nuts before I have time to eat, I am very hungry." ”

"Thank you."

Mu Chun stretched out his hand to take it.

"Doctor Mu Chun really lives up to his reputation, if you weren't here, I'm afraid I wouldn't have thought of cardiogenic shock and broken heart syndrome. Because I've been working in Sumikawa for more than ten years, I've never met it. ”

"While the exact mechanism is uncertain, broken heart syndrome is thought to occur when stress hormone levels are too high after physical or emotional stress, which can be negative, such as the death of a loved one; It could also be positive, such as winning the lottery. But in about one-third of cases, broken heart syndrome occurs in the absence of a known stressor. It seems that there is another name in medicine, called ......"

"Stress myocarditis." Deng Li said while putting the lunch box in the microwave.

"Yes, stress myocarditis."

Accompanied by the sound of the microwave oven running, Deng Li said: "Stress myocarditis is a self-limiting disease, although it is a bit scary at the onset, similar to a real myocardial infarction, but after all, it is not a coronary blockage, so it generally does not pose a fatal threat." ”

"If there is no cardiogenic shock, maybe the patient will slowly stabilize on his own soon, but cardiogenic shock is still very dangerous, and Director Deng's treatment is very timely, if I would definitely not be able to think of it."

"There's a specialization in the art industry, and it's here that psychosomatic doctors treat, right?" Deng Li pointed to his forehead, his expression a little naughty.

The doctor in his forties is wearing a white coat with a Spider-Man decorative buckle pinned to the pocket of the white coat, which looks a little out of place.

Looking at Deng Li's feet is a pair of red cave shoes, which are decorated with decorative buckles of various Marvel elements such as Iron Man and Captain America, which looks like a Marvel super fan.

is different from another Marvel superhero [Doctor Strange], although Doctor Strange was still a doctor before he had super magic, he is a doctor who wears a famous watch and drives a luxury car, he is handsome and unstoppable, and the luxury car beauties are endless.

Deng Li is different, he is obviously forty-five years old, but he doesn't look mature at all.

"Keeping the patient's blood flowing can actually stabilize her condition and help her get through it, you see, we've got it done, right?"

There was no tension on Deng Li's face.

Mu Chun was also a little relieved, if it was really Qiu Tong who died so suddenly, he really didn't know how to tell Li Mu what happened between midnight and one o'clock in the morning today.

Deng Li took out the heated rice and sat opposite Mu Chun.

"Eat quickly, I'm fine, I'm really not hungry."

didn't wait for Deng Li to speak, Mu Chun helped him speak first.

"Doctor Mu Chun, I actually really want to visit you, but I haven't had time, mainly, it's not a big deal."

Deng Li took a bite of the eel, but he couldn't stand the saltiness, so he looked for a glass of water everywhere.

Why is the current Director Deng and Director Deng treating patients like two people? The current Deng Li can be described as cute, and even a little too cute.

So he said he was going to talk to a psychologist, maybe there was really something a little bit big?

Deng Li didn't say anything, and Mu Chun naturally didn't speak.

There are too many things to worry about in his heart now, and anger has the upper hand compared to trouble.

Who is behind this? Xu Dan? If it was really her, I would see Qiu Tong who almost died today, Li Mu who finally survived, Geng Meng who was in a trance, and Liu Mei who lost everything......

If all this was carefully planned by Xu Dan, her purpose was to be slim?

The reason behind it?

"By the way, Doctor Mu? Is this patient your patient? ”

Deng Li asked while eating, completely ignoring the image, this is one of the reasons why he likes the night shift, he is comfortable! You can be like a child, who is not a child!

Mu Chun remembered that Deng Li had asked once before, but it didn't matter, he replied again, "Qiu Tong is not my patient, my patient is ......"

Patient!

That's right, it's the patient, Mu Chun opened the pentagram formation map in his mind, in addition to Liu Mei, Yang Xing from Qingshan Road, Li Mu from Lanhai Flower Garden, and Geng Meng from Linhai Community.

There are also Bai Lu and He Ping before, these people are all related to Mu Chun, except for Geng Meng, they are all Mu Chun's patients.

Wrong? It's still not right, Geng Meng is not my patient, neither is Chen Feng, nor is Liu Mei, these people can't be considered related to me......

"Isn't it Dr. Mu Chun's patient?" Deng Li patted his stomach and burped, which seemed to be caused by eating too quickly.

"No, let's be honest with you, Qiu Tong is not my patient, her husband is my patient."

"Huh?" Deng Li wiped his mouth with a tissue, tilted his head and stared at Mu Chun.

"Why is Director Deng looking at me like this? Is there something on my face? ”

Mu Chun looked around, and then saw his own face in the mirror above the sink.

"No, no, Dr. Mu Chun is as handsome as I imagined!"

Mu Chun: ...... Wouldn't this Deng Li be?

邓黎仍旧笑着问，“我就是好奇，好奇啊，身心科医生还负责照看病人的家属吗？ ”

Recommend a book: Mid-Autumn Festival Yuemingda's new book "I'm a Killer of Feelings".

At present, the word count is 750,000 words, and the update is very stable and can even be said to be very powerful. If you don't like to chase more, you can watch "The Great Beauty Era" first.

But I guess you must have read "The Great Beauty Era", so let's catch up with the new book!

The brief introduction of the author's feelings is as follows:

I, like a pigeon killer;

I, what feelings;

Also, I don't have to get money.

I am Yi Haizhou, whose surname Yi has disappeared;

The man who is half proficient in the four great inventions;

I DIDN'T WANT TO TALK TO YOU AND THREW A BENG......