"Doctor, how's it going?"

The girl's mother asked Zhao Sheng very nervously and apprehensively.

The female teacher and the girl's father also looked at Zhao Sheng with a nervous expression.

"The child is in a bit of a bad condition, and now he is suspected of having pericardial effusion and pulmonary edema, and some tests must be done first to confirm the diagnosis."

Zhao Sheng said with a solemn expression.

"Okay, okay, doctor, let's start an examination quickly, let's take Miao Miao to do it immediately!"

The girl's mother nodded again and again, she didn't want to wait for a second.

"You take them for an examination, and they all do it urgently, and they say that I said it."

Zhao Sheng nodded, and quickly opened the emergency blood test, chest CT and heart color ultrasound, and said to Song Wei at the same time.

"Okay."

Song Wei nodded, and led the girl and the girl's parents to go for an examination.

An hour later.

Rescue room.

At this moment, the girl Miao Miao was already lying in the emergency room, and Zhao Sheng gave the girl assisted ventilation, diuretic, anti-infection, and ECG monitoring, and now she is waiting for the test results to come out to be diagnosed.

"Doctor, Miao Miao will be fine, right? Why is it so serious? ”

The girl's mother looked at the pale and very weak girl lying on the rescue bed, and tears flowed out of her eyes.

The daughter is the hope of the whole family, not only does she study well, but she is also very sensible, and she has no bad habits, and her children begin to rebel when they reach junior high school, but on the daughter's side, she is more sensible, and she can even understand that it is not easy for adults to accompany her to study.

In today's words, this daughter is an angel sent from heaven.

Therefore, whether it is the husband and wife, or the old people on both sides, they all love this child very much.

"Now we have to wait for the results of the examination to come back."

Zhao Sheng said.

He vaguely had a direction in his mind, but he was not very sure, the diseases that can cause chest tightness and asthma were too many and too complicated.

After a while, the girl's father came in with a stack of urgent test results.

"Doctor, it's back."

The girl's father was very anxious and handed the stack of test results in his hand to Zhao Sheng and said.

"Okay."

Zhao Sheng took the inspection results and looked at them carefully.

However, after taking a closer look, Zhao Sheng couldn't help frowning.

The results of blood examination showed no abnormalities in electrolytes, liver, kidney function, troponin, blood glucose, thyroid function, and respiratory virus.

Routine blood count: white blood cells and C-reactive protein were slightly elevated, but NT-proBNP reached 24913 pg/mL!!

NT-probnp, which is the precursor brain natriuretic peptide, should be less than 300pg/ml in the normal range.

NT-probnp is currently an important biomarker that reflects cardiac function. Normally, NT-probnp should be less than 300 pg/ml. When NT-probnp is greater than 1000 pg/ml, it indicates a higher risk of long-term death; When NT-probnp is greater than 5000 pg/ml, it indicates that patients with heart failure have a higher risk of short-term death.

After doing emergency work for so long, the NT-probnp generally only needs to reach five or six hundred, or more than one thousand, that is, it is necessary to give the patient a critical illness notice, indicating that his life will be in danger at any time.

Twenty thousand?

This is equivalent to saying that the girl in front of her has a very serious heart failure and is on the verge of death at any time.

Looking at the chest CT again, sure enough, there was pulmonary edema, pericardial effusion and pleural effusion, and the results of cardiac color imaging were: mild enlargement of the left ventricle, 25% ejection fraction of the left ventricle, severe regurgitation of the aortic valve, moderate regurgitation of the mitral valve, dilation of the ascending aorta, thickening of the wall of the tube, and regurgitation of the descending aorta.

ECG: sinus tachycardia, poor R-wave increment in V1-V4, nonspecific ST-T changes.

How did a good 14-year-old junior high school girl get to such a serious level?

After reading the inspection results, Zhao Sheng's face was unusually solemn.

"Contact Dr. Li Mujia in the ICU, and prepare to transfer there, and then contact the cardiac surgery department for consultation."

Zhao Sheng said to Song Wei very seriously.

"Okay."

Song Wei saw that Zhao Sheng's face was so solemn, so she immediately nodded and went to execute.

"Doctor. . . Miao Miao her? ”

Seeing that Zhao Sheng saw the results of the examination, his face became so solemn, and he was transferred to the ICU, and it was called a consultation, the girl's mother suddenly felt that the situation was not good, and asked Zhao Sheng with a trembling voice.

"The child now has severe heart failure, which is heart failure, and must be transferred to the ICU immediately."

Zhao Sheng said quickly.

"I look okay, Miao Miao is just a little out of breath now, her face is a little white, it's not that serious."

When the girl's mother heard this, it was like a thunderbolt from the sky, and she suddenly said in disbelief.

"Now it doesn't look serious because the child is young, and the heart still has a compensatory function, once it can't be compensated, then cardiac arrest may occur at any time."

Zhao Sheng explained and said that the situation is already so serious, and it must be made clear to the family.

"Huh?!"

When the girl's mother heard this, she immediately felt that her eyes were dark and her body was weak.

"Miao Miao's mother!"

The female teacher standing next to her exclaimed in surprise, and the girl's father held the girl's mother at once.

Soon, the girl Miao Miao was transferred to the ICU, and at the ICU bedside, the ICU attending doctor Li Mujia and the attending cardiac surgeon Lin Yi who came to the consultation all arrived at this time.

The girl Miao Miao was already confused at the moment, lying on the ICU bed in a semi-recumbent position, wearing an oxygen mask, and the ICU attending doctor Li Mujia had already given the girl measures to control acute heart failure such as cardiac diuresis and vasodilation, although the situation was serious, the girl was still in a relatively stable state at this time.

There is still time to find out the cause!

At this time, the three experienced attending doctors standing at the ICU bedside were all thinking about it.

According to the examination results and situation of the girl Miaomiao, the only diseases that may be suffered at this time are heart valve disease, cardiomyopathy, lung disease and aortic disease.

"Judging from the results of electrocardiogram, cardiac color ultrasound and troponin, the patient has no cardiomyopathy, no obvious fever recently, impaired cardiac function but no significant increase in troponin, and the course of the disease may be relatively long, which can rule out the possibility of coronary heart disease and acute fulminant myocarditis."

Lin Yi, the attending doctor of cardiac surgery, spoke first and said very methodically.

"Yes, combined with the patient's chest CT and clinical manifestations, the pulmonary edema of the patient is considered to be related to pulmonary edema caused by heart failure, and the possibility of lung disease can also be ruled out."

Li Mujia, the attending doctor of the ICU, thought about it and said, once again ruling out an alternative.

"The aortic valve and mitral valve have no malformations, thickening, adhesions, vegetations and perforations, mitral regurgitation is considered to be related to left ventricular enlargement, and aortic regurgitation is considered to be related to ascending aortic dilation, so valvular heart disease can also be ruled out."

After the two attending doctors finished speaking, Zhao Sheng then ruled out the third possibility.

"For such a young child, the possibility of atherosclerosis is too small."

After a pause, Zhao Sheng said again.

As soon as he said this, he ruled out the last possibility, which was aortic disease.

All four possibilities have been ruled out, and the three doctors, you look at me, I look at you, looking at each other, this is really a tricky game.

(End of chapter)