Li Mujia, the attending doctor of the ICU, and Lin Yi, the attending doctor of the cardiac surgery, are thinking hard at the moment, and this kind of situation that excludes all conceivable possibilities from the examination results and clinical symptoms is indeed very rare and tricky.

At this time, Zhao Sheng suddenly had a flash of inspiration and said, "Doctor Li, Doctor Lin, I noticed that the color photos of the patient's heart showed that the local tube wall was enhanced, maybe it was related to this. ”

"According to monism, I think there is only one possibility for the current clinical manifestations of the patient, and that is Takayasu's arteritis, and I really can't think of any other possibilities."

Monism is a kind of guiding thinking for clinical diagnosis, which mainly includes two meanings: first, try to use one cause to explain the lesions of multiple systems or organs; Second, try to explain as many symptoms as possible with one disease.

"Takayasu's arteritis?"

When Lin Yi, the attending doctor of cardiac surgery, heard Zhao Sheng's words, his eyes suddenly lit up.

"Yes, why didn't I think that the patient's current symptoms can be explained by arteritis caused by arterial blockage, which causes heart failure, which makes sense."

Li Mujia, the attending doctor of the ICU, also suddenly realized when he heard this.

"The patient is a 14-year-old young girl, so I think the possibility of high-level arteritis is the most likely, and now the patient must be given a CTA of the whole artery to confirm the diagnosis."

Zhao Sheng nodded to the two attending doctors and continued.

Gao'an artery refers to the chronic progressive non-specific inflammation of the aorta and its main branches and pulmonary arteries, which mainly causes stenosis or occlusion of different parts, which is extremely rare, and cardiac surgeons in general hospitals sometimes may not encounter this rare disease.

CTA, CTA, on the other hand, is angiography, and in the case of whole arteries, all arteries are imaging.

However, when imaging is done, the blood vessels of the whole body must be examined by intravenous injection of contrast medium.

Now the girl Miao Miao may have cardiac arrest at any time due to severe heart failure, and at this time, it is very risky to do a whole angiography!

One is not good, in the process of doing the examination, it is very likely that the worst outcome will occur, that is, cardiac arrest!

"In the patient's current condition, if you do a whole angiogram, the risk is very high."

Lin Yi, the attending doctor of cardiac surgery, has rich experience in angiography, and the patient is now in a state of severe heart failure, and it is very likely that he will not be able to tolerate it and have serious complications.

But without a total angiography, this last possibility cannot be confirmed, and targeted treatment cannot be carried out to save the young life of the girl, who may die at any time.

In other words, if you don't do this test, you can only watch the girl come to the end of her life because of severe heart failure.

But doing this test, the risk is also very high, to put it bluntly, it is a possibility!

"I'll go and explain the situation to the family, this test must be done now, otherwise, the cause cannot be determined, and the patient can only watch the patient die of heart failure."

ICU attending doctor Li Mujia made a decision very neatly, such a dilemma, as an ICU doctor, often encountered.

It's like this kind of risky inspection or operation, but it's not really anything, and there's still some hope.

If you have a situation where you are already relying on medical equipment to keep you alive, and once you remove the life support device, the patient will die immediately, then that's really tricky.

In that case, if you have money, you can just use a machine to maintain your life for a few hours or more days, and the cost is very expensive.

But if you don't maintain it, you just give up, and the family doesn't seem to feel good.

That's the real dilemma.

"I'm the attending doctor, Dr. Li, let's go together."

Zhao Sheng nodded to Li Mujia, in this situation, the risk of doing an examination is very large, and it is impossible for Zhao Sheng to let Li Mujia, the doctor in charge of the bed, bear this kind of risk alone.

As for Lin Yi, the attending doctor of cardiac surgery, he only came for consultation, and it was not his turn to take the risk.

"Okay."

Hearing Zhao Sheng's words, Li Mujia looked at him deeply before nodding.

Soon, Li Mujia and Zhao Sheng came out of the ICU together.

As soon as they came out, the couple greeted them, and the female teacher had already gone back, and she was able to send the students to come with her, and she stayed for two hours, which was already very good.

"Doctor, how is Miao Miao?"

The girl's mother asked with tears in her voice.

"The situation is not optimistic, heart failure is very serious, now we suspect that the child has a rare arteritis, must do a full angiography examination, this examination, usually there is basically no risk, but in the current situation, there is a great risk, when doing the examination, there may be cardiac arrest at any time."

Before Li Mujia could speak, Zhao Sheng said to the girl's mother first.

"Doctor, do you have to do this test?"

The girl's father said with a painful face.

"If we don't do an examination, with the severity of the patient's heart failure now, we can only watch her condition get worse little by little."

Li Mujia said regretfully.

Such a young, only 14-year-old little girl, with a bookish face, good at studying, and knowledgeable when she looks at it, such a beautiful life, if she passes away like this, it is too cruel.

Especially Li Mujia, she can empathize with this little girl's situation even more, because when she was studying, she was exactly the same as this girl.

The same grows good, learns well, knows how to be polite and not rebellious.

He is a person who truly loves to learn.

As soon as Li Mujia's words came out, the girl's mother covered her mouth with her hands, and tears rolled down like beads.

In a short period of time, the girl's father experienced a very painful torment in his heart, and said to Zhao Sheng and Li Mujia: "Doctor, let's do an examination, as long as there is a glimmer of hope, we will not give up!" ”

"Okay."

Hearing the words of the girl's father, Zhao Sheng and Li Mujia were suddenly awe-struck, although as doctors, they had encountered this situation many times, but every time, Zhao Sheng and Li Mujia felt an incomparable sense of responsibility and mission in their hearts.

This kind of scalp tingling is difficult to experience if you are not a doctor.

Half an hour later, the angiography room.

At this moment, Zhao Sheng, Li Mujia and Lin Yi all looked at the senior imaging doctor Miao Jie with a nervous face, and began to inject contrast agent into the girl lying on the examination table little by little.

During the whole process, Zhao Sheng and the three of them were all in their throats, and they were ready to rush to the rescue immediately if there was any situation.

But maybe the girl has an inexplicable luck in her body at the moment, and the imaging process is very smooth.

When the results of the imaging appeared on the screen, Zhao Sheng and the three of them breathed a long sigh of relief.

"Yes, it is Gao'an arteritis, the patient's aorta contour is irregular, the aortic arch and the right renal artery are narrowed, the remaining canal wall is thickened, and the abdominal aorta wall is thickened and shows strengthening, which is a manifestation in the inflammatory response phase."

Lin Yi, who is the most professional in cardiac surgery, said excitedly.

Just find the cause!

Zhao Sheng and Li Mujia also glanced at each other, and an inexplicable thing flowed between the sights of the two, and their mood suddenly relaxed.

(End of chapter)