"Dean Xue, do you know the situation of the county hospital?" Wu Mian asked the D county hospital with a smile...... Mr. Wu, what do you want to know?"

Xue Chunhe was a little curious, it was enough for Mr. Wu to be the chief of the medical department of Bajingzi Traditional Chinese Medicine Hospital, so he was surprised to inquire about the county hospital? Could it be that Mr. Wu was still ready to upgrade along the county and township and experience the novice village again?

"Be detailed, the more detailed, the better. Wu Mian did not shy away from it, "On the rescue helicopter, the county hospital refused to accept patients. This evil breath is going to come out, but you can't come to the door and beat him. Tell me about the situation, I've been thinking about it lately. ”

"Huh. Dean Xue smiled, he could imagine why Wu Mian was so short-tempered at that time.

On the one hand, there are comrades with severe burns, and on the other hand, the hospital refuses to admit patients, even if Mr. Wu takes a helicopter to the county hospital to make a fuss, Dean Xue understands.

However, with the ability of doctors, it seems very difficult to take revenge on the big capitalists.

"Mr. Wu, the county hospital has been restructured and sold to the capital side. Dean Xue said, "It is said that it is a big capital in the south, integrating more than 30 hospitals in the north to prepare for listing." ”

"Make fake accounts, and then sell them at a high point after the lock-up period?" Wu Mian smiled, "Forget about other companies, use hospitals as bargaining chips, they are really bold." ”

"Mr. Wu, we all know the reasons inside, and there is nothing we can do. Dean Xue sighed and said, "It is uncertain whether these public hospitals in the provincial capital can be retained in the future." ”

"The ultrasound probe is placed on the stomach and the subxiphoid section is examined. Wu Mian suddenly raised his voice and said something inexplicable.

The head of the emergency department was doing an echocardiology, just after checking the heart, and the patient's heart was fine, but strangely enough, the ST segment changes were real.

It is estimated that it is a rare symptom, the director of the emergency department was guessing, and suddenly heard Wu Mian's words, and subconsciously pressed the B-ultrasound probe on Wang Chengfa's stomach, preparing to do a subxiphoid examination.

The next second,

Witness the miracle!

When the ultrasound probe is pressed against the stomach, the electrocardiogram changes, the elevated ST segment disappears, and the electrocardiogram returns to normal.

The incident happened suddenly, and before Wang Chengfa could react, the B-ultrasound probe pressed on the stomach.

By the time the oscilloscope on the ECG monitor returns to normal, it is too late to stop it.

The director of the emergency department lifted the ultrasound probe, and the ST-segment elevation oscillosum appeared again on the ECG.

He was stunned, thinking that he was dazzled, and just wanted to press the B-ultrasound probe again, but he didn't expect his wrist to be grabbed by Wang Chengfa, "Director, don't do it, I'm fine." ”

Wang Quan couldn't understand the ECG, but he sensed that something was wrong, and opened his mouth to scold and scold, "My dad said no, you didn't hear it......!

"Shut up!" Wang Cheng said angrily, at this time, he didn't care about pretending anymore, his illness and weakness disappeared, and he drank Wang Quan with confidence.

"Echocardiography reveals an ejection fraction of 60% to 65%, no segmental wall motion abnormalities, no characteristic octopus can-like findings, and no pericardial effusion. Doesn't it seem strange that it does not match the echocardiac manifestations of ST-segment elevation myocardial infarction?" asked Wu Mian with a smile.

The director of the emergency department nodded, looking at the ECG monitoring screen in a daze, and really didn't understand why this was the case.

"Echocardiography does not support common conditions such as STEMI, pericarditis, and stress cardiomyopathy. Wu Mian smiled, "That's because you ignored one point, which is also a question I said at the national conference on emergency first aid two years ago." ”

The director of the emergency department grinned, "Teacher Wu, do you remember me?"

"You're sitting in the third-to-last row and you're playing on your phone all the time. ”

"......" The director of the emergency department almost cried, Mr. Wu, can you give me some face? Have a meeting, everyone has to have fun, a few people take it seriously.

"I made it very clear at the time that if you have a problem that you don't understand, you must first think about the right and wrong of the medical history. Wu Mian said with a smile, "At that time, I gave a few examples, one was to pretend to vomit, and the other was to pretend to be burned. It seems necessary to talk about the ...... of pretending to have a heart attack next time."

As he spoke, Wu Mian paused, looked at Wang Chengfa, stretched out his right hand, and gave a thumbs up.

"Director Wang, awesome!"

"Even I was almost deceived by you, and you are a talent. ”

"What the hell are you talking about!" Wang Quan scolded.

"Speak quietly, and you can lose a little less people. Speak so loudly and finally ...... Director Wang, aren't you going to go home, and you still have to wait here for me to finish?" Wu Mian looked at Wang Chengfa with clear eyes.

Wang Chengfa's face was pale, and he was stunned for a while, not knowing what to do.

"Director Bao Hongchao, I'm not mistaken. Wu Mian smiled, "If you press on the patient's stomach with your hand, it will have the same effect." Changes in the ECG oscilloscope are not necessarily cardiac problems, but may also be caused by extracardiac causes. ”

Wu Mian looked at Wang Chengfa and took a step forward, Wang Chengfa suddenly felt as if there was a big mountain pressing on top of his head, his chest was stuffy, and he couldn't breathe.

How did he know? Wang Chengfa no longer doubted it now, but he couldn't explain why Wu Mian knew his secret.

"The exact pathophysiology is still not well understood, but it is currently being studied by several research institutes in theory, and there are many possible speculations. ”

"Generally speaking, heart displacement is often accompanied by electrical axis changes and electrical alternations, but Director Wang did not notice this. ”

Second, the visceral-cardiac reflex was dominated by increased vagal tone, but Director Wang did not have bradycardia or heart rate fluctuations. ”

"Stress cardiomyopathy is mostly related to microvascular spasm or dysfunction, but Director Wang's electrocardiogram changes rapidly, and no characteristic apical balloon-like changes were seen. In other words, microvascular spasm, which is an important cause to be investigated, can be preliminarily ruled out. ”

"In pericarditis, echocardiography showed no pericardial effusion, and the rapid changes in the ECG did not match. Therefore, it can be assumed that the direct stimulation or compression effect of the dilated gastrointestinal tract on the heart leads to the dynamic change of ST-T. ”

"Director Wang, you have really refreshed my three views. Wu Mian said with a smile, "You know why I can say so much? Because this is what was said in the papers given by the two research institutions last year and the year before last." ”

"I didn't pass it at the time, and there were some minor problems with the logic, which is one thing. The main thing is that I think it's a bit ridiculous, according to their logic, it's the expansion of the gastrointestinal tract that causes the ECG to change. To put it simply, it is to be full of food. ”

"You're really well fed. Wu Mian said with a smile, "In the middle of the night last night, I drove all the way to the provincial capital, just to avoid the mountain fire?