This Doctor is Great

not long,

Zhou Mo's job is coming.

Senior brother Chen Bing on duty walked into the duty room and shouted to Zhou Mo.

"Zhou Mo, when a patient comes over later, you can accept it."

"What disease?"

"I came from the outpatient clinic, I haven't confirmed it yet, I took an X-ray, and the left and right ventricles are enlarged..."

"good……"

Zhou Mo pondered for a moment.

"What is the cause of left and right ventricle enlargement?"

"Left ventricular enlargement is commonly seen in hypertensive heart disease, coronary atherosclerotic heart disease."

"And right ventricular enlargement is common in cor pulmonale."

"Both left and right are enlarged, and the high probability may be "dilated cardiomyopathy." "

With these basic judgments,

Zhou Mo's mind began to call up some information about these types of diseases.

Not long after, the patient came.

Patient, male, 38 years old, named Qin Xiong.

It was his younger brother who came to go through the formalities and accompany him.

The nurse went through the admission procedures, and then Zhou Mo also assisted.

...

half an hour later...

28 beds.

"Bed 28, Qin Xiong, hello, I am your bed doctor, just call me Doctor Zhou from now on..."

"Hi Doctor Zhou..."

Qin Xiong sat on the bed, a little out of breath, his face was slightly pale, and he felt that breathing was laborious.

His hair was shaved and he felt a bit fierce, but he had become a sheep at this time.

Qin Xiong's younger brother looked at Zhou Mo: "Doctor, you must cure my brother..."

Zhou Mo nodded: "I will definitely try my best..."

Then it's interview time.

"Now, what's wrong with you?"

"The chest is a bit suffocated, even if I try to breathe, it feels like it's not enough..."

"When did it start? Were you sick then?"

"It started half a month ago, when I had a fever, and then it became like this in the next few days."

Speaking of this, Qin Xiong's face hurts, and he developed a fever. As a result, it seems that he has a heart problem now, it's a big hole!

"Besides chest tightness, are there other symptoms?"

"It's hard to breathe, but I've obviously taken a big breath..."

"A little dizzy..."

"It seems that there is nothing else..."

Zhou Mo nodded.

The dyspnea, chest tightness, and big mouth breathing described by the patient actually all mean the same thing: the heart power has deteriorated.

Reduced pumping power.

Zhou Mo: "In the outpatient clinic, did you have an electrocardiogram?"

Qin Xiong's younger brother: "Yes, yes..."

Then he took out a file bag from his schoolbag, which contained medical records and inspection reports.

And an X-ray.

Zhou Mo took a look at the X-ray first. The upper left atrium and right atrium were nothing special.

But the lower left ventricle and right ventricle did enlarge.

Then Zhou Mo unfolded the 1-meter-long ECG drawing.

Extensive ST-T changes, left ventricular high voltage, pathological Q wave, low voltage in each lead.

at this time,

The nurse brought the ECG monitor and placed it on the bedside of the hospital bed.

Then connect to the patient.

Soon, all the data from the ECG monitor came out.

——Blood pressure: 98/68

- Heart rate: 113

——Blood oxygen: 94%

The heart rate is a bit fast; the blood pressure is a bit low; the blood oxygen is not good, and it is in the critical range...

These are all within Zhou Mo's expectations.

"Lie down first, I need to give you a physical examination..."

"Okay ok..."

Brother Qin Xiong started to shake the head of the bed a little clumsily.

The patient Qin Xiong lay down.

Zhou Mo took the noble 3m stethoscope and began to listen to the patient's heart and lungs.

The first is the lungs.

After listening to the left and right lungs, there is a little moist rale at the bottom, but it's okay, just slight.

Zhou Mo was relieved, and then put the stethoscope on the heart.

The stethoscope is constantly moved around the precordial area.

First, the first heart sound at the apex can be heard, which is weakened and accompanied by a systolic murmur.

I also heard the third heart sound and the fourth heart sound... Under normal circumstances, the third heart sound and the fourth heart sound cannot be heard.

hear here,

Zhou Mo has roughly made a judgment.

99% are dilated cardiomyopathy.

The heart sound characteristics are very consistent.

What is "dilated cardiomyopathy"?

It roughly means that the left ventricle, right ventricle (single, or two), is dilated.

picture

It is a primary cardiomyopathy of unknown cause. Possible causes include infection, genetics, and cellular immunity.

Zhou Mo asked suddenly: "Has your family ever had such a disease? A history of heart disease."

Brother Qin Xiong looked at each other.

"Have you heard of it?"

"Maybe not……"

"I've never heard of an elder suffering from such a disease..."

Zhou Mo nodded.

"Pull up your trousers and show me..."

Brother Qin Xiong quickly pulled up his brother's trouser legs.

Wearing gloves, Zhou Mo pressed the patient Qin Xiong's ankle.

sunken!

No rebound!

Obviously, it's edema.

It is also one of the symptoms of "dilated cardiomyopathy".

"Show me the neck..."

Open the collar of the neck.

Everything is working fine.

Some patients with dilated cardiomyopathy have dilated veins in the neck.

Then the abdomen was checked and there was no ascites. Ascites is also one of the symptoms of dilated cardiomyopathy.

at this time!

Zhou Mo had a headache.

Because the clinical manifestations and auxiliary examinations of "dilated cardiomyopathy" lack specificity. Its symptoms, other heart diseases may also have this symptom.

Moreover, different dilated cardiomyopathy patients may have very different symptoms.

so,

It can only be diagnosed by excluding other diseases (diagnosis of exclusion), and finally based on clinical manifestations and auxiliary examinations.

kind of hard.

"Let's do various inspections first..."

Zhou Mo could only do this.

Blood biochemistry, thyroid function, immune antibody, myocardial enzyme spectrum...

And an echocardiogram...

It is estimated that many patients will shout after seeing so many examinations:

"Black-hearted doctor! Stealing money!"

It took 40 minutes,

After checking the room.

...

...

Back to the duty room,

Zhou Mo received a bank account reminder.

"[Guangfa Bank] You received RMB 800.00 from your card with the end number 7483 at 13:50 on the 20th (online banking account). Account balance: 1394.14 yuan."

Zhou Mo was overjoyed.

Subsidies have arrived!

But look at the balance.

emmmm~~~~

4 digits!

It's just too shitty!

"Brother, how do you think I can make more money?"

The poor Zhou Mo asked senior brother Chen Bing for advice.

"If I knew, I wouldn't have bought a house now..." Senior Brother Chen Bing looked at Zhou Mo speechlessly.

"Oh, yes, you are also quite poor." Zhou Mo sighed.

Senior Brother Chen Bing: "..."

I really appreciate your emphasis!

Senior Brother Chen Bing: "You can ask Senior Brother Huang Li, he speculates in stocks, and it is said that he hasn't lost money in the past two years."

Zhou Mo was surprised: "Didn't lose money? This is awesome!"

Senior Brother Chen Bing: "So, this is a master...I heard that he made a little money."

at this time,

Dr. Huang Li walked into the duty room with a stinky face, holding a mobile phone in his hand, cursing.

"This new play is really poisonous. I lost tens of thousands twice in a row!!"

"If I play new games in the future, I will be a dog!"

.