I can see health

Chapter 639 Causation

Chapter 639 Causation
Cardiology CCU.

show the classroom.

Lu Chen stood up and faced everyone in the classroom.

His eyes were firm, and he didn't care about other people's comments at all.

"Lu Chen, what did you just say?" Zhang Shuqing thought that Lu Chen had made a mistake, so he asked again, wanting to give him a chance to correct himself.

Lu Chen didn't rush, and still insisted on the sentence just now:

"Is this patient's electrocardiogram a slow arrhythmia or a tachyarrhythmia?"

Zhang Shuqing's complexion changed.

He felt that Lu Chen was not such a targetless person.

It's an electrocardiogram at 37 beats per minute, why do you want to ask this question?
on the podium.

Liu Jun stared at Lu Chen closely, then seemed to think of something, and immediately lowered his head to look for something, "Shuqing, where is the patient's ECG?"

Zhang Shuqing looked at Liu Jun strangely, and whispered, "I have a copy here."

Liu Jun took the electrocardiogram and studied it carefully.

……

under the podium.

The voices of the crowd were endless.

Many people saw Lu Chen's face and felt that he was a little strange.

"Which ward is he a doctor? Why haven't I seen him before!"

"I haven't seen it either. Could it be some intern who came from somewhere to mess around?"

"Hey, I heard that he is director Zhang Shuqing accepting doctoral students this year, you didn't hear that, just now Director Zhang directly called out his name!"

"Hey, that's right! It's called Lu or something..."

Seeing that Liu Jun and Zhang Shuqing on the stage did not speak, Lu Chen paused and continued: "Maybe some doctors think that this is just a simple sinus bradycardia, which can be perfectly resolved after implanting a pacemaker. problem, but..."

He paused and looked around the crowd, "If we divert our attention a little at this time, pay attention to the sharp waveform on the T wave of V1 lead in this ECG..."

T wave in lead V1?
Everyone heard Lu Chen's voice and looked at the place he reminded.

However, the graphics in the PPT on the podium are relatively blurred, and no one can see anything abnormal.

Only those doctors who had a copy of the ECG in their hands slowly noticed the difference.

Director Qin suddenly stood up and looked back at Lu Chen in surprise, "Doctor Lu, you mean the T wave in lead V1, not the T wave?"

"Yes, not T wave!" Lu Chen nodded with a smile.

T wave, not T wave?
What does it mean?
Everyone's mind is a mess.

The call between Lu Chen and Director Qin seemed to be encrypted.

Everyone can't understand!
……

on the podium.

Liu Jun heard the conversation between the two, and when he looked at the electrocardiogram again, a flash of surprise flashed in his eyes.

T wave, not T wave?
Such a small detail that is easily overlooked, was actually discovered by the doctor in front of him? !
He whispered to Zhang Shuqing beside him: "Which ward is he a doctor? New here this year? Do you know him?"

Zhang Shuqing immediately replied: "Director, he is the doctoral student I just recruited this year, Lu Chen."

Liu Jun was taken aback for a moment, and then laughed, "Well recruited! What a hero! This big discussion in the department really went right."

Zhang Shuqing didn't know why.

He glanced at the electrocardiogram and found nothing unusual.

But seeing Liu Jun's change of attitude, it must have something to do with Lu Chen.

The doctors under the podium also saw the change in the expression of the chief director Liu Jun.

Combined with Director Qin's words just now, everyone began to re-examine Lu Chen's words.

More and more people are looking for copies of ECGs.

"Shuqing, can you magnify the electrocardiogram on the PPT so that everyone can see it better?"

The smile on Liu Jun's face was very bright. After Lu Chen's call just now, he has already seen the essence of this electrocardiogram.

"Okay, Director."

Zhang Shuqing nodded slightly, and immediately began to operate on the stage.

……

The electrocardiogram on the PPT gradually enlarged, and all the doctors present could clearly see the T wave on the V1 lead.

The crowd began to whisper.

"The shape of this T wave is really different from the normal one! It's very sharp, it's really not a T wave!"

"Yes, it's not a T wave, it's not a QRS wave, it's not a U wave!"

"It's nothing, shouldn't it be an interference wave?"

"Have you seen this kind of interference wave? I don't think it is an interference wave..."

All the people here are the backbone of each ward. After Lu Chen's reminder, they immediately found something wrong with the T wave of the electrocardiogram.

On the stage, Zhang Shuqing was startled suddenly.

He understood immediately, and murmured: "This is not a T wave, nor is it any other waveform."

"Then there is only one possibility left!" Zhang Shuqing looked at Lu Chen in surprise, "That is P wave!"

……

Most of the doctors present suddenly realized at this moment.

The way they looked at Lu Chen began to change!

"Doctor Lu, please continue to explain to everyone."

On the stage, Liu Jun looked at Lu Chen, the corner of his mouth curled up.

"Okay, Director." Lu Chen responded, holding the electrocardiogram in his hand, and said in an unhurried tone, "I believe all teachers should have discovered that from the T wave on lead V1, it is not a real The T wave, but the P wave!"

"And this P wave is different from the normal P wave, so it must be premature room."

Following Lu Chen's voice, everyone began to re-examine the electrocardiogram in front of them.

Sure enough, everyone can find that the shape of this P wave is really different from the normal P wave!
Lu Chen continued: "There is no QRS wave behind atrial premature, which means that atrial premature came very early, encountered the refractory period of the atrioventricular node, and did not pass it down. The current heart rhythm is called sinus rhythm. Not downloaded."

"Fang Zao didn't pass it down, but it had a compensatory pause."

"The emergence of compensatory intervals caused the heart rate to slow down and also caused the patient's fatigue symptoms."

Lu Chen's explanation was very clear, and everyone present understood the essence of this electrocardiogram.

However, there are always people who have different opinions.

Jiao Jingqiu at the side raised her hand.

Lu Chen was slightly taken aback, but still handed the microphone to her.

"Doctor Lu, your analysis just now is not wrong. But after analyzing for a long time, isn't the final conclusion still a slowing of the heart rate? Is it different from our analysis? Why do you say it is a tachyarrhythmia?"

"I think I can answer this question for you."

Just as Lu Chen was about to answer, Director Qin in the front row suddenly stood up, staring at Jiao Jingqiu with a smile on his face.

All eyes were on him again.

"If you start from the perspective of QRS or systole, it is undoubtedly a slow arrhythmia."

"But from the perspective of P wave, frequent premature atrial, this should be a rapid arrhythmia!"

"If you analyze it from a causal relationship, the slowed heart rate is the result, and the frequent premature atrial is the cause!"

Speaking of this, Director Qin's tone paused slightly, his eyes turned to Lu Chen, and his eyes softened, "I think this is what Doctor Lu just said, tachyarrhythmia!"

 If anyone is interested in this ECG, I will post it
  
 
(End of this chapter)

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