I can see health

Chapter 841 Misunderstanding
Case discussion begins.

Lu Chen sat behind the Kebed team.

He checked visually, and there were a total of seven cardiology teams in the entire demonstration classroom, with a total of about 17 people.

On the podium, the doctor in charge of this case began to introduce the basic situation of the patient to everyone.

This model is similar to that in China.

After the doctor in charge explained the condition, he asked questions.

Then each doctor will continue to discuss and analyze the answers.

"Patient, male, 18 years old."

"I went to the doctor because the electrocardiogram was obviously abnormal after the exercise. The patient did not have any uncomfortable symptoms."

"Previously healthy, denies cardiomyopathy or family history of sudden unexplained death."

The patient's medical history is simple, a few simple sentences.

But then, the examinations and tests released by the doctor in charge are not easy!
There are many copies of the ECG.

Lu Chen picked out the most typical ones.

As soon as he flipped through the electrocardiogram, Lu Chen read the result immediately.

This is caused by a typical asymmetrical T wave, and the ST in the precordial leads is still depressed.

Obviously, this is an EKG of cardiomyopathy.

For example, the most common disease is hypertrophic cardiomyopathy.

Sure enough, this picture came out.

Everyone began to discuss, and at the same time, they were very puzzled.

We are all top doctors in the world, and we can recognize this basic electrocardiogram.

The doctor in charge smiled, telling everyone to be patient and continue to check the patient's other information.

Next.

The doctor in charge took out the patient's ECG, echocardiography, and cardiac magnetic resonance for reexamination.

The patient's cardiac ultrasound and cardiac MRI all confirmed the diagnosis of "cardiomyopathy".

Echocardiographic results showed: apical myocardial hypertrophy with a maximum thickness of 24mm, left ventricular size and systolic function were normal, and there was no obstruction of blood outflow.

Cardiac MRI revealed apical and anterior septal thicknesses of 25 mm and 13 mm, respectively.

At the apex, delayed contrast enhancement can be seen.

In addition, the patient also underwent genetic testing.

Genetic examination showed that the patient had mutations in MYH7 coding and β-MHC genes!

However, the patient's parents and siblings were found to be negative.

These results all confirmed the possibility of the patient being "hypertrophic cardiomyopathy"!

Since no signs of sudden death risk were found in this examination, there is no indication for ICD implantation for the time being.

……

Seeing this, Lu Chen frowned.

At first glance, this case seems too simple.

No matter how you look at it, what kind of tricks are pulled out, this is a hypertrophic cardiomyopathy!
Could it be that Mayo's doctors can't diagnose such an obvious disease?
This is absolutely impossible!

Lu Chen continued to look down.

The following medical records gradually dispelled Lu Chen's doubts.

After the patient was discharged from the hospital, he stopped strenuous training according to the doctor's advice, but he still maintained an active lifestyle.

One year later, the patient was re-examined.

Cardiac MRI re-examination showed that the left ventricular hypertrophy was relieved!

The maximum thickness of the apex is 10mm.

The re-examination of the electrocardiogram showed that the ST-segment depression was significantly improved compared with the first visit!
As soon as the result came out, everyone in the demonstration classroom fell silent.

The patient has not undergone any treatment, and the symptoms are so miraculously cured!

Kebed next to Lu Chen frowned and said in a low voice, "It looks like hypertrophic cardiomyopathy, but the exercise stopped and the hypertrophy relieved. This is like physiological hypertrophy of the heart muscle!"

Lu Chen also frowned.

Kebed is right, pathological cardiac hypertrophy is impossible to reverse.

Only physiological hypertrophy of the heart muscle may have a chance to be reversed after stopping exercise.

However, the patient had undergone genetic testing before, and the gene for hypertrophic cardiomyopathy was indeed detected.

Before and after this, it seems to be contradictory!

Lu Chen's heart sank. It is indeed a case that can appear in Mayo!
There is absolutely no such thing as an easily diagnosed disease.

"Lu, what do you think about this case?" Kebed looked at Lu Chen who was beside him.

Lu Chen shook his head, "I have no idea for now."

Kebed touched his chin and said slowly: "Lu, I have an idea. This patient's myocardial hypertrophy relieved itself after he stopped training, and the genetic tests of family members were all negative. So I think it may be necessary to do another genetic test to rule out The possibility of a false positive on the initial test."

Kebed's idea is simple.

He felt that the first genetic test was wrong!
His opinion is to re-do genetic testing.

After Kebed finished talking about this idea, other Mayo cardiologists also raised this possibility.

This 18-year-old athlete is likely to have purely physiological cardiac hypertrophy.

Lu Chen frowned, because when he considered this diagnosis.

The system did not pop up any prompts.

That is, "physiological cardiac hypertrophy" is wrong!
For a while, everyone's opinions were not unified.

Some doctors said it was "physiological cardiac hypertrophy", and some doctors said it was "genetic pathological hypertrophic cardiomyopathy"!
Everyone has their own opinions, and no one can convince anyone.

……

Lu Chen remained silent.

Because he discovered a very strange thing.

When he thought of "physiological cardiac hypertrophy", the system did not pop up a prompt.

When he thought of "pathological hypertrophic cardiomyopathy", the system also did not pop up a prompt.

Is this patient not "cardiomyopathy" at all?
This idea came to Lu Chen's mind.

Everyone has been arguing for a long time, but in fact it is not cardiomyopathy at all? !

This is too ridiculous...

Lu Chen reorganized the patient's examination.

Whether it is from the electrocardiogram, cardiac ultrasound, cardiac magnetic resonance, or even genetic testing, it has been confirmed that the patient is cardiomyopathy!

There is absolutely no other possibility.

"Could it be that the system is down again?"

But since Lu Chen owned the system, the system has been very reliable.

There has never been a system bug!

……

While Lu Chen was thinking, the entire Mayo Cardiology Demonstration classroom was mainly divided into two factions.

One side thinks it is physiological myocardial hypertrophy, the main reason is that after stopping exercise, the patient's myocardial hypertrophy has recovered compared to before.

On the other hand, it is considered to be pathological genetic cardiomyopathy, because the result of genetic testing is positive!

Any other test may not be as accurate as genetic testing.

Kebed continued to say to Lu Chen: "Lu, now everyone is sticking to their own opinions. We can only wait for the genetic test again and wait for the results before we can judge."

But at this moment, a flash of inspiration suddenly appeared in Lu Chen's mind.

Everyone seems to have entered into a misunderstanding.

Why does everyone think that it is either physiological or pathological?

Can't both situations exist at the same time?

When Lu Chen thought of this, the system immediately popped up a long-lost notification sound.

"Congratulations, the completion of the system upgrade has increased!"

(End of this chapter)