I can see health

Chapter 96 Menopause
"Junior Sister Ke, what diagnosis are you considering?"

Sun Guoguo looked at Ke Yue who was on the side.

"I, I judged by the results of the electrocardiogram, the possibility of coronary heart disease is relatively high." Ke Yue frowned, and whispered, "Of course, I don't rule out other chest pain diseases."

"Junior Brother Dong, what's your opinion?"

Dong Hao touched the back of his head and said, "I also think it is coronary heart disease. The electrocardiogram and symptoms are all in line with the diagnosis of coronary heart disease."

"Look, I've said it many times, I have coronary heart disease, you are still asking so many times, it's a waste of time." Fu Fengqin raised her eyebrows and said, as if she had coronary heart disease and she was very proud.

"Junior Sister Jiang, what do you think?"

Sun Guoguo looked at Jiang Qingyan with a smile again.

"Sister, although the patient's electrocardiogram showed myocardial ischemia, she did not have high-risk factors for coronary heart disease, nor did she have typical symptoms of angina. Pain, costochondritis, etc.”

"Yeah." Sun Guoguo nodded, "What do you think is the next treatment plan and plan that is feasible?"

Jiang Qingyan said softly: "Do coronary angiography or coronary CTA to rule out coronary heart disease; if the result is negative, then do a gastroscope to rule out digestive tract diseases, and other minor problems can be checked slowly."

As soon as Jiang Qingyan finished speaking, Fu Fengqin immediately answered:

"Why do you want to do cardiac coronary CT? I want to do cardiac angiography directly. The accuracy rate is high, and it can be done in one step. If I want to do cardiac CT, then I will do it directly at the county hospital. Why should I come to you?"

Lu Chen frowned.

This aunt's character is too impatient.

When the doctor said one word, she would say ten more.

"Okay, Auntie, I already know what you want." Sun Guoguo smiled, "The pre-operative examination will be completed today and tomorrow, and then I will perform contrast surgery for you as soon as possible."

"Well, that's good." Fu Fengqin's unsightly complexion slightly improved, "It's better for Dr. Sun to be straightforward, and I will listen to your arrangement."

……

Sun Guoguo led the crowd away and returned to the doctor's office.

"Lu Chen, I didn't ask you just now, what do you think the patient's diagnosis is?" Sun Guoguo smiled.

Among the people present, except for Jiang Qingyan's diagnosis, everyone's primary diagnosis is approaching in the direction of "coronary heart disease".

Lu Chen said in a deep voice: "I think the patient's age has not met the criteria for diagnosing coronary heart disease, and he does not have the typical chest pain symptoms of coronary heart disease. In addition, we have overlooked a very important point, that is, the patient has recently started menopause. "

"Menopause?" Ke Yue frowned, "What does this have to do with chest pain?"

Lu Chen smiled and said, "After menopause, the patient's endocrine system is out of balance, and autonomic dysfunction may occur. What we often call menopausal syndrome will eventually lead to cardiac neurosis, followed by chest pain symptoms. The symptoms of chest pain have nothing to do with fatigue or activity. In addition, this patient is more irritable, which may also be related to cardiac nerve dysfunction."

When the other people in the group heard Lu Chen's explanation, they all had a look of enlightenment in their eyes.

At this time, Sun Guoguo smiled and said: "Actually, everyone's analysis makes sense. Whether the patient is suffering from coronary heart disease, cardiac neurosis, or other causes of chest pain, the ideas of diagnosis and treatment are similar. , we must rule out coronary heart disease first!"

"If the patient has coronary heart disease, if we don't find out, it is our doctor's negligence, and there is a potential threat to the patient." Sun Guoguo continued, "So if a patient with this kind of chest pain is not fully If you are sure, it is recommended to complete coronary CT or angiography to rule out coronary heart disease.”

"Secondly, it involves the question of what kind of examination to do. It is recommended that patients complete coronary angiography or CTA?"

"For example, the 11-bed patient who just arrived, from a medical professional point of view, do you think it should be CTA or direct angiography?"

Seeing Sun Guoguo smiled at Dong Hao, "Junior Brother Dong, please tell me first."

"I think it's better to do a cardiac angiography directly. If the patient has vascular stenosis and needs treatment, then he has to do a cardiac angiography again, which wastes the money for two examinations and suffers an extra crime." Dong Hao thought for a while and said .

Ke Yue also nodded in agreement.

"Junior Brother Lu, what do you think?"

Lu Chen said in a deep voice: "I think it is still necessary to classify the disease. If it is just to rule out coronary heart disease, coronary CTA may be better. It is economical, non-invasive, and simple. At the same time, the diagnostic accuracy rate exceeds 95%."

"At that time, if the patient had high-risk factors and typical symptoms—chest tightness and chest pain after exercise, and typical ischemic changes in the ECG, it was still recommended to do a cardiac angiography directly."

"The patient who was just admitted to the hospital just now, I don't think he has coronary heart disease. Even if he really has coronary heart disease, it has not reached the level of stenting, so I suggest that she have a coronary CTA."

As soon as he finished speaking, Sun Guoguo shook his head slightly, and sighed, "Junior Brother Lu's thinking is more idealistic. In clinical practice, most of the time, it is a one-size-fits-all treatment plan. No matter what kind of patient it is, as long as there is chest pain, it may be asked Cardiac angiography, which may involve disputes, medical expenses, patient wishes and other issues."

Lu Chen nodded slightly, and Sun Guoguo made a lot of sense.

In terms of cost alone, cardiac angiography far exceeds cardiac CTA.

For the sake of performance, many hospitals will also exaggerate and publicize the efficacy of cardiac angiography to varying degrees.

Often avoid its complications and side effects.

In fact, a considerable number of patients only need a simple CTA to rule out the diagnosis, so as to avoid irreversible damage to blood vessels.

Sun Guoguo continued: "The new patient just now strongly requested a cardiac angiography after being admitted to the hospital. We will tell her all the treatment options, including the advantages and disadvantages of each method, and let her choose by herself. The most important thing The most important thing is to get her to sign and agree to undergo a cardiac angiography before arranging the operation."

"Okay." Lu Chen nodded.

Clinically, it is like walking on eggshells.

Only by signing more, communicating more, and leaving paper records can you protect your rights to the greatest extent.

At the same time, when a medical accident occurs, the patient can also request to seal up the medical records at the first time, and obtain relevant medical record documents as litigation materials.

……

Although this patient is a relative of Wang Zihao, judging by her posture, she might not be easy to mess with.

Lu Chen tried his best to do what he could do perfectly.

Write the two treatment plans in the disease communication and ask Fu Fengqin to sign it.

Choose cardiac angiography and give up coronary CTA.

……

(End of this chapter)