When doctors have a simulated operating room

Although the family members didn't understand, they could feel that the young man in front of them didn't seem to be fooling people.

Although they didn't understand, they felt that he was very impressive!

In the office, many young doctors showed expressions that they had never seen the world.

Among them was Lu Gao.

Dynamic obstruction?

Haha!

I don't believe it!

I'll check it out first!

So Lu Gao quickly took out his mobile phone to check it out.

After checking, it turned out that there was indeed such a disease!

How come he had never heard of this disease before? !

In addition, Zhang Yi and he went to the same university, and even had the same teacher.

How could he know about this disease while he didn't know it?

It's so infuriating!

Zhang Yi beat them again!

Zhang Yi looked at everyone's confused expressions and continued:

"This disease is indeed very rare, but as long as the right treatment is found, it is actually the same as obstructive heart failure.

Director Wang, you can now do a hemodynamic test on the patient to see how much the pressure difference is.

Generally speaking, the warning line of the pressure difference is 50-60 mmHg.

But once it exceeds 80, you have to consider whether to remove the overly thickened myocardial wall.

Below 80, the condition can still be stabilized through drug treatment."

Wang Xiao Mian nodded immediately: "Okay, I'll arrange it right away."

Then, Wang Xiaomian looked at the family members next to him and said:

"Are you relieved now? The cause of the disease has been revealed, it is obstructive hypertrophic cardiomyopathy.

To put it more bluntly, as long as her heart is beating, she will have problems such as shortness of breath and hypoxia.

But I saw that her ventricular wall hypertrophy is not particularly thick. Let's do an examination first, and then start using the correct medication after the examination."

The woman named Xiaoling then looked up at Wang Xiaomian.

Then she looked at Zhang Yi again:

"Doctor, please give me a definite answer. Can my mother's disease be cured?"

Zhang Yi nodded happily:

"Yes, of course. Look at the degree of hypertrophy of the ventricular wall. If the pressure difference between the ventricle and the outflow tract is too large, the ventricular wall is too thick.

Then we can only choose to surgically remove the hypertrophic ventricular wall.

Of course, it is best not to have surgery if it is possible.

Because the heart is different from other organs, the entire ventricular wall is muscle.

There are many nerve conduction systems inside. These nerves and muscles are connected together, and the heart will beat again and again.

If the hypertrophic ventricular wall is removed, That will definitely have an impact on the entire heart function.

It may cause arrhythmia, that is, a part of the muscle is suddenly cut off, and the heart conduction is cut off.

Then the heart rate will definitely be unstable.

Another example is acute heart failure, a part of the ventricle is cut off, and the recovery after suturing is very poor, the myocardium is damaged and the heart can't beat.

That may cause heart failure of the entire heart.

But don't worry too much, it can definitely be cured, but any surgery has risks.

I hope your family members can understand more. "

It is best if the pressure difference between the outflow tract and the ventricular inflow tract does not exceed 50-60 mmHg.

The drug can stabilize it.

Once the pressure difference is too large, even above 100 or 150, it is very serious.

Although the complications are dangerous, this resection surgery has to be performed.

The family members looked at Zhang Yi again, and then left the doctor's office worriedly.

At this time, the sky has gradually darkened.

Zhang Yi is waiting for the patient's latest pressure difference results.

An hour later, the results came out.

Pressure difference 110! !

Seeing this result, Zhang Yi also looked worried.

"Director Wang, I saw that the pressure difference shown in your previous hospitalization examination was more than 70.

This time it reached 110. I guess it must be related to the use of drugs such as dopamine and sodium nitroprusside.

How about this, I suggest using verapamil and metoprolol to control the patient's myocardial contractility first.

After slowing down the speed, do another check and see."

Listening to Zhang Yi's suggestion, Wang Xiaomian nodded again.

Today, Zhang Yi is the boss here~!

Listen to him~!

In the ward.

Wang Xiaomian is instructing the nurse to give the patient medication.

Behind him, several younger attending physicians following him couldn't help asking:

"Director Wang, do you trust that doctor so much? What if... he is wrong?"

Wang Xiaomian looked at

He scolded at one glance:

"I can see that you rarely read books and rarely take the initiative to learn!

After get off work, go and check the various symptoms of obstructive hypertrophic cardiomyopathy!

Write me an article about the main symptoms, simulated diagnosis and treatment plan of obstructive hypertrophic cardiomyopathy within two days!"

"Ah?!"

The people behind him widened their eyes.

No way...

We are just asking...nothing else!

Two hours later.

After taking the right medication, the old lady's symptoms improved a lot.

The shortness of breath was significantly relieved, and the oxygen saturation index also went up.

At this time, arrange for a hemodynamic test.

Looking at the result again, 73 mmHg.

"Isn't this right? This is not that much worse." Zhang Yi looked at the check list and said.

Wang Xiaomian finally showed a trace of relief and said:

"Yes, it means that the medicine is used correctly. Hey... Today is really thanks to you. I'm so sorry that you have to work overtime in the capital so late.

Oh, it's bad. It's my fault. Doctor Zhang, you haven't had dinner yet, right?

Let's go to the cafeteria to eat something first?

We have a midnight snack cafeteria in Ping An Hospital."

Don't mention it.

Zhang Yi is really a little hungry at this time.

"Okay, then I'll trouble Director Wang."

Wang Xiaomian waved his hand quickly:

"Doctor Zhang, don't be polite to me. You helped us so much today that I don't know how to thank you!

Hey, think about it, there seems to be your classmates in our department, right?

Lu Gao? Where is Lu Gao?"

Wang Xiaomian said and glanced around the department.

But he didn't see Lu Gao.

"Maybe Lu Gao has already finished get off work, but I have something to tell you, Doctor Zhang.

Don't think that you are from the same school and are classmates.

If you ask me, he is really not as good as you!"

They are in the same class and taught by the same teacher.

See, the gap is so big.

Zhang Yi saw such a rare disease after a few glances at the examination list.

And Lu Gao can only follow the attending physician and make excuses!

Oh!

What a pity.

Why doesn't Zhang Yi work in our hospital?

(Lu Gao: Woohoo... Director, do you dislike me??)

The two were about to get up and go to the hospital cafeteria to eat something.

Suddenly.

Wang Xiaomian's cell phone rang.

It was Liu Xiongwu calling.

"Director Liu?" Wang Xiaomian picked up the phone.

In the afternoon, the patient's condition was difficult, and Wang Xiaomian called Liu Xiongwu and wanted to ask several leaders to come and take a look.

"Yes, yes, there is indeed such a patient, left heart failure and pulmonary edema."

"Yes, but..."

Wang Xiaomian said and glanced at Zhang Yi who was sitting next to him.

"But it has been solved! The patient's condition is getting better now!"

On the other end of the phone, Liu Xiongwu frowned and asked:

"Well? Didn't you say that the patient's condition was very dangerous this afternoon? And that the cause of the disease could not be found? I also specifically asked Professor Jin of Union Hospital about the situation."

Wang Xiaomian smiled and said, "It's like this, Dean Liu, I have asked Dr. Zhang Yi to come and help me, and the cause of the disease is now known.

It is a heart disease of dynamic obstruction, that is, obstructive hypertrophic cardiomyopathy."