bookpower Chapter 643
Chapter 643
Lin Feng finished watching the heart color ultrasound,
Found:
The left ventricle is hypertrophied, and it is hypertrophic asymmetric!
Access from the left ventricle to the aorta, stenosis!
left ventricular hypertrophy and asymmetric hypertrophy,
This can rule out that "years of high blood pressure can lead to hypertrophy of the left ventricle of the heart" (prolonged high-power pumping of blood to the aorta, forcing the left ventricle to thicken evenly).
So
The most likely is "hypertrophic cardiomyopathy"!
"Hypertrophic cardiomyopathy" is a hereditary cardiomyopathy!
Features: is asymmetric hypertrophy for.
This disease is prone to sudden death.
so
Combine all the above symptoms and examination results:
The derivation is as follows:
Narrowing of the left ventricular pumping channel + hypertrophic cardiomyopathy - > the pumping is not smooth - > coronary ischemia - > causes chest pain, chest tightness...
Instead of what everyone was nervous about at the beginning: myocardial infarction, aortic dissection, pulmonary embolism and other diseases.
This disease, a little lighter, is not so urgent.
However, it cannot be sloppy, and the sudden death rate is also very high.
When the family heard this, they breathed a sigh of relief.
The hanging heart finally landed.
"Doctor Lin, what should I do then?"
Lin Feng thought for a while: "This disease, generally does not require surgery, you can take medicine... The main thing is to deal with high blood pressure + high blood pumping power..."
And then
Lin Feng prescribed several medicines, the most important of which was "Metoprolol tablets", which were used to lower blood pressure and lower heart rate.
Soon, it's going to be used.
After about an hour, the patient felt that the chest pain and chest tightness were relieved a lot.
At this time, the patient's family finally put their hearts down.
The treatment is effective, then it means that you have found the right direction, indicating Lin Feng's diagnosis, right!
Now,
It was the patient's turn to start pressing.
Now that the cause has been identified, how to solve it? Can it be cured? If it can't be cured, won't you have to carry a time bomb for the rest of your life?
"Dr. Lin, can I cure this disease?"
"At present, there is no cure, and the current view of the medical community is that it is a genetic problem. But in fact, I still can't find a specific reason, and if I can't find the reason, I can't cure it. "
"Isn't surgery okay?"
"There is no such operation..."
“............"
Tears came out of the patient's eyes.
It's bad news!
Lin Feng: "By the way, since it is genetic, you can let your children check it, lest they also have ..."
The patient nodded repeatedly: "I'll call my parents later..."
Lin Feng: "By the way, remember to take medicine regularly in the future, don't be intermittent, this is not good for the condition... In the future, I will mainly eat "metoprolol", and in addition, don't eat "nitroglycerin" that I used to eat, because it will aggravate your condition..."
"Yes yes yes, I remembered, thank you Dr. Lin!"
The patient, Mr. Chen, is obedient to Lin Feng!
......
......
Return to the consultation room,
Soon received a more special patient.
"Doctor Lin, my stomach hurts..."
The patient is 24 years old, young man.
My girlfriend followed.
"It hurts? Lying on the bed, I'll see..."
Lin Feng gave the patient a physical examination to the young man.
Because the cause of abdominal pain will be very complicated, Lin Feng did not find it specifically after a physical examination.
"Have you ever eaten something unclean? Do you have diarrhea? "
"Nothing..."
Temporarily rule out gastroenteritis...
However, it is only temporary.
The patient was more painful, Lin Feng thought about it.
"Let's go draw some blood..."
"Okay, Dr. Lin..."
The patient's girlfriend supported the patient and prepared to walk out of the ward...
suddenly
Lin Feng noticed that there were a lot of black things on the patient's lips, a little, a little, like a grain of sesame, sticking to the lips.
At first, Lin Feng thought that he had eaten something black and stained his lips.
"Wait! Come back! "
"Huh?"
The patient looked puzzled and turned around.
"Sit down, I'll take another look..."
The young patient sat in front of Lin Feng, and when he saw Lin Feng's serious face, he suddenly felt apprehensive in his heart.
Lin Feng carefully looked at the young patient's lips, the black dots,
"You black... When was it there? "
"Half a year ago, from one or two points at the beginning, and then now it is multiple points ..."
Lin Feng listened.
There is already a rough guess in mind.
"P-J syndrome"!!
(PS: Diseases with a general suffix of the syndrome are diseases that cannot find a cause.) ）
"Are there any of these black spots elsewhere on your body?"
"Yes, my hand..."
The young patient stretched out his hand in front of Lin Feng.
Sure enough, several fingers, wrists, there are black spots, about forty or fifty ...
Dense!!
Lin Feng glanced at the patient's girlfriend and thought that this was true love.
The patient quickly asked, "Doctor Lin, do you know what kind of disease this is?" "
He was also full of distress about his black spot.
Lin Feng nodded: "It should be "P-J syndrome"!" "
The so-called "P-J syndrome":
Full name: "Peutz-Jeghers, also known as familial mucosal skin pigmentation gastrointestinal polyposis.
It is an autosomal dominant "inherited" disease, characterized by "skin and mucous membrane pigmentation" (black spots) and multiple "polyps" in the gastrointestinal tract.
If the patient in front of you is really "PJ syndrome", the cause of the patient's stomach pain is likely to be - "gastrointestinal polyps"!!
Even more serious is the "intussusception" and "intestinal obstruction" caused by gastrointestinal polyps!
Typical: polyps + black spots
There are also atypical: simple polyps. Many patients continue to undergo surgery to cut polyps, and they may not find themselves with "pJ syndrome" in their lives.
"Have anyone in your family like you had black spots on their mouths or gastrointestinal polyps?"
The patient was taken aback: "Huh? Dr. Lin, how do you know? I have several relatives, my mother, sister-in-law, cousin... All have been cut! "
Lin Feng nodded.
Didn't run!
Definitely "PJ syndrome"!
"Let's go for a CT... I suspect you have a stomachache, it's intussusception! "
CT is the diagnostic method of intussusception.
Or do
"Barium enema": can be used both as a test and as a treatment, but because it is invasive and carries the potential risk of bowel perforation, it is not as common as CT.
As for why not intestinal obstruction?
Just after a physical examination, the intestinal obstruction can be felt by hand.
。.