bookpower Chapter 348
Chapter 348
"Doctor Lin, am I serious now?"
Mr. Zhang did not understand what infarction meant, and he was still relaxed at this time.
Lin Feng glanced at it: "You better call your wife right away, next, you will be hospitalized..."
"Huh? Hospitalization? Mr. Zhang was frightened.
Lin Feng was serious: "That's right, I must be hospitalized immediately, the situation is very critical!" "
"Good, good..." Mr. Zhang called nervously.
And Lin Feng is thinking urgently to find the cause.
Because infarction of the spleen and kidney rarely occurs, if it occurs, it means that infarction of the lungs, liver, and even the brain may occur.
That's big trouble!
At this point,
Time is life!!
Lin Feng began to use a stethoscope to listen to the sound of Mr. Zhang's heart.
See if there is a problem with the heart.
Earlier, because the patient kept saying lungs, the electrocardiogram was no problem, so Lin Feng did not auscultate the patient's heart.
A stethoscope is placed on the heart.
This listens,
disastrous
Lin Feng's face changed.
Lin Feng heard a murmur in Mr. Zhang's heart area.
In general, the heart is a clean sound, and experienced doctors understand it.
But now, there is a murmur.
Listen carefully!
It's reflux!!
Lin Feng's experience was so rich, he immediately heard the sound of blood refluxing inside his heart at this time.
The heart has four chambers: left atrium, left ventricle, right atrium, and right ventricle, and there will be a "valve (mitral valve and tricuspid valve)" in the middle as a door, only allowed to enter but not to retreat...
Once the valve is broken, blood can move in and out, forming a "reflux".
(ps: Previously written, [Chapter 284] mitral valve)
This is definitely a very fatal condition!
At present, the patient's condition inferences:
Regurgitation is not serious, otherwise the blood oxygen saturation has dropped.
Excluding reflux is not serious, which indicates that the patient's spleen and kidney infarction are due to blood vessels blocked by thrombus (or foreign body), resulting in tissue ischemia.
Then the question arises:
Is it a blood clots? Or a foreign body?
Where did it come from?
Lin Feng thought of a disease!!
"Infective endocarditis"!
Very much in line with the patient's current symptoms.
This roughly means: the heart valve is infected by bacteria, and emboli (bacteria, necrotic tissue mixture) are formed locally.
If this emboli falls off, it can also tie many organs, resulting in infarction.
This corresponds to "splenic infarction, renal infarction".
At the same time, because of bacterial infection, the patient has a fever and cough... It also corresponds.
Lin Feng told him about "infective endocarditis".
Mr. Zhang's whole person was stupid.
I originally thought it was a common cold and fever, but it developed into pneumonia, and then what heart inflammation ...
These are doctors,
That's awesome!
Mr. Zhang was glad in his heart that he had found Dr. Lin instead of continuing to go to the outpatient clinic, otherwise he would have finished himself.
"Hospitalized, hospitalized first..."
The patient's situation, Lin Feng felt a little tricky.
Need to do as soon as possible.
If this "infective endocarditis" is not treated in time, maybe more emboli will fall and infarct other organs, such as the blood vessels that cause the intestines to be blocked, or the blood vessels in the brain, with unimaginable consequences...
"Xiao Ai, draw his blood..."
Nurse Xiao Ai drew several tubes of blood for him.
Lin Feng explained: "This blood is used for blood culture, and now the bacteria must have entered the blood, as long as you find this bacteria, which bacteria it is, with the corresponding medicine, you can quickly cure your "infective endocarditis". "
At this time, Mr. Zhang was already grateful and adored Lin Feng.
Nodded repeatedly.
"Doctor Lin, you can do whatever you want, I cooperate unconditionally!"
Lin Feng nodded: "Next, do a cardiac ultrasound to confirm whether it is really "infective endocarditis". "
Patient: "Go right away!" "
......
Urgent
20 minutes later...
The results of the cardiac ultrasound came out.
Confirmed: infective endocarditis!
Mitral valve, tricuspid valve, there are several black things, that is, bacterial infected vegetations.
And the plug, it is very likely that this vegetation fell off.
When the disease becomes more serious, reflux will worsen - the body must greatly increase the heart rate for oxygen, speed up blood pumping - and finally lead to heart failure...
More emboli fall off, which can embolize other tracheal tissue, causing infarction...
The situation is serious.
......
At this point,
The wife of the patient, Mr. Zhang, has not yet arrived at the hospital.
The "Critical Illness Notice" was signed by the patient, Mr. Zhang.
At this time, Mr. Zhang did not know whether it was a psychological reason or a deterioration of his condition, and he began to breathe harder, felt more strenuous, and his heart rate was also accelerating. (Regurgitation is aggravating)
Lin Feng determined that it was "infective endocarditis",
Then there's the use of antibiotics.
Although, blood culture, what bacteria is has not yet come to fruition.
However, it does not affect the use of broad-spectrum antibiotics.
Increase the amount of medicine!
At this time, you can not worry about resistance, and use a small amount of antibiotics, you must use a large amount.
As long as antibiotics kill the bacteria on valve vegetations, they can stop the emboli from continuing to form and fall off...
It takes three days for blood culture and 2 days for acceleration...
Therefore, during this time, broad-spectrum antibiotics need to be used first.
......
The next day, the patient's most important lung and brain CT was reviewed...
It was found that there was a relatively small cerebral infarction inside the skull, that is, the most worried situation appeared, the new emboli fell off, ran to the cerebral blood vessels, and blocked part of the blood vessels!
No way
Only antibiotic therapy can be increased,
It is hoped that the bacteria can be suppressed quickly and prevent further formation and shedding of emboli in the heart valves.
Moreover, this drug can reach the brain, inhibit the bacteria of the emboli, and then let the emboli ablate, achieve the effect of 'thrombolysis', restore the blocked blood flow, then Mr. Zhang can escape death.
Kill two birds with one stone...
......
On the third day, in the evening,
The results of the blood culture, came out.
Found the murderer!
"Staphylococcus aureus"!
Then the next thing becomes simple.
Change from broad-spectrum antibiotics to specific antibiotics against "Staphylococcus aureus".
Antibiotics are used,
The patient's condition improved rapidly...
Decreased cardiac reflux...
Heart rate reduction, recovery...
・ The thrombolytic effect appeared...
Other embolisms and heart failure that I was worried about did not appear...
The valve damage is not too big, and there is no need to replace the artificial valve...
This may be the patient's own luck, or perhaps Lin Feng's own passive ability "luck" is at work.
......
......
On the other side,
Qin Fuli, the CEO of a certain company.
48 years old, it is the peak of a man's career!
However, he has a problem,
Since 5 years ago, he has had low back pain, intermittent, backache, and slight pain.
At first, he didn't pay much attention to it, because that period was when the company was developing rapidly, and he was busy, and he thought that he was too tired and caused muscle strain in his waist.
He also has a problem and avoids medical treatment.
Think those doctors are bullshit.
Then I checked it on the Internet and got some painkiller plasters and pasted them indiscriminately.
The pain did get better for a while, but soon it started to hurt again.
Repeatedly......
In a flash, 5 years have passed ...
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ps: Three more ends...
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