I Can See Health

Myocardial ischemia at the age of ten?

Lu Chen frowned.

Coronary heart disease that occurs in men younger than 55 years old is premature coronary heart disease.

Not to mention a ten-year-old kid like this.

Lu Chen had never seen the electrocardiogram of a ten-year-old child look the same as that of an old man in his seventies or eighties.

"Ten years old? This should go to the pediatrician."

Lu Chen paused and said.

Generally, children aged 14 can basically go to the pediatrician.

"The pediatrics department in our hospital is not very good. There are only five doctors left in the entire department. All the young doctors have left, and there are only a few deputy directors and directors left." Jiang Qingyan shook her head, "So when it comes to heart problems like this, Most diseases come to the cardiology department.”

"Does the patient have any symptoms?" Lu Chen asked next.

"Intermittent chest pain for 1 month."

"According to the electrocardiogram and symptoms, there must be something wrong with this child's heart and blood vessels." Lu Chen said, "But it is definitely not a conventional coronary heart disease, but has other causes."

"Yes." Jiang Qingyan nodded, "Currently I have several considerations, including vasculitis, cardioectasia, myocarditis, and patent ductus arteriosus, etc."

"It is most likely that secondary coronary vascular disease is caused by these causes!"

Lu Chen frowned and said, "No matter what the cause, this child's vascular disease is serious and may need immediate treatment. Does Senior Sister know about this patient?"

"I know." Jiang Qingyan nodded, "But senior sister can't figure out what's causing it yet. I asked her to do a blood test and a heart ultrasound first, and then adjust the treatment plan after the results are reported."

"Yes." Lu Chen put down the electrocardiogram.

He was very interested in this young patient.

"Which bed is he in?"

"13 beds."

…

Came to bed 13.

This is a ten year old girl.

The girl huddled in the corner of the bed, her face a little pale.

Lu Chen stepped forward, and her mother stood up.

"The doctor is here."

The girl turned her head and looked at Lu Chen, then buried her head in the bed.

"Auntie, let me ask about her situation."

"Well, ask the doctor." The girl's mother forced a smile.

Seeing that the girl didn't respond, Lu Chen asked her mother directly.

The girl developed intermittent claudication 3 months ago.

One month ago, chest pain occurred after activity. It was a squeezing-like pain, centered in the precordium area. It was significantly aggravated after activity and could be relieved slightly after resting for 3-5 minutes.

During this period, he did not go to the hospital for treatment and had frequent chest pain attacks.

"Auntie, does your family have a history of coronary heart disease?"

"No."

Lu Chen wanted to give the girl a physical examination, but she resisted.

The girl's mother shook her head gently, and Lu Chen could only give up.

…

Back to the doctor's office.

Lu Chen looked through the medical records written by Jiang Qingyan, focusing on the physical examination part.

Physical examination on admission: HR 120 times/min, BPHg. A mid-late systolic click-like murmur in the mitral valve auscultation area could be heard during heart auscultation, and no abnormal breath sounds could be heard during lung auscultation.

"There are painless nodules in the elbow joints, knees, and ankles; white rings can be seen at the edge of the cornea."

"Peripheral vascular pulses are normal, intermittent claudication occurs in both lower limbs when walking, and there is no edema or skin color change."

The medical examination written by Jiang Qingyan on admission is extremely detailed.

During auscultation of the heart, murmurs can be heard.

A thought flashed through Lu Chen's mind, could it be congenital heart disease?

However, he also noticed that painless nodules could be seen on the girl's joints.

"this is……"

Lu Chen frowned and looked back at Jiang Qingyan.

"Jiang Qingyan, what is this painless nodule?"

"This nodule, I think it should be tendon xanthoma."

"Tendinous xanthomas?"

Lu Chen suddenly thought of something, but he couldn't grasp it.

"What's wrong?" Jiang Qingyan asked confused.

"It's nothing..." Lu Chen shook his head gently, "Let's take a look at the patient's test and examination results first."

…

The whole morning.

There are really too many patients from the eight districts in my heart.

Lu Chen was always there, treating patients, giving medical orders, and writing disease history records, switching between the three.

He admitted three patients in total, and Dong Hao and others admitted two each.

So that at 12 noon, everyone stayed in the department.

"Today at noon, I invite everyone to have dinner in the department."

Sun Guoguo walked into the doctor's office with a smile, took out her mobile phone, and opened the ordering app.

“Everyone can give us your opinion on what you want to eat and which restaurant you want to eat at.”

"Girls have priority, the two junior sisters should order first."

Sun Guoguo handed the phone to Jiang Qingyan.

"Ke Yue, you order it, I can do it."

Jiang Qingyan is dealing with the ten-year-old patient.

"Well, how about braised pork rice?"

Ke Yue swiped at the ordering interface.

"Oh, what are you going to eat with braised pork rice?" Dong Hao came over and said with a smile, "I know there is a chicken with saliva, it's so delicious."

"Then, won't it be too expensive?" Ke Yue whispered.

"Don't worry, Teacher Li will pay the bill." Sun Guoguo smiled, "Whatever you want."

With Sun Guoguo's words, everyone had no worries about ordering food.

Lu Chen followed the crowd and ate saliva chicken together.

…

About half an hour later.

The "saliva chicken" was sent to the department.

Everyone was just about to open their lunch boxes and enjoy the delicious food.

There was a shout from the nurse's station.

"Is the doctor from the director's team here? The laboratory system has a critical value!"

Upon hearing this, Sun Guoguo immediately ran to the computer and opened the laboratory system.

Everyone also stopped unpacking lunch boxes.

There are too many patients coming this morning.

Sun Guoguo quickly reviewed all the new patients in her mind.

It seems that there are no particularly critical patients.

Who could it be?

Turn on the assay system.

A pop-up window popped up immediately.

Department: Cardiovascular Medicine Ward 8

Name: Yuan Hui

Bed number: 13 beds

Age: 10 years old

Critical value: cardiac troponin I (fluorescence method) 3.12ng/ml (normal value 0-1 ng/ml).

It’s actually the critical value of a little girl in bed 13!

A trace of doubt flashed in Sun Guoguo's eyes.

According to the diagnostic criteria of myocardial infarction.

Currently, the girl in bed 13 has met the three diagnostic criteria of chest pain, elevated cardiac enzymes, and electrocardiogram changes!

Acute myocardial infarction can almost be diagnosed!

Myocardial infarction at 10 years old!

This is extremely rare.

Sun Guoguo frowned deeply. UU Reading www.uukanshu.net

"Junior Brother Dong, ask the nurse to provide ECG monitoring and oxygen inhalation for the 13-bed patient!"

"Junior sister Ke, please contact the CCU cath lab on the fourth floor to have the cath lab ready at any time."

"Junior Brother Lu, please write down a record of the critical illness."

"receive!"

Everyone also saw the critical value report and understood that the situation was serious.

"I will explain the condition to the patient's family."

As Sun Guoguo walked out of the ward, she took out her mobile phone and called Director Li Yao.

This patient's condition is very difficult.

The most important thing is that the patient is too young, a ten-year-old child!

Once there is any mistake, it is very likely to cause medical disputes!

"Teacher Li, we have a new patient here today, a 10-year-old girl. The electrocardiogram showed myocardial ischemia. The test values ​​just came back and myocardial enzymes were elevated."

After answering the phone, Sun Guoguo immediately reported the patient's condition.

"Let the cath lab prepare immediately!" Li Yao's voice came from the other end of the phone, "No matter what the cause is, according to the patient's current condition, immediate intervention is needed!"

"Guoguo, please talk to the patient's family clearly!"

"I'm in a meeting in the school department right now, and I won't be able to make it back for a while."

"Okay." Sun Guoguo hung up the phone and immediately followed Li Yao's instructions, preparing to communicate with the family about the interventional surgery.

…

Lu Chen on the side was writing a critical illness course record.

In his mind, he kept recalling information about this ten-year-old girl.

"Myocardial infarction, murmur, painless nodules, xanthomas..."

"If it were all explained by medical monism... what would it be?"