I Can See Health

The cath lab of the Department of Cardiology, Jinghua Second Hospital.

A 10-year-old girl is lying on the operating table.

Looking at everything unfamiliar in front of her, she closed her eyes tightly and tried her best to tell herself to ignore the pain coming from her wrist.

"Kid, you are so brave! The operation is quick and you will be fine soon."

It was the first time for the nurse in the cath lab to see such a young patient.

"Dr. Ren, the doctor in the ward upstairs is not mistaken. Is such a young girl going to undergo cardiac angiography? Does she need to insert a stent?"

The nurse looked at the tall surgeon next to her with confusion.

"Yes, I looked at the patient's test results and electrocardiogram, and the diagnosis of myocardial infarction should be correct." Ren Feng frowned, "However, this is the first time I have seen such a young patient."

Ren Feng is a leader of the younger generation of coronary intervention in the Department of Cardiology, Beijing Second Hospital.

Most of the more difficult surgeries were performed by him.

This time, when the 10-year-old suffered a heart attack, he was also responsible for it.

"The youngest patient I have ever seen who had a heart attack was an 18-year-old patient. That patient stayed up late for a long time, smoked and drank, and ruined his body to no avail."

"But this 10-year-old girl shouldn't have any bad habits."

"I always feel that such a young girl would suffer too much if she had a stent." The nurse couldn't help but sigh.

"Let's check the blood vessel condition first and then make a decision." Ren Feng frowned and said, "If possible, try to do PTCA."

Coronary interventional treatments in a broad sense include the following:

First, coronary artery balloon dilation: PTCA in a narrow sense, can improve coronary artery stenosis or obstruction.

Second, stent implantation: PCI treatment can solve the problem of restenosis.

Third, coronary rotational atherectomy: It can be used when the lesion is very serious and the balloon cannot be expanded.

simply put.

PTCA uses a balloon to dilate a narrowed blood vessel, but no stent is implanted. After stenotic lesions are dilated by a balloon, 40% of the lesions will restenose.

PCI means implanting a stent after balloon dilation to reduce the risk of restenosis.

…

A 10-year-old patient with myocardial infarction is really rare.

This case also attracted doctors and nurses from several other cath labs.

It won't take ten minutes.

A group of doctors and nurses were already surrounding the door of Ren Feng's cath lab.

Everyone is paying attention to the situation in the cath lab.

"Brother Ren has encountered such a difficult patient again!"

"Hey, the risk for this kind of patient is too high. Whether to put a stent or what type of stent to put is a difficult problem! Once something goes wrong, the patient's family will definitely find trouble with the hospital!"

"Yes, the most important thing is that the patient is too young!"

Suddenly a familiar voice came from behind.

"Have you finished the operation? Are you free to watch here?"

Everyone was stunned for a moment, then immediately dispersed and returned to their own cath lab.

Cao Zhiying looked at the people leaving with a sullen face, and then turned her attention to Ren Feng's cath lab.

"Such a young patient?"

Seeing the little girl on the stage, Cao Zhiying frowned and suddenly became interested.

He walked to the monitoring table in front of the cath lab, sat down, and opened the patient's medical record folder.

"With chest pain, elevated cardiac enzymes, and abnormal electrocardiogram, the diagnosis of myocardial infarction should be clear."

"Mitral valve prolapse, intermittent claudication, tendon xanthomas..."

Seeing these physical signs and auxiliary examinations, Cao Zhiying couldn't help but raise the corners of his mouth slightly.

This case is quite interesting and relatively rare.

Can the little doctor in the ward upstairs make a diagnosis?

…

At this time, Ren Feng in the catheterization laboratory had completed cardiac coronary angiography.

"Ren Feng, look at the patient's blood vessels in every position."

The director's voice suddenly came to mind in the cath lab.

Ren Feng looked back.

Cao Zhiying was sitting on the monitoring console of the cath lab outside, talking to him through a microphone.

Ren Feng nodded slightly, indicating that he understood.

Contrast agent is injected to reveal the coronary vessels.

"This is... extensive vascular stenosis!" Ren Feng couldn't help but sigh in his heart, "It's difficult to do PCI now!"

Extensive blood vessel disease is not a blood vessel blockage in one or two places!

"Ren Feng, use the balloon to expand it, don't put in the stent first."

Cao Zhiying's voice sounded again, and Ren Feng immediately performed the balloon expansion operation.

About forty minutes later.

The operation was successfully completed!

Ren Feng walked out of the cath lab, sweating all over his back.

Mainly because the patient was too young, Ren Feng was extremely careful in every step he performed.

Because once something goes wrong, the consequences can be disastrous.

"Ren Feng, what disease do you think this patient has?"

Cao Zhiying suddenly asked.

"Vasculitis, such as Takayasu arteritis, ANCA-related vasculitis, etc."

"Then what? No other ideas?"

Ren Feng pondered for a moment and still shook his head.

"Director, this is all I want for the time being."

Cao Zhiying's face darkened and she said seriously: "Ren Feng, it is undeniable that your coronary intervention technology is very good. In the hearts of the entire Jinghua Second Hospital, you can definitely be ranked in the first echelon."

Ren Feng was expressionless on the surface, but he was happy inside.

It is rare to get praise from the chief director Cao Zhiying.

"But!" Cao Zhiying suddenly changed his tone, "Do you want to be an excellent cardiologist, UU read www.uukanshu.net or do you just want to be a surgeon?"

"This... of course is a cardiologist." Ren Feng replied immediately.

Cao Zhiying smiled and continued.

"The most important thing for an excellent cardiologist is solid basic knowledge and good clinical thinking skills, rather than performing surgeries day after day, and just becoming a craftsman of interventional surgeries!"

"Look at you, you can't even analyze this case now. This disease should be familial hereditary hypercholesterolemia. I remember that there was a case in the third heart zone before, but you have forgotten it now?"

After hearing what Cao Zhixin said, Ren Feng reacted immediately.

In his impression, there was indeed such a patient.

"Director, this disease is a rare disease." Ren Feng said helplessly, "I couldn't think of it for a moment. It must be normal. The doctor in the ward upstairs, as the first doctor, didn't diagnose it at the first time. ah!"

While talking, Ren Feng clicked on the disease history record on the computer.

"Director, look, the doctor in the ward upstairs made the same diagnosis as me. He also considered myocarditis, cardiomyopathy, and vasculitis, which is similar to mine!"

However, when Ren Feng clicked on the latest ward round record.

He was stunned.

In the disease course record, it is clearly written:

Diagnosis: Familial hereditary hypercholesterolemia.

The expression on Ren Feng's face was extremely wonderful.

Cao Zhiying on the side also showed a surprised look.

The doctor in the ward upstairs made the diagnosis so quickly? !

His eyes moved down to the signature area of ​​the medical history record.

I want to see who diagnosed this case.