I Can See Health: Chapter 50 Coronary heart disease at the age of 30?
Chapter 50 Coronary Heart Disease at Thirty Years Old?
At ten o'clock in the morning, just after Lu Chen finished writing the ward round, a new patient came to the department.
"Junior Brother Lu, it's your turn to accept the patient."
Sun Guoguo glanced at the order table of the admitted patients, and just arrived at Lu Chen.
"Okay." Lu Chen nodded, saved the medical records he had written, and pushed the electrocardiograph to the ward.
The patient is a thirty-one-year-old male.
When I was pulling bamboo shoots on the mountain this morning, I had chest pains, accompanied by cold sweats. After about ten minutes, the symptoms resolved on their own.
This patient is thin, with a drunken red flush on his face.
First thing, look at the color.
Lu Chen concentrated and glanced at the color on his head, it was yellow!
In the past two days, Lu Chen has observed in the ward.
For the same disease, if at different stages of development, the color of the patient's head is also different.
For example, most patients with high blood pressure have no complications, and the color of their heads is yellow.
And there is a hypertensive crisis, that is, a patient with severe complications, the color of the head is red.
Another example is a patient with coronary heart disease. If an acute myocardial infarction occurs, it is definitely red!
If it is just ordinary angina, the color is still yellow!
Similarly, if the acute myocardial infarction is recovering, the color of the patient's head can change from red to yellow.
In short, the color represents the health value of life, and the color can be changed at any time according to the state of the patient!
…
"Senior Brother Lu, Teacher Sun asked me to follow you to receive patients."
Lu Chen just finished his electrocardiogram when a little intern girl in the group blushed and followed him into the ward.
As for why his face was blushing, Lu Chen couldn't figure it out.
glanced at her badge, her name was Yao Jie, a fifth-year intern at Jinghua Medical University.
"Well, good." Lu Chen smiled and nodded, "Then you can ask about the medical history."
Yao Jie heard the words and responded lightly, then took out a pen and paper, walked to the patient's bed, and began to ask about the patient's condition.
Taking medical history is an essential skill for medical students.
Jinghua Medical University is still a first-class medical university. The quality of students is good, and Yao Jie's medical history inquiries are very standardized.
As she asked, she wrote down the main contents on paper.
From the main symptoms of the onset, accompanying symptoms, onset time, as well as the mode of relief and treatment, all of them were asked in detail.
"Well, the question is very detailed, but you forgot to ask about one thing." Lu Chen smiled, "The diseases of the Cardiology Department are different from other departments, and the content of the past history is also different. Think again."
Yao Jie frowned and thought for a moment.
"Ask about risk factors for heart disease!"
Lu Chen nodded with a smile and said, "Yes, by evaluating the risk factors, we can simply judge the risk of coronary heart disease."
"Yes." Yao Jie nodded, then turned around and continued to inquire about the patient's related risk factors, including smoking history, drinking history, etc.
"Do you usually smoke? How much per day?"
"Pumping, about two to three packs a day."
"drink wine?"
"Drink, drink a little white wine every night, about two or two."
"What work? Staying up late?"
"Truck driver, often running at night."
"Have you ever had high blood pressure or diabetes before?"
"Has diabetes, no high blood pressure."
After recording all the medical history, Yao Jie looked back at Lu Chen.
"Senior brother, is there anything else I missed?"
"Very good." Lu Chen smiled, "It's better than when I was an intern."
Yao Jie blushed, a little embarrassed.
"But what do you think the diagnosis of this patient is?" Lu Chen changed the subject and began to inherit the fine tradition of the group - asking questions.
"This..." Yao Jie looked at the patient on the bed again, "Coronary heart disease?"
"The patient is just 31 years old this year, are you sure about coronary heart disease at such a young age?" Lu Chen smiled.
"Huh?" Yao Jie shook her lower lip, "Could it be aortic dissection?"
"The pain of dissection is generally difficult to relieve. The patient has not used any medicine, and the pain will relieve itself. Are you sure it is a dissection?" Lu Chen said.
"Is that a pulmonary embolism?" Yao Jie muttered.
This senior is really bad!
He looks handsome, but he asks a lot of questions, just like Mr. Sun.
"Junior sister, don't be affected by my thinking." Lu Chen smiled, "Just follow your own thinking and consider what the initial diagnosis of this patient is?"
Lu Chen smiled, this junior sister is quite clever, not sure about it, so she talked about several diseases related to chest pain.
Yao Jie thought for a long time and replied.
"Coronary Heart Disease?"
"Yes." Lu Chen nodded, "I also think it is coronary heart disease."
Lu Chen's voice just fell, and the young man on the bed immediately became anxious.
"Doctor, don't talk nonsense! How could I have coronary heart disease at such a young age!"
"I checked Baidu before I came to the hospital. Coronary heart disease is a disease of the elderly in their 60s and 70s."
"On the Internet, it is said that my chest pain may be caused by pleurisy, or it may be caused by not paying attention to it."
Lu Chen glanced at the anxious man on the eye bed.
"According to your current symptoms and electrocardiogram, as well as your usual bad living habits, the initial diagnosis is coronary heart disease, and the final diagnosis can only be made after the results of blood tests and other auxiliary examinations are completed."
The young man still shook his head when he heard the words.
"You doctor is too young and inexperienced. Let me tell you, I just have a good rest. I'm tired after going out to pluck bamboo shoots. I'll rest for two days."
"Of course I would rather you be tired and have no other problems." Lu Chen said lightly, "But you'd better quit smoking and drinking, don't stay up late, and control your blood sugar."
The young man raised his brows and put his hands on the back of his head, looking indifferent.
"Sister, let's go back and write the medical records."
After asking the medical history, Lu Chen pushed the electrocardiograph, turned around and left the ward.
Yao Jie nodded and followed.
Going back to the office, Lu Chen finished writing all the doctor's orders, and after letting Dong Hao review it, he finally clicked to upload the doctor's order.
This time, Liu Mei's voice did not come from the nurse's station, so there should be no wrong doctor's order.
"Junior brother, this patient's electrocardiogram is normal, and he still considers coronary heart disease and angina pectoris?"
Sun Guoguo frowned while holding the electrocardiogram of the young man just now.
Although the medical history was admitted by Lu Chen, Sun Guoguo, the superior doctor, will check all the patients to prevent any missed doctor's orders or auxiliary examinations.
"Judging from the symptoms he described himself, chest pain after activity, accompanied by cold sweats, and his usual irregular work and rest, he is more likely to have coronary heart disease." Lu Chen said.
Sun Guoguo shook his head.
"I am only 30 years old. I feel that the probability of coronary heart disease and angina pectoris is not high. It may be coronary spasm caused by long-term smoking. When the patient's test results come out, make an appointment for coronary CTA first."
"Well, okay." Lu Chen nodded.
…
After half an hour.
Lu Chen was writing his medical records when a pop-up window popped up in the computer testing system.
"Test critical value, please accept it!"
Lu Chen's eyelids jumped, and a bad premonition suddenly rose in his heart.
(end of this chapter)