"Acute severe myocarditis!" This is a disease in which a virus directly invades the myocardium, causing acute myocardial edema and necrosis, and then quickly leading to heart failure, arrhythmia, and cardiogenic shock! The early symptoms of this disease are atypical and can be easily misdiagnosed as a common cold. Some community hospitals, even many tertiary hospitals, have misdiagnosed acute severe myocarditis as a cold, resulting in death! Xu Qiu glanced at Li Qianqian again. The other party's complexion was getting worse and worse, and there were signs of cyanosis on the lips, which was obviously hypoxia. In this case, it is best to transfer to the ICU. But Xu Qiu's intuition made him feel that something was wrong. "Let's see the effect of oxygen inhalation through the mask first." Xu Qiu said. But, a few minutes later, Li Qianqian's hypoxia became more and more serious, the data on the ECG monitor was also declining, and the blood oxygen saturation was getting lower and lower.
Xu Qiu frowned: "Push a sedative and change the ventilator." At this time, a man in casual pants in the ward spoke, and he asked: "Doctor, can it be cured? If there is any expensive medicine, just use it directly, and it will be cured." Another man pushed his gold-rimmed glasses and said: "It's 34 weeks now, and it should be possible to have a cesarean section. Let's do it first." Xu Qiu ignored them. Fortunately, after pushing the medicine and putting on the ventilator, Li Qianqian's blood oxygen slowly rose. The crisis was temporarily resolved. Everyone breathed a sigh of relief. However, the stone in their hearts was still not put down. Before the real cause of the disease is found, the crisis can recur at any time. "Doctor Xu, go to the conference room first. Our department has contacted the respiratory department and the cardiology department to discuss this case..." Li Xue reminded in a low voice. Before leaving, Xu Qiu looked back. The man with gold-rimmed glasses was pressing the sides of Li Qianqian's pregnant belly, listening with his head against her belly. Another man was on the phone, and seemed to be calling the remaining three people to rush back to the hospital. "Alas, there is really no bottom line..." After leaving, the nurses all shook their heads in condemnation. ... Five minutes later, in the meeting room. When everyone saw Xu Qiu coming in, they temporarily stopped the progress of the discussion. A pair of eyes looked at Xu Qiu, all releasing kindness.
After Xu Qiu sat down, the discussion resumed. Director Zhang of the respiratory surgery department said: "From the CT scan, the patient's pneumonia is not serious. Such severe dyspnea and hypoxia are definitely not related to pneumonia." The director of the cardiology department frowned: "The symptoms are very similar to acute severe myocarditis, and the heart failure markers are also high..." At this time, Xu Qiu finally finished reading the examination report that had just been released. One of them is very meaningful: The patient's myocardial enzyme is slightly elevated! If it is severe myocarditis, the myocardial enzyme will definitely rise sharply when the myocardial cells are damaged. But, the patient's myocardial enzyme only rose slightly! Obviously, the director of the cardiology department also noticed this, and he sighed: "If a myocardial biopsy can be done, it can be confirmed." Everyone present shook their heads. It is not clear whether it is severe myocarditis or not. Just to judge, we have to puncture the endocardium for examination, which is too expensive. Clinically, doctors are reluctant to do invasive examinations unless it is absolutely necessary. At this moment, Li Xue, who was next to Xu Qiu, raised her hand, and she stood up and said, "Could it be hyperthyroidism?" Hyperthyroidism? Everyone was stunned, and they thought along Li Xue's line of thought, and suddenly they felt enlightened. Yes! The patient's irritability, tachycardia, and sweating, all symptoms can be explained by hyperthyroidism. And the dyspnea that just broke out- It is the manifestation of hyperthyroid crisis! In addition to severe myocarditis, hyperthyroid crisis can also cause such sudden heart failure! "If it is hyperthyroid crisis, the mortality rate is about 30%, so we have to deal with it quickly!" "Yes, we have to consult the endocrine department!" But, at this moment, Xu Qiu's voice interrupted everyone's discussion. He said lightly: "I have palpated, and there is no sign of enlargement of the thyroid gland." Everyone's excitement came to an abrupt end. Director Hu of the Department of Obstetrics and Gynecology asked tentatively: "How about checking the thyroid hormone level?" Hyperthyroidism crisis does not necessarily mean that there is an enlarged thyroid gland. The hormone level is the gold standard.
The Director of Cardiology suggested: "Check the thyroid hormone first. If it is normal, then ask the family members whether to do a myocardial biopsy." But Li Xue directly refuted and said: "This patient is special, and the family members cannot be consulted!" The five rich second-generations just used Li Qianqian as a tool for gambling- The other party did not care about Li Qianqian's life or death at all! This joint consultation did not reach a final diagnosis in the end. However, Xu Qiu clearly ruled out pulmonary embolism, and Li Qianqian's life was saved. The diagnosis can be slowly promoted, and everyone breathed a sigh of relief. ... In the afternoon, Xu Qiu returned to the emergency department and started the operation. After completing an operation, he went to the Department of Gastroenterology for a meeting. Everyone in the department had memorized the video of Chen's pancreatico-enteric anastomosis, and they were waiting for Xu Qiu to teach in person. However, Xu Qiu still postponed the time to after the academic exchange of neurosurgery. He really has no time recently. After leaving the meeting room of the Department of Gastroenterology, Xu Qiu actually saw another acquaintance. Gao Pei'an! Academician Chen's favorite student, a medical expert in the field of duodenal and liver cancer! Seeing Xu Qiu, Gao Pei'an left the others behind and walked over quickly, "Xu Qiu, do you also want to come to the gastroenterology department for surgery?" Xu Qiu shook his head and asked: "Professor Gao, do you have a flying knife again?" Gao Pei'an nodded, looked at a potbellied man not far away, and said, "Bureau Zhang, the leader of the city, his mother has liver cancer, and he asked me to perform an operation." Just as he was talking, Director Zhang came over with eight-character steps. Just as Gao Pei'an was about to introduce him, Director Zhang glanced at Xu Qiu's nameplate, his face suddenly sank, and he said, "Are you Xu Qiu?" Gao Pei'an was pleasantly surprised, "We all know each other, so I don't need to introduce you." Director Zhang shook his face and cursed: "Of course I know him! It was this bastard who got rid of the clerk at the blood station, and the new guy was like a lump, he had to help each other donate blood—— My blood fat was too high and I couldn’t donate it, so I struggled for a long time before I found a few people to exchange four bags for my mother! " He was angry. A few days ago, I just made a call to the blood station and a green channel was opened. As a result, it won’t work today! After asking, I found out that it was this young doctor named Xu Qiu who was responsible.
Realizing that something was going wrong, Gao Pei'an hurriedly stopped him and said: "Zhang Ju, I will make an exception and come here to fly the knife. You should also show me some respect. Xu Qiu is my teacher's favorite junior, you'd better be careful with your words!" Director Zhang choked. In the end, he sneered a few times, gave Xu Qiu a slap in the face and left. Another voice came from afar: "Professor Gao, I'm just a junior, why do you care so much about him? Such a boy who doesn't know how to adapt is destined to never achieve great things!" Gao Pei'an scolded him with a cold face: "Shut up." Only then did Director Zhang realize that Xu Qiu's identity was not simple, and finally calmed down. … On the elevator. Xu Qiu thought for a while and stopped on the obstetrics and gynecology floor. As a result, as soon as he stepped out of the elevator door, he bumped into the oncoming Li Xue. "Doctor Xu!" Li Xue was extremely anxious at this moment. When she saw it was Xu Qiu, surprise appeared in her eyes. "Something happened again?" "Yes...it's that Li Qianqian again, she has a brain hemorrhage!" Xu Qiu was startled. Cerebral hemorrhage? How could there be a cerebral hemorrhage! He looked at the medical record Li Xue was holding, which belonged to Li Qianqian. Xu Qiu took it and quickly read through it while rushing to the emergency room. At the same time, various symptoms from the physical examination at that time also passed through my mind quickly. Irritability, sweating, difficulty breathing, increased heart rate, heart failure... And now, another sudden cerebral hemorrhage... At this moment, he suddenly stopped and the picture in his mind was fixed on a certain scene! Xu Qiu's eyes lit up and she finally figured everything out!
