N-A-A Chapter 558
Chapter 558
Other results:
Liver and kidney function: normal
Electrolytes: normal
Coagulation indicators: normal...
· D-Dimer: Normal...
"Xiaoru..."
"Teacher..."
"Remember what D-dimer is?"
"You know, this is an indicator of blood clots, once the human body has thrombosis, the body will immediately start the fibrinolytic system accordingly, the purpose is to dissolve the thrombus. The moment the thrombus forms, the thrombolytic system begins. Once part of the thrombus is dissolved, some small molecular substances are produced, and D dimer is one of them. So if we find that the patient D dimer is elevated, it means that there may be a thrombus formation. "
Xiao Ru's knowledge is still very solid, especially after following Lin Feng, he is more diligent.
Lin Feng smiled and nodded: "Not bad, then do you know why I want to check this D dimer?" "
Xiao Ru thought for a while: "It should be to rule out pulmonary embolism... Because the patient complains of chest pain, chest pain may not only be because of the heart, but also may be the liver, kidneys, lungs... Among them, pulmonary embolism is one of the possibilities, so it is necessary to check D dimer. Now, the patient does not have D dimer, which obviously rules out the possibility of pulmonary embolism, and also rules out the possibility of myocardial infarction caused by thrombus blocking the coronary artery. "
Lin Feng was satisfied.
Not bad!
At present, the results of the inspection point to:
Coronary heart disease (that is, coronary atherosclerosis, coronary artery blood vessels have a lot more blood lipids, resulting in narrowing of vascular channels)
Angina.
Lin Feng prescribed medicine.
First of all, antiplatelet, avoid thrombosis, prescribe aspirin, clopidogrel.
Secondly, lipid-lowering drugs, corresponding to high blood lipids.
Finally, nitroglycerin, which belongs to the classic drug of angina, its role is to expand blood vessels, especially the coronary arteries of the heart, so as to relieve cardiac ischemia and hypoxia, relieve angina.
Hospitalization......
Medicine......
soon
The patient Chen Meijuan felt that her body became much more comfortable, chest tightness, chest pain symptoms were reduced, and walking was much easier.
......
At noon, after Lin Feng ate, he went to the ward and inquired about the results of medication.
Seeing that the effect of the medication is good, the problem of the coronary artery is basically determined.
But
Further examination is needed!
- "Coronary angiography"!
Coronary angiography can clearly see whether the coronary arteries are narrowed, whether there is plaque formation, how severe the stenosis is, and even the flow rate.
It is the gold that determines whether it is "coronary heart disease"! Sign! Permit!
If you see severe narrowing of the coronary arteries, which affects the blood supply, you can implant a stent on the spot to dilate the coronary arteries, thereby alleviating the condition.
"Doctor Lin, does this have to be done?"
"It doesn't have to be done... But if you want to confirm, you still need it to confirm..."
"Then do it..."
"Yes, do..."
The couple agreed.
Then half an hour later, the nurse printed an informed consent form, which needed to be signed by the couple, and before signing, the nurse talked about the side effects of coronary angiography.
There are two main aspects:
Side effects of radiation, contrast agents...
The couple thought about it.
At first, I was a little hesitant, but I thought that coronary heart disease is a time bomb, now I am out of breath when I walk, and it will be more troublesome if it is serious in the future, it is better to get this done now.
Agree!
Sign.
As a result, after signing, his wife Chen Meijuan was ready to go to the toilet.
Get up
And then walked a few steps,
Suddenly!
Whoops~~~~
Patient Chen Meijuan fell directly to the ground!
"Husband~~It hurts~~"
At this time, it can frighten the nurse and husband.
Quickly help yourself up.
The nurses are experienced and find this very problematic.
thereupon
After helping the patient to the hospital bed, she quickly ran to Lin Feng's No. 3 consultation room.
"Doctor Lin, that patient Chen Meijuan suddenly fell..."
“？？ Chen Meijuan, who? "
Lin Feng was diagnosing a patient with a chicken problem, and after hearing the nurse's words, he was stunned for a moment, and he didn't remember who it was.
"Admit it in the morning, the patient with coronary heart disease!"
"Oh... Come to think of it...... Wait, fall? "
"Yes, take a few steps, and then suddenly fall ..."
"Coma?"
"No, consciousness is clear."
Now,
Lin Feng's face changed.
If the coma is okay, but the consciousness suddenly falls, it is very problematic.
"Xiaoru, you go over and ask about the situation first, I'll go over after seeing this patient..."
"Okay, teacher..."
Student Xiaoru, go first...
Lin Feng spent 3 minutes to diagnose this patient.
Then walk quickly to the ward.
Came to Chen Meijuan's hospital bed.
"Doctor Lin!"
When the couple saw Lin Feng, they immediately breathed a sigh of relief in their hearts.
Lin Feng nodded.
Turned to Xiao Ru and asked, "What's the situation, is it clear?" "
Xiaoru: "Conscious, there is not much problem, and then I asked five times, why did I fall, the patient said that he didn't know why, just fell suddenly, without any warning..."
Lin Feng looked serious.
This is not a good sign!
Generally, there should be a process when falling.
For example, severe coronary heart disease can also lead to cardiac ischemia followed by heart failure, insufficient blood supply to the brain, and then fainting and falling. But this is a hundred million processes, when the heart is ischemia, there will be chest pain and chest tightness, and there will be no sudden fainting for no reason.
And Chen Meijuan in front of her did not have any warning!
Then it is possible that the condition is more serious!
。