Chapter 1413: Myocardial Infarction or Aortic Dissection?

Chapter 1413: Chapter 1413: Myocardial Infarction or Aortic Dissection?

The next morning, Liu Banxia arrived at the emergency center, beaming with joy.

Yesterday was a proper day, really enjoyable. If only every day could be like that, but alas, my work is so busy that even getting off work on time has become a luxury.

"Teacher Liu, the little baby is fine and seems to be in high spirits," Xu Yino said.

"Very good, then I won’t need to wander over to see. What about our other patients?" Liu Banxia asked.

"Haven’t received any notices, just waiting to check during rounds," Xu Yino replied.

"All right, today I’ll take it easy, you guys go do the rounds yourself," Liu Banxia said casually.

"Teacher Liu, what’s up? This doesn’t look like you trying to slack off," Xu Yino asked curiously.

"Yesterday’s surgery on the little baby was very stressful, I need to take it slow, right? Go on, call me if anything comes up, don’t forget the VIP," Liu Banxia waved.

With suspicion all over her face, Xu Yino obediently went off to do the rounds.

Feeling quite puzzled inside, every morning the time Teacher Liu spends chatting and goofing around with patients is his rare moment of rest.

What’s up today? Not even going to the VIP.

"Honorable Director Liu, do you think once these six can truly take on the role of attending, our rest time will be relatively stable?" Wei Yuan leaned in.

"Definitely, otherwise why would I work so hard? What’s up with you? Why are there dark circles under your eyes? You weren’t on duty yesterday," Liu Banxia asked curiously.

"What else, tutoring. Oh my god, it’s torturing me to death," Wei Yuan said with a wry smile.

"Haha, I haven’t experienced that kind of pain yet. But Qiaoqiao said not to put too much pressure on the little ones," Liu Banxia said.

"Let me tell you, that’s easy for you to say now. When the time comes and you see other kids learning this and that, doing well in school, you’ll be stressed," Wei Yuan said.

"It’s a common ailment among parents, no cure available. If they don’t do well in school, you hope they will. If they do well, you hope they excel. Ugh... you guys have two, tut tut, we’ll see if you can still laugh then."

"Is that really the case? I’ve heard Brother Huan say that families are quite concerned about their kids’ education," Liu Banxia asked.

"It’s all the same, just ask anyone here who has kids, every single one cares. They’d rather live in a smaller house than not buy an expensive school district house," Wei Yuan said.

"Though your family conditions are a bit better, you might be a bit more relaxed in this area. But generally, it’s not much different, just watch."

"Makes sense, my father-in-law’s younger son is also doing well in school, with quite a few tutoring classes," Liu Banxia nodded.

"But let’s talk about it later, with our work, it’s probably hard to invest much in the kids. Yesterday when I got home, I held both of them in my arms, so happy."

"Two babies happy?" Wang Chao asked curiously.

"They didn’t really pay much attention to me, it was me who was happy," Liu Banxia said.

"Tsk tsk, seems like having babies is repaying a debt, who knows from which lifetime," Wang Chao lamented.

"But you still have to have them, just a cycle after another. Once they’re born, you have to take care of their schooling, then work and housing issues when they graduate, it’s a bit worrying."

"What are you worrying about, you’re still far from that point. Just work hard, what’s there to worry about. When the time comes and you have a daughter, she can be a candidate for my son-in-law," Liu Banxia said.

"Pfft, as if I’d fall for that. Don’t think I don’t know, you’re thinking of too many daughters-in-law," Wang Chao scoffed.

Just some office chit-chat before work, once the topic turns to babies, it centers around babies.

"Get ready to receive a patient, someone passed out on a bus. They’re on their way to our hospital now, sounds like a heart issue," at this moment Qi Wentai approached.

"Have you called the cardiology and cardiac surgery departments?" Liu Banxia asked.

"Called, but Director Chen is stuck in traffic, asked if you could assist in the reception and handle any issues directly," Qi Wentai said.

"Any problem is probably a heart attack or something, not really my field. Fortunately, there are others, let’s go see," Liu Banxia nodded.

He was unsure himself, thinking more towards a heart attack. Because that’s what’s going around, it doesn’t matter how old you are these days, it just happens.

The ones accompanying the reception were Peng Bo from cardiology and Liang Xiaolin from cardiac surgery, which is why he was asked to come along and take a look.

After about ten minutes, the bus came over, and once it stopped, Liu Banxia hurried onto the bus with the others.

"Driver, how’s he doing?" Peng Bo and Liang Xiaolin asked while checking, Liu Banxia inquired.

"Not long after we started, he clutched his chest, seems like he came late and ran a bit. Then, after taking some medicine, he fainted," the bus driver said.

"He was unconscious for a while, came around a bit after we drove for a while. But we didn’t dare let him get up, just let him lie there. Is it a heart attack?"

"Alright, thanks driver. Once we transfer the patient, you can get back on the route," Liu Banxia said.

"Thanks to everyone as well, everyone’s waiting to get to work, no one’s afraid of being late, life is of utmost importance," the driver said.

"That’s no problem, later we’ll have a proof from our side, you can note down our phone number as well. There are traffic officers here too, we can all vouch," Liu Banxia said.

"Director Liu, we initially suspect it’s a heart attack. He has a history of heart disease, just felt angina, and took nitroglycerin. Everyone, make way, it’s hard to get a stretcher here, I’ll help him off the bus first," Peng Bo said.

With Peng Bo’s words, everyone also walked down from the front door, giving up the space.

"Don’t worry, we’ve arrived at the hospital, we still have time." Peng Bo said to the patient again.

"Doctor, now half of my arm hurts a bit as well, and I’m feeling a little dizzy." the patient said.

"It’s okay, it might be referred pain. We’ll conduct a comprehensive examination once we’re in the hospital, and have you contacted your family?" Peng Bo asked.

The patient nodded.

"Alright, let’s not talk for now. Director Liu, could you lend a hand?" Peng Bo looked at Liu Banxia.

The patient was somewhat overweight, and he tried twice but couldn’t lift the patient.

Liu Banxia walked over, used some strength, and helped lift the patient up a bit, then squatted down and carried the patient on his back.

Indeed, it was somewhat heavy, this weight must be around 180 pounds.

But this weight was still manageable for him, and it wasn’t too far, he carried the patient directly to the emergency room one.

"Start an intravenous line, measure blood pressure, connect the ECG, electrocardiogram, echocardiogram, blood test, blood biochemistry, focus on myocardial enzymes, troponin." Peng Bo said.

Everyone got into action, after all, the current symptoms indicate a heart attack. This situation is very dangerous, if some people’s heart attacks are not treated in time, they lose the chance.

Peng Bo was not idle either, carefully auscultating the patient’s heart and lung sounds.

Because the patient’s current symptoms only tend towards a heart attack. What if it’s an aortic dissection? This is also very possible.

"Blood pressure 170/100."

The nurse reported.

Liu Banxia frowned, the patient’s blood pressure is indeed high. Because the action of nitroglycerin is to relax the vascular smooth muscle, causing peripheral vasodilation, reducing cardiac output, and lowering the cardiac load.

It is effective for angina, but it can also lower the patient’s blood pressure.

But even with medication, the patient’s blood pressure is still 170/100, which indicates how high the patient’s blood pressure usually is.

This also raised a new issue, the patient indeed might have aortic dissection.

It’s just that the chest pain combined with his history of heart disease made him mistakenly think it was a heart attack, so it is still necessary to look at the ECG, blood test, and echocardiogram results.

"ST segment horizontal depression." Liang Xiaolin, who was staring at the ECG, said.

"Come, do another echocardiogram." Peng Bo said.

If the ST segment was elevated, he would almost directly perform coronary angiography. Although ST segment horizontal depression could also indicate acute non-ST segment elevation myocardial infarction, it is still better to check more thoroughly.

One reason is the cost of coronary angiography is not small, another is because this is an invasive examination.

But after starting the echocardiogram, he frowned.

"Am I seeing it wrong? The patient has asymmetric left ventricular hypertrophy with outflow tract obstruction, we can’t rule out the possibility of aortic dissection. Doctor Liang, what do you think?" Peng Bo said.

"Teacher Peng, I also think we should check further. Don’t you think it might not be a myocardial infarction? Could it be the angina is caused by this asymmetric obstructive left ventricular hypertrophy?" Liang Xiaolin said.

"Have you had your heart checked before? What tests did they perform at that time?" Peng Bo asked the patient.

"That was many years ago, they measured blood pressure, did an electrocardiogram. I have high blood pressure and heart disease." the patient said.

"You never had coronary angiography?" Peng Bo pursued the question.

The patient shook his head, "I don’t even know what that is."

Peng Bo glanced at Liu Banxia, and Liu Banxia nodded.

The cause of the patient’s previous heart disease might have been due to asymmetric left ventricular hypertrophy, not influenced by coronary arteries.

In this case, the diagnosis for a heart attack is not well-supported, the indications are insufficient.

At this time, Liu Banxia also picked up the stethoscope, carefully performed a cardiopulmonary auscultation on the patient.

"The heart has some murmurs, but the breath sounds from both lungs are normal, it shouldn’t be a pulmonary embolism. Are you still in pain now?" After examining, Liu Banxia asked.

"It hurts, this time it’s been painful for too long. Usually, after taking medicine it gets better in a minute or two, but this time it keeps hurting." the patient said.

"Let’s do a chest MRI, just in case it’s an aortic dissection, and also inform the catheter room to prepare?" Peng Bo said.

Liu Banxia nodded, acknowledging his judgment.

However, this is somewhat risky, because if it is indeed a heart attack, it may delay rescue time.

But what if it’s really an aortic dissection? If you treat it as a heart attack with anticoagulation therapy, it could cause the dissection to rupture.

This is why they are so cautious, a wrong judgment might cost the patient’s life.