Chapter 2374 Like a 134-Year-Old Patient

After explaining the operation images, Zheng Ren fell to the ground with a stone.

This kind of cardiac X syndrome is not uncommon, but it is particularly easy to be ignored. After all, it is difficult to find out the truth through non-invasive examinations. It is normal for patients to go to countless hospitals and not get a definite diagnosis in the end.

"Ahh!" Su Yun was stunned for a moment, and then said: "I forgot one thing!"

"Ah? What's wrong?" Zheng Ren asked in surprise.

"Boss Wang came looking for you just now." Su Yun said, "He asked me if you have time, and when he came out, he saw a patient with heart X syndrome..."

"Oh, what does Mr. Wang want from me?" Zheng Ren asked.

"It is said that there is a patient who has difficulty breathing and faints when walking. There is nothing to diagnose. I want you to take a look." Su Yun said, "The whole hospital is preparing for a consultation in Haicheng. Do you know if the consultation is over?"

"Oh?" Zheng Ren asked, "Did they judge whether it was emphysema or vertigo?"

"Boss, do you need to charge for consultations in the future? Why are we all experts in the imperial capital? Just asking us for consultations is like calling a girl from Tongfang." Su Yun didn't answer Zheng Ren's words, but babbled about other things.

"Don't say it so harshly." Zheng Ren smiled, "Has the information been passed on?"

"No, he just asked to see if you are interested." Su Yun said.

"Let's take a look. If you don't understand, let the patient come over." Zheng Ren said casually.

"What are you doing here?"

"..." Zheng Ren was stunned for a moment, and then said: "Look, touch, tap, listen, look, smell, ask, all you have to do is see the patient. Do you think that remote consultation can solve all difficult and miscellaneous diseases?"

"Boss, why does it seem like you've been stepped on your tail?" Su Yun asked with a smile. He just asked casually, but he didn't expect his boss to be so serious.

But Su Yun didn't care, he just gave up after habitually insulting his boss.

"Don't talk nonsense, ask Mr. Wang for information." Zheng Ren said.

Su Yun took out his mobile phone, and his hands flickered back and forth on the screen of the mobile phone almost with afterimages.

The hospital-wide consultation hadn't ended yet, so it looked really troublesome, Zheng Ren judged. Whether it is the disease or the patient's family, there will be trouble.

Soon, Mr. Wang sent over the patient's information.

The patient complained of malaise, fatigue and dyspnea and was admitted to the hospital for three months.

He doesn't smoke, doesn't drink alcohol, doesn't have pets at home, and eats normally, with no special changes recently. No previous medical history, no family history, etc. The job is a bank clerk, and there is no chance of exposure to dust and other metal substances.

It's just that this happens suddenly, and it doesn't heal for a long time. Both the patient and the doctor are helpless.

A chest X-ray was done at the first visit a few months ago, and it was diagnosed as lower respiratory tract infection, and targeted treatment was carried out.

After anti-inflammatory and symptomatic treatment, his symptoms improved at the beginning, but they recurred again one month later. What's even more strange is that his X-rays did not appear to have any problems after the second time.

All inspections have been done, but there is still no problem found in the patient.

Just looking at the test results, this is a very healthy person. But according to Mr. Wang's description, the patient's condition is extremely serious, and now he can't go up the stairs, and walks tremblingly on flat ground, and has to take a rest after walking a few steps.

Looking at the brief introduction of the patient's condition, Zheng Ren sat on the chair in Zhou Litao's duty room and began to ponder.

"Looking at the briefing of the condition, it looks like severe pulmonary heart disease, but the chest X-ray and lung CT showed no problem." Su Yun said.

Zheng Ren clicked the mouse to enlarge the chest radiograph.

"Do you want the original data?" Su Yun asked.

"No, I can see clearly." Zheng Ren said: "There is no wheezing sound in the medical record, Su Yun, do you think asthma can be ruled out?"

"In the early stages of an asthma attack, the transparency of the two lungs increased, showing a state of hyperinflation, which was not shown on the film, but there are also reasons why the film was not in the asthma attack period." Su Yun continued: "But I don't think about it, it's not at all. Wheezing was not mentioned, and I think this obvious symptom should not be overlooked."

After finishing speaking, Su Yun smiled, "No matter how it is a third-class hospital, if the wheezing sound cannot be heard, Dean Xiao can take the blame and resign."

"Well, and when asthma is not attacking, it is not considered that there will be symptoms of limb weakness." Zheng Ren added, ruling out the possibility of asthma.

"There is nothing wrong with the heart examination. The 24-hour dynamic ECG is also checked. The patient is very healthy."

"Epileptic?" Su Yun asked.

"It's possible. It's possible that the patient complained about the symptoms. It's not right to convulse... If the limbs are weak... Let's keep this diagnosis for now. Although it is unlikely, it is possible." Zheng Ren said in a deep voice.

Su Yun recorded the diagnosis of epilepsy on the A4 paper. If he wanted to confirm the diagnosis, he could do an EEG examination on the patient when the seizure occurred.

After all, it is a remote consultation. If you want to check whether the patient has other reactions during activities and make a more definite diagnosis, the possibility is not great.

"What about pneumonia?" Su Yun said, "On the first X-ray examination, you can see a vague image of inflammation. Although there is no later stage, it cannot be easily ruled out."

"The anatomical classification is lobar pneumonia, lobular pneumonia, and interstitial pneumonia. According to the patient's condition, I think interstitial pneumonia is more likely."

"Etiology is divided into bacterial pneumonia, viral pneumonia, mycoplasma pneumonia, pneumonia caused by other pathogens, fungal pneumonia and pneumonia caused by other non-infectious factors, such as radiation pneumonia, aspiration pneumonia, hypersensitivity pneumonitis..."

Zheng Ren and Su Yun investigated all the way and began to make various differential diagnoses.

Zhou Litao watched silently from behind. The patient was only 34 years old, with weakness in limbs and difficulty in breathing. After many tests, the diagnosis was not clear. It was so strange to watch.

His first thought was that the patient's age was wrongly written.

34 years old! This patient appears to be 134 years old.

...

...

Haicheng, the first hospital of the city.

Although they are off work, the doctors are still working like worker ants.

Mr. Wang is participating in the consultation of the whole hospital.

As the support expert of the imperial capital, now the city's first hospital will ask him to take a look at it when the whole hospital consults.

But this time, Mr. Wang didn't have any idea, so he had no choice but to use the ultimate skill - Summon Boss Zheng.

"The patient's family is very dissatisfied. After so many tests, the diagnosis has not yet been confirmed." Director Zhou of the medical department knocked on the table with his fingers, and said in a deep voice: "If there is no definite diagnosis, the patient should be referred to a higher-level hospital. .”

The director of respiratory medicine nodded.

She had wanted to transfer the patient away a long time ago, but she was still a little worried because the pneumonia diagnosed in the Department of Respiratory Medicine was given symptomatic treatment for the first time.

No one thought that an ordinary pneumonia patient would last for a long time, and finally turned into a huge trouble.

It's just that there is no way, I really don't understand. If you don't go to a higher-level hospital to see her, I'm afraid the patient's condition will get worse.

Judging from the degree of difficulty breathing, it is not impossible to go on a ventilator in a few days.

If that's the case, once you enter the ICU...

Director He of the Department of Respiratory Medicine has begun to think about patient referrals. It doesn't matter if you don't understand the disease, who can guarantee that you can understand all the diseases.

As long as the patient doesn't "smash" it in his own hands.

Director He began to think about how he would communicate with the patient's family. Should he go to the provincial capital or the imperial capital? It seems that in the provincial capital, the patient's family members are more acceptable, after all, the road is closer.

But she didn't think the provincial capital could solve this case, such a weird situation... Thinking about it, she was a little distracted.

The next few directors who came for consultation also expressed their views, and what they said was very simple, and they didn't have anything special to say.

What to check, what is normal, what to say.

It's all nonsense, meaningless.

Mr. Wang repeatedly recalled the patient's condition, but still had no clue. Autonomic dysfunction? Or hysteria? It doesn't even look like it.

It is quite difficult for a 34-year-old man to be so hysterical that he is out of breath when he walks.

Just thinking about it, the phone vibrated.

Mr. Wang glanced at it. It was Su Yun's call. He smiled at Director Zhou in embarrassment, and went out to answer the call with his head down.

Fortunately, this is not 912. If Director Wei is required to sit here, or Director Lin is in charge of the consultation of the whole hospital, he is not afraid of being scolded as a bloody sprinkler? As for Director Ye, Mr. Wang didn't dare to think about it at all.

For ordinary doctors, Director Ye Qingqiuye of the medical office is the captain of Jin Yiwei. If he really came forward, he might lose his skin even if he didn't die.

Director Zhou shook his head, and looked around at the directors of the relevant departments of the First City Hospital. Seeing the expressions on their faces, he had already guessed a thing or two.

Everyone is right.

While going through the referral procedures, he was sent to the provincial capital by 120 ambulance. As for who to contact in the provincial capital, Director Zhou felt that it would be better for the patient's family members to contact them first.

If this kind of thing is done too much, the patient's family will definitely think that there is a problem with the hospital's diagnosis and treatment. If there is no reason, how can they be so attentive.

Among them, the measure mainly lies in a degree, how to grasp it, Director Zhou gradually has a clue. Clinical work is really troublesome, thinking about it, Director Zhou felt bored. When can I go to the logistics work?

"Then it's settled. Director He should communicate with the patient's family." Director Zhou said, "This disease..."

"Director Zhou." Mr. Wang came back with his mobile phone and interrupted Director Zhou.

"President Wang, what do you think?" Director Zhou asked.

"I just consulted with Boss Zheng, and he said that he suggested to check an EEG when the patient has difficulty breathing. In addition, a lung-enhanced CT should also be checked." Mr. Wang said seriously.

He didn't change his expression because it was Boss Zheng's consultation opinion, but just stated a fact calmly.

Director Zhou was taken aback, Zheng Ren? He suggested checking what the enhanced CT of the lungs is for.