What kind of patients and family members do doctors are most afraid of? During the consultation, I concealed my medical history from the doctor for various reasons!
At 10 pm, the Department of Cardiology of Xu Mining General Hospital, the patient was highly suspected of acute myocardial infarction. On one hand, the doctor was racing against time to find the cause of the disease and urgently saving lives, while on the other hand, the family members who were nervous about their mouths and refused to tell the patient's medical history.
"The patient's condition is very dangerous now. Director Qi wants to confirm again. Did the patient receive any strong stimulation before the onset of the disease? Have you quarreled with his family or encountered something particularly sad?" After the doctor received a negative reply, he participated in the rescue again.
A female patient, 64 years old, was rushed to Xuming General Hospital for emergency treatment by 120 for acute chest pain 1 hour ago.
Preliminary examination points to acute myocardial infarction
At 9 o'clock that night, Qi Chunmei, director of the Department of Cardiology of Xu Mining General Hospital, finished her day's work and was about to go home. She received a call from the doctor on duty at night shift: "A patient with chest pain and just came to the emergency department. The electrocardiogram prompted myocardial infarction on the left main trunk. You should go to the catheter room! "
Qi Chunmei was running towards the way to the catheter room and received a second call: "The patient's blood pressure can only be maintained at 50mmHg/40mmHg. Hypotensive shock lasts for half an hour. Have you given up treatment?"
The mortality rate of myocardial infarction in the left main trunk is extremely high. Myocardial infarction causes hypotensive shock for more than half an hour, and the chance of being rescued is extremely low.
Qi Chunmei asked the doctor on duty to never give up his efforts until the last moment, inject a pressure-up medication, and push the patient into the catheter room for surgery. After entering the catheter chamber, Qi Chunmei quickly changed into lead . The assistant told her that the examination results all pointed to the left main trunk myocardial infarction. had already injected the patient with a large dose of pressure-enhancing drugs, but it did not work at all.
Acute myocardial infarction is because the blood vessels in the heart are blocked by a thrombus and the blood cannot flow. The distal cardiomyocytes will naturally be ischemia and hypoxia, and will soon die. Cardiac myocardial cells are not ordinary cells and cannot regenerate. If one dies, one less will die, and one more dies... the whole heart will go on strike.
Once the heart strikes, heart failure will occur, and the patient may die. Therefore, the only effective way to treat myocardial infarction is to open blocked blood vessels (coronary arteries) as soon as possible. As the saying goes, "Time is the myocardium", this is a disease that cannot be delayed for a moment. In addition, the patient's blood pressure continues to drop, and all organs of the body cannot get the supply of oxygen , which can also cause exhaustion.
Qi Chunmei asked the assistant to fully communicate with the patient's family to explain the severity of the patient's condition. The patient's family decided to let the doctor give it a try.
1 The patient ruled out myocardial infarction, and the family kept silent
Coronary angiography was beyond everyone's expectations. The patient's coronary artery blood vessels were unobstructed, without thrombosis, no obvious stenosis, and no spasm . In other words, the patient does not have a myocardial infarction!
Considering that the patient is a middle-aged and elderly woman, Qi Chunmei thought of a disease: stressed cardiomyopathy . patients usually develop the disease after being strongly stimulated. The heart is suddenly thinning in an emotional state, anxious and nervous, and then bulges like a balloon after being hit by blood, so it is called stress cardiomyopathy. There is also a simple name for this disease: "Heartbreak Syndrome".
If it is confirmed that the patient has encountered strong stimulation before the onset of the disease, it can basically be confirmed that he has "heartbreak syndrome". Qi Chunmei asked her assistant to go outdoor catheter to consult the patient's family, whether the patient was strongly stimulated before the onset of the disease. Outside the catheter room of
, more than 10 families looked at each other and denied it. received a negative answer from the family. Qi Chunmei carefully traced her diagnosis and treatment process, for fear of losing any details.
is aortic dissection ? Pulmonary embolism ? acute myocarditis caused by cold? She checked the diseases that could cause this symptom one by one.If you do another electrocardiogram, it still indicates a myocardial infarction on the left main trunk. asked the patient's family again whether the patient was strongly stimulated before the onset of the disease, and received a negative answer again.
Home family was moved by the doctor and told the truth
The blood pressure of the patient gradually increased under the action of the drug, but the cause of the disease is still a mystery. After eliminating aortic dissection, pulmonary embolism, myocarditis, and other diseases, Qi Chunmei became more convinced of her judgment: it is heartbreak syndrome.
There is another way to judge heartbreak syndrome, that is, you can see heart deformation on ultrasound. When the patient's heart cavity is deformed and bulged, there may be local thinning, and there are dysfunctions of contraction and movement, and there are segmental movement abnormalities. At the same time, the function of ejaculation can be seen to be reduced.
It was already late at night and the doctor in the heart color ultrasound room had already gotten off work. For the patient's life, please ask colleagues from the Heart Color Ultrasound Room to come to the post immediately. The doctor arrived at work in the middle of the night and really moved the patient's family. When the patient was carried onto the operating table, a patient's family secretly told the doctor who was doing the color ultrasound: the patient had a big fight with his family during dinner, and then he was so angry.
Heart color ultrasound results are exactly the same as Qi Chunmei expected. The patient's heart is like a blown balloon, with an ejaculation score of up to 30, and was diagnosed with heartbreak syndrome. "She is not diagnosed with 'heartbreak syndrome' again, and the hearts of our doctors in the whole department are 'breaking'!" said Qi Chunmei.
The following problem can be solved by finding the cause. Drug treatment and psychological counseling, and the patient recovered and discharged from the hospital soon.
"Lovebreaks" may also cause "heartbreak syndrome"
Qi Chunmei told reporters that "heartbreak syndrome" is common in middle-aged and elderly women. When the disease occurs suddenly, there are obvious psychological or physical emergency situations as inducing factors. Often, it can become sick after a sudden emotional excitement. Clinically, many young people can also cause "heartbreak syndrome" due to strong stimuli such as love breakup.
Broken Heart Syndrome is life-threatening, characterized by transient local contraction disorder in the left ventricular, similar to acute myocardial infarction, but there is no evidence of angiography for obstructive coronary heart disease or acute plaque rupture. In some cases, it can lead to severe myocardial weakness, which leads to congestive heart failure, hypotension, , shock, , etc. Qi Chunmei reminds that emotional problems deserve attention, and maintaining a good mood is also protecting the heart.
Producer: Rong Liangqun
Editor in chief: Wang Yunqing
Editor: Deng Yonghong
Editor: Deng Yonghong
