I Can See Health

Lu Chen's faint words made both people in the office stunned.

"This, isn't this the speed limit?"

Lu Wenguo's brows furrowed into the character "Sichuan".

He walked to Lu Chen and watched him making gestures on the electrocardiogram, feeling surprised and uncertain.

The director of the cardiology department is very senior. He has been engaged in clinical work for more than 30 years and has rich experience.

Many young people in the hospital were brought out by Lao Dong.

Could it be that the electrocardiogram that Lao Dong couldn't see was seen by his son, who had just graduated from medical school?

impossible!

Absolutely impossible...

Wu Yun didn't have so many thoughts, and asked quickly: "Xiaochen, you said this is not superspeed, what could it be?"

Lu Chen laid the electrocardiogram flat on the computer table, then looked up at Lu Wenguo and Wu Yun.

"What can you see when you first look at this picture?"

Study this EKG again.

Wu Yun found that he could only detect tachycardia, a tachycardia with a narrow QRS wave.

"I, I'm not very good at reading electrocardiograms." Wu Yun touched the back of his head awkwardly, "I can see a narrow QRS tachycardia."

"Dad, what do you think?"

Lu Wenguo groaned: "First there is left axis deviation, then there is narrow QRS complex tachycardia, there is rSR' type in lead V1, and there are thick and blunt S waves at the end of leads V5 and V6. This should be the right bundle. Branchal block.”

Lu Chen smiled and gave Lu Wenguo a thumbs up.

"Dad, you are pretty good. You almost told me all the contents of this electrocardiogram."

But Lu Wenguo frowned: "Xiaochen, if this is all, then the diagnosis made by the director of the Department of Cardiology should be correct. This is supraventricular tachycardia with right bundle branch block."

Wu Yun also looked at Lu Chen with the same confusion. Isn't this the highway speed?

Why do you say it's not a speed limit?

Lu Chen smiled and took out the compass, "Dad, let me draw on the picture and you will know."

"Look at the electrocardiogram. What's the relationship between the rhythms of the atria and the ventricles?"

Lu Wenguo looked towards where Lu Chen was pointing.

The rhythms of the atria and ventricles seem to be unrelated.

When the heart beats normally, the sinoatrial node causes the atria to beat, and the atria stimulate the ventricles to beat.

The rhythms of the atria and ventricles are regular and fixed.

But in this picture, the beatings of the atria and ventricles are completely separate!

The atria beat their own, the ventricles beat their own, there is no connection between the two!

"This, is this room separation?"

Lu Wenguo grabbed the electrocardiogram on the table and looked at it without blinking.

"Ah? Atrioventricular dissociation?" Wu Yun was stunned, "Isn't atrioventricular dissociation the most common electrocardiogram seen in ventricular tachycardia, atrial fibrillation, and high-grade atrioventricular block? Then this picture..."

"Well, Brother Yun is right!" Lu Chen nodded and smiled, "This is atrioventricular dissociation. This picture shows a very special type of ventricular tachycardia - left posterior branch ventricular tachycardia."

"Left posterior branch ventricular tachycardia originates from the left posterior branch area, which is excited first, followed by the left anterior branch and right bundle branch areas, which is equivalent to being passively blocked by the latter two branches."

"Therefore, the electrocardiogram showed right bundle branch block + left anterior fascicular block."

"Right bundle branch block is manifested by rSR' pattern in lead V1 and thick blunt S wave at the end of leads V5 and V6. Left anterior branch block is manifested by left axis deviation. These two characteristics constitute the left ventricular The most striking feature of idiopathic ventricular tachycardia.”

"So, left posterior branch ventricular tachycardia can easily be confused with paroxysmal supraventricular tachycardia with right bundle branch block."

The barriers between various medical specialties are extremely deep, and the various internal medicine specialties do not understand each other very well, let alone internal medicine and surgery.

Lu Wenguo and Wu Yun had never heard of this "left posterior branch ventricular tachycardia".

Although he didn't understand what Lu Chen was talking about, Lu Wenguo had an intuition that Lu Chen was most likely right.

Because in this electrocardiogram, he did find the phenomenon of atrioventricular separation.

"Xiaochen, ventricular tachycardia is a malignant arrhythmia. For most people, if ventricular tachycardia lasts for such a long time, they should be dead." Wu Yun said doubtfully, "However, our patient is in stable condition, but he feels a little flustered. Hemodynamics They are all stable, it doesn’t look like ventricular tachycardia!”

Lu Chen explained with a smile: "Because this left posterior branch ventricular tachycardia is a benign ventricular tachycardia, which is common in healthy men."

Wu Yun was like a student full of curiosity at this time, "Then how should this kind of ventricular tachycardia be treated?"

Lu Chen picked up the milk tea on the table and took a sip.

"This type of left posterior branch ventricular tachycardia has another name, verapamil-sensitive ventricular tachycardia. As the name suggests, verapamil can terminate its onset."

Lu Wenguo and Wu Yun looked at each other, and both of them could see the surprise in their eyes.

Lu Chen spoke clearly and logically, and every sentence made sense. He had to be convincing!

Is this still a newly graduated medical student?

"Dad, please don't look at me with such surprised eyes." Lu Chen shrugged his shoulders and said, "When I was an intern at the Department of Cardiology, Jiangcheng Central Hospital, I encountered several cases of this kind of patient, one of which It was also treated as supraventricular tachycardia, and was finally discovered because radiofrequency ablation failed.”

Wu Yun smiled at the side and said, "Xiaochen, you can't just read an electrocardiogram once. You must have put in a lot of effort."

At this time, Lu Wenguo had almost believed Lu Chen's diagnosis.

But just to be on the safe side, he still called the director of the cardiology department.

The old director was lying down in the duty room and scrolling through Douyin. When he saw the call from Lu Wenguo, he sighed helplessly.

"Hey, these surgeons are just too nervous. Aren't they just suffering from supraventricular hyperplasia? It took a lot of phone calls."

Old Dong sat up, cleared his throat, and answered the phone.

"Hey, Lao Lu, your patient hasn't recovered yet?"

"Not yet. UUReading www.uukanshu.net "

"Ouch, Lao Lu, don't be too nervous. Many patients in our department have heart rate surges that last for most of the day. Use Cordron and your heart rate will slowly come down."

Lu Wenguo held his mobile phone and recalled what Lu Chen said just now, "Old Dong, do you think this patient may not have supraventricular tachycardia?"

"How could it be? I looked at the electrocardiogram." Lao Dong smiled, "Supraventricular tachycardia with right bundle branch block, it's correct, I guarantee it."

Lu Wenguo paused and said slowly: "Old Dong, please don't mind if I put forward individual diagnostic opinions."

"It's okay, just tell me." Old Dong found it a bit funny. How can a surgeon analyze such an electrocardiogram?

"Do you think this electrocardiogram suggests left posterior branch ventricular tachycardia?"

"Ah? What?" Old Dong looked stunned, "Left posterior branch ventricular tachycardia?"

"yes."

Both sides of the phone suddenly became quiet.

It seemed that only the other person's breathing could be heard.

Lu Wenguo was waiting for Lao Dong's reply.

In Lao Dong's mind, he was recalling the electrocardiographic characteristics of "left posterior branch ventricular tachycardia".

After a long while, Old Dong said: "Lao Lu, please send the electrocardiogram to my WeChat. I will take a look at it and get back to you later."

"good."

After hanging up the phone, Wu Yun immediately stepped forward: "Director Lu, what did Director Dong say?"

"Let me send him the picture again, and he will take a look at it."

Lu Wenguo quickly sent the electrocardiogram to Lao Dong via WeChat.

About two minutes passed.

Lu Wenguo received Lao Dong’s WeChat message.

"Damn it, Lao Lu, when did you learn to read an electrocardiogram?! You are trying to destroy my job!"