【1241】The academic dispute between two seniors

Young people who go out to work are lonely. If such young people get a serious illness, they may not be much better than the elderly.

Doctor Dong and Sister Xu rushed over and asked Xie Wanying: "Did you do an electrocardiogram on her?"

"It hasn't been done yet. The results of the blood test are not very good, so I asked the teacher to come over and take a look." Xie Wanying said, holding the result report that had just been released by the laboratory department in her hand.

Dr. Dong took the test results from her hand and was surprised: "You didn't do an electrocardiogram on her, how could you suspect that there was something wrong with her heart?"

Generally, patients with colds and fevers do not need to be prescribed examinations related to heart disease.

"Her fever was not very high, not like tonsillitis. She was not in good spirits. I auscultated her and found that her heart rate was fast. Fever and fast heart rate are a relatively normal physiological phenomenon, but her apex pulse point was abnormal. The possibility of moving downward. I calculated it based on her weight and body shape." Xie Wanying explained her thoughts to the teacher.

Others heard that she seemed to be on high alert for myocarditis in young cold patients, like an old cardiovascular doctor who seemed to have seen too many such patients.

Dr. Dong, a cardiologist, and Li Chengyuan, a cardiothoracic surgeon, couldn't help but make eye contact. They heard it, and she had definitely seen and dealt with such patients.

But she has never studied cardiology or cardiothoracic surgery.

"Have you ever seen such a patient?" Xin Yanjun asked Xie directly.

Teacher Xin suspected more than anyone else that Xie had already accumulated a lot of clinical experience.

Xie Wanying must clarify this point. She does not have clinical experience in all diseases, because she was not a clinician before her rebirth.

"We used to have a neighbor who only had a son. After his son caught a cold, he went to the hospital and was not diagnosed with myocarditis at first. He didn't find out until he had heart failure that it was already too late." Xie Wanying said, "This situation seems to be hidden. Progressive myocarditis.”

While expressing his thoughts, he discussed academic issues with the seniors from the Department of Cardiology and Surgery present.

Dr. Dong did not reject her words and said: "Insidious progressive myocarditis is the most troublesome thing. In fact, the prognosis of acute myocarditis is generally better, as long as it is detected and treated early."

"The patient's condition she mentioned." Li Chengyuan disagreed with their statement and said, "It should be dilated cardiomyopathy. As for whether it is dilated cardiomyopathy caused by a virus, this is a question that needs to be explored. Dilated cardiomyopathy It’s two different things than myocarditis.”

"Some patients with myocarditis will eventually develop dilated cardiomyopathy." Dr. Dong argued with him and said.

The doctor who was not a cardiologist could only stand by and listen silently to the two of them arguing.

"Who told you?" Li Chengyuan shook his head at Dr. Dong's words, "Myocarditis caused by a virus may also cause dilated cardiomyopathy. It's not dilated cardiomyopathy caused by myocarditis. Don't get confused."

"You are confused. Some patients with myocarditis will develop dilated cardiomyopathy in the final stage. How could this phenomenon not come from myocarditis? Dilated cardiomyopathy is naturally caused by viral infection, and the latter is undoubtedly the same virus as Associated with infectious myocarditis.”

Debates on academic medical issues are often chicken-and-egg or egg-laying. The two men argued for a long time, and it was obvious that they couldn't decide whether the egg lay the chicken or the chicken laid the egg.

Myocarditis is often called viral myocarditis by clinicians. This does not mean that myocarditis is only caused by viral infection. Myocarditis can be caused by non-infectious immune factors, and there are also toxic myocarditis, such as drug-induced myocarditis caused by taking the wrong medicine.

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