The only thing we can do is to reduce our own pressure and minimize the resistance. Therefore, the physiological structure of pulmonary circulation is reflected in the short pulmonary blood vessels, thin wall, and large expansion. This can speed up the blood flow and quickly expand the volume to accommodate the huge cardiac stroke volume.
In pulmonary hypertension, which is contrary to normal physiology, the pressure and resistance of the pulmonary arteries are increased, and the blood cannot receive the blood pumped by the heart, causing the heart's blood to accumulate in the right ventricle. Over time, the right ventricle is forced to expand, leading to right heart failure.
Du Meng'en, who proudly expressed his opinion, waited for a while and saw that Xie Wanying did not agree, so he asked: "Do you think the patient does not have pulmonary hypertension?"
Pulmonary hypertension is divided into primary pulmonary hypertension and secondary pulmonary hypertension. Simply put, it means pulmonary hypertension caused by problems with the pulmonary arteries themselves or pulmonary hypertension caused by other diseases including heart disease or systemic diseases. Primary pulmonary hypertension is a rare disease clinically, and its cause is currently unclear in modern medical research.
Secondary pulmonary hypertension is more common clinically. At this time, pulmonary hypertension may be a complication, comorbidity, or syndrome.
"Why do you think the patient has secondary disease rather than primary disease?" Du Meng asked, not thinking that she could tell anything based on the patient's clinical symptoms just now.
She didn't have the patient's medical records and examination reports as evidence base, so Xie Wanying didn't dare to vouch for it, but there was something she could try to discuss with her classmates, saying: "The patient's attending doctor is in the cardiac surgery department, not the thoracic surgery department."
After Du Meng'en heard her finishing words, his lungs felt like he was about to bleed profusely. He held her finger on her for a long time and didn't know what to say: You guys, aren't you the legendary academically stubborn person? How did you learn to be opportunistic?
What it means is that the patient's attending team is responsible for extracardiac surgery, not thoracic surgery. If the problem is lung-dominant, the thoracic team should be seen. Guozhi is not another hospital, it is a specialized hospital. It is more detailed in this aspect, including separate cardiac surgery and separate thoracic surgery.
In any case, Ye Qing and Du Haiwei, who were walking in front, clearly heard the discussion of their group of students behind them and burst out laughing. It can make two serious teachers laugh out loud, which is enough to prove how weird Xie's answer is.
Du Meng'en tugged on the collar of his white coat unconvinced and said to her: "Did you know? Patients like this, whether it is secondary or primary, will basically die after giving birth."
Xie Wanying could not deny her commitment to classmate Du. Patients with pulmonary hypertension during pregnancy are a key patient group targeted by obstetricians, gynecologists and cardiovascular doctors. Patients like this are most afraid of sudden death. For this reason, clinicians often recommend early termination of pregnancy for such patients. If there is a primary disease, treat the primary disease and see if another pregnancy can occur. After all, I only have one life, so there is no need to fight for a child.
Unfortunately, some women will do whatever it takes to have a baby. This kind of maternal love is like a moth flying into a flame. On the one hand, it makes people feel admirable. On the other hand, it seems to put doctors and their families on the stake.
Maybe some patients always think that clinical practice can be like a TV series and they can perform miracles as long as they dare to work hard and ignore some scientific facts. The fact is, the mortality rate from this disease is too high.
