Another important factor is that, as Lin Hao suspected, the child's clinical symptoms were "too mild" and many of them were inconsistent with the description of the disease in the textbook.
It is written in the textbook that the clinical symptoms of this type of children are: dyspnea, hypoxia, cyanosis, heart failure, etc. It is a type of severe neonatal heart disease that will soon lead to death if surgery is not performed as soon as possible.
Of course, it is written in the textbook that children with left heart hypoplasia can easily be missed because the above symptoms may reappear hours later or within a day or two.
Looking back at the birth history of this child, this is indeed the case. The records at the time of the child's birth showed that there was no major problem of dyspnea and heart failure. Routine newborn examinations do not include electrocardiogram and echocardiogram. It is unreasonable to accuse the maternity hospital of missing the diagnosis when the child was asymptomatic in such a short period of time.
When they realized that the child had breathing problems, the obstetrics hospital did not neglect its responsibilities and instead gave the child as many tests as possible as soon as possible. Therefore, the problem is not a failure of responsibility, but the limited technical capabilities of grassroots hospitals.
The neonatal echocardiogram displayed by the maternity hospital did not give a diagnosis. It was only a preliminary suspicion that the child had a heart malformation or heart disease. To make an accurate diagnosis, you need to find a specialist from a specialized hospital to make a judgment.
To illustrate another problem, it is not easy to diagnose left heart hypoplasia. The main reason is that this disease is very rare clinically in China, and the number of affected people is large in foreign countries.
Clinicians do not rely on textbook guidelines to make diagnoses. There are too many similar diseases in clinical practice, and there are too many special circumstances that confuse each other. Clinicians need to learn real cases in clinical practice and have a good idea before they can make a diagnosis. Therefore, the grassroots hospital failed to make a diagnosis and send Shou Er.
Two days have passed, and the child's symptoms are still so "mild." A young doctor who has never seen such a case must be worried in his heart when making a diagnosis. Because of this, Dr. Cheng did not dare to say anything for a long time and could only wait for his superiors to confirm or deny the decision.
Now it’s not about missed diagnosis but about possible misdiagnosis.
Is left heart hypoplasia really such a serious disease?
If not, it needs to be transferred to anal atresia surgery. You see, Dr. Wu, who was in charge of the anal atresia surgery, came out and said that he could do my surgery first.
If it is this disease, needless to say, the heart surgery may have to be performed tonight. Doctors other than cardiologists know that hypoplasia of the left heart is more likely to kill a child in a short period of time than anal atresia with a fistula.
"Yingying, what do you think?" Lin Hao turned around and asked his classmate.
Unlike them, classmate Xie may already have some answers in mind by keeping an eye on the patient's ECG monitor early in the morning.
Like other students, Xie Wanying has not yet seen the echocardiogram report. She can only make judgments based on what she has observed, saying: "I estimate that this child has a relatively small left ventricular cavity and has mitral atresia."
It sounds like a sign of left heart hypoplasia.
Back to the original question, what is left heart hypoplasia?
The reason why left heart hypoplasia is called a syndrome means that it is not one abnormality but a combination of multiple abnormalities.
Medically, the heart can be divided into left ventricular system and right ventricular system. The left heart system includes the left atrium, left ventricle, and atrioventricular openings such as the bicuspid aortic valve and connected blood vessels such as the ascending aorta.
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