It's a bit like doing math problems.
When I first learned, I could only do simple addition.
Later, I learned subtraction, even multiplication and division, and could do some comprehensive questions. Think comprehensively and calculate comprehensively from multiple angles.
This is a significant improvement in diagnostic thinking capabilities.
There seems to be only one level difference between the attending physician and the resident physician, but there is a huge gap in clinical ability and diagnosis and treatment level.
The attending physician has been able to stand alone, but the resident physician is still highly dependent.
Even senior residents still need to consult superior doctors at all times during clinical diagnosis and treatment. When encountering cases with slightly higher risks or more difficult diseases, it is difficult for them to complete them independently.
Under normal circumstances, the attending physician can already solve problems for the chief physician or team leader in the ward.
Only some particularly difficult questions require consultation with the chief physician.
In most cases, even when rescuing patients, the attending physician can independently lead his residents, trainees, and interns, and then complete the rescue task together with the cooperation of nurses.
At this moment, Li Jingsheng has initially achieved the level and ability to treat patients in the field of cardiovascular medicine.
Of course, it's not enough to just be good at diagnosis. You have to improve the efficacy and metabolism of the medicine, so that you can truly have the ability to diagnose and treat patients.
Right now, it only has attending-level diagnostic capabilities.
"The patient's valvular regurgitation is definitely not congenital. Because I have just asked, the patient has had a physical examination and has never had a heart disease. If you can hear a heart murmur, you can basically determine that it is caused by valvular regurgitation, but which valve is closed specifically? Incomplete, still unable to diagnose.”
Damn, this medical skill upgrade is like a matryoshka doll game, it's too over the top.
Each time you upgrade to a level, you can gain a lot and reach a higher level, but you are still a little powerless when facing some difficult and complex cases.
His current doctor level is a senior resident doctor, which also means that his medical skills can only be upgraded to the proficient level.
Because medical skills can only be one level higher than the doctor level.
At this point, the properties panel is severely limited.
This restriction is relatively reasonable.
Otherwise, it would be scary for an intern to have director-level medical skills.
It feels like a baby carrying a big knife.
Even if the interns really have director-level medical skills, because the foundation is very weak, all aspects of medical knowledge have not yet reached a corresponding level, and they cannot integrate them. Therefore, it is difficult to exert the level of director-level medical skills.
The improvement of doctors' level should be the improvement of comprehensive and overall abilities, not just a single medical skill.
"I can't determine which valve is insufficient by listening to the heart sounds, so I won't care about it for the time being. Anyway, my goal is to find out the cause, specific treatment, and diagnosis. I have the doctors in the big hospitals to worry about."
Li Jingsheng decided not to get into trouble anymore.
There are four heart valves, namely the mitral valve, tricuspid valve, pulmonary valve, and aortic valve.
The specific valve regurgitation is set aside for now.
"There are many causes of valvular insufficiency. Among acquired heart diseases, heart enlargement is more common."
As an analogy, a valve is equivalent to a door.
The heart is the house.
Due to some special reasons, the house has become larger in size, but the door is still the same size, which may cause the door to not close tightly.
Gaps will appear.
The function of the heart is to pump blood and is a kinetic energy station for arterial and venous blood throughout the body.
Exports arterial blood to all parts of the body to provide oxygen and nutrients. Then the venous blood is recovered.
This endless life forms the blood circulation of the human body.
Considering that this patient often stays up late, works overtime, and sits for long periods of time, it is very easy to cause an enlarged heart.
Because when people sit, the load on the heart increases.
As for some people saying, isn’t the load on the heart greater when standing? You are wrong.
The gastrocnemius muscle on the calf is the second heart of the human body. It works when people walk. This can greatly reduce the burden on the heart.
Therefore, the burden on the heart is not only minimal when a person is lying flat.
When walking upright, the load on the heart should be minimal.
This is somewhat similar to a horse standing and resting. It always has one leg free and the four legs are constantly rotating.
The human calf gastrocnemius can help the heart easily complete the recovery of distal venous blood and the distal delivery of arterial blood. This is equivalent to putting the heart in a more relaxed semi-resting state.
Doctors often recommend that everyone exercise more, and this is why.
Of course, exercise brings more benefits than just this.
If office workers, especially those who sit in offices, need to sit for long periods of time, there is a simplest way to prevent venous thrombosis in the lower limbs.
That is toe hooking.
Push your toes back hard.
This may pull the ligaments and be a little painful at first, but as long as you can continue to do this action, it will be very good for your body.
"The patient is likely to have an enlarged heart, which then causes valve regurgitation, and then the heart sound is abnormal. But theoretically, valve regurgitation will not cause diarrhea symptoms..."
Li Jingsheng thought about it and felt that although the patient had diarrhea and heart valve insufficiency at the same time, there was no connection between the two.
There should be no danger for the time being.
Only the patient mentioned that the abdominal pain moved upward.
This has to make people vigilant.
"Diarrhea causes lower and mid-abdominal pain, which generally resolves on its own. As long as intestinal obstruction or perforation does not occur, there is usually no danger. But if it is pain in the right upper quadrant, then you must consider whether the appendix is inflamed. If it is pain in other parts of the upper abdomen , there may also be a problem with the ascending colon. But this patient clearly described both times that there was a dull pain in the left chest."
Li Jingsheng frowned and thought.
The patient was holding his stomach firmly, with a painful expression on his face, and could hardly hold it in. He was mainly worried about having diarrhea on his body.
If someone filmed this scene, it would be quite funny.
But behind the scenes, a doctor from a small clinic is trying his best to save a life.
Carefully investigate possible potential dangers.
"Do you have chest tightness?"
Li Jingsheng asked the patient.
"No...can you please give me some antidiarrheal medicine quickly? I have to go home and use the toilet quickly."
The patient urged with some embarrassment.
"I have a toilet here. If you are in a hurry, you can go and solve it at any time. I always feel that your chest pain symptoms are very strange and may be very dangerous. I just can't figure out what is wrong for a while. Give me a little more time. .Even if you don’t buy medicine from me, I can help you eliminate some potential dangers, which is also beneficial to you.”
Li Jingsheng had no choice but to try to comfort the patient.
Sincere communication is conducive to mutual trust between doctors and patients.
It is often easier to communicate with these young people with higher academic qualifications.
Because their ability to understand is stronger.
The patient might not be able to hold it in anymore, so he thought about it for about three seconds, asked for the location of the toilet, and ran in holding his stomach.
Only a folded urban daily newspaper was left, from that day.
You can vaguely see the report on Sunshine Clinic and Li Jingsheng above.
Very few people subscribe to newspapers now.
Some companies or public units have mandatory subscriptions.
Even so, newspapers cannot stop their decline and are being replaced by emerging self-media.
Because the news types on self-media platforms are richer and more timely.
Many news events can be trending on the same day.
Regular newspapers, TV stations, and news platforms have strict review mechanisms, and their timeliness is inevitably much slower.
There is also the content, which is the same as praising virtues. Ordinary people will get tired of it after watching it too much. Some interesting and unique little news is more in line with the tastes of ordinary people.
Li Jingsheng's small clinic was published in the newspaper, which was a great honor, but the publicity effect did not seem to be as significant as imagined.
However, its publicity effect should be relatively long-lasting.
It shouldn’t be difficult to maintain the heat for at least ten days and a half.
Li Jingsheng is looking forward to seeing the new health medicines and tonics arrive tomorrow and continue to sell like hotcakes.
The rent is now the only big thing weighing on his head.
After glancing at the Metropolis Daily that was folded into a rectangular shape, Li Jingsheng seriously thought about the cause of this patient's illness again.
Now it is basically clear that the patient should have eaten unclean food and then contracted viruses or bacteria, causing diarrhea.
At the same time, staying up late and sitting for long periods of time can lead to an enlarged heart and valvular insufficiency.
Why does diarrhea cause chest pain?
No coughing or anything.
This is definitely not radiating pain.
Li Jingsheng thought hard.
Could it be viral myocarditis?
The fatality rate of this disease is quite high, but as long as it is discovered in time and receives regular treatment, it generally does not cause serious consequences.
This disease often occurs after a cold and is a serious complication after a cold.
Especially some office workers who lack exercise.
It’s just that patients with viral myocarditis will have prodromal symptoms before the onset, such as fever, muscle aches, etc. In the acute attack stage, patients will experience general fatigue, chest tightness, palpitations, chest pain, etc., and the symptoms will continue to worsen.
Although this patient also had chest pain, the symptoms were mild and mainly labor pains.
Therefore, the possibility of viral myocarditis can be basically ruled out.
If it's not this disease, what kind of disease could it be?
Li Jingsheng found that after his cardiovascular medicine diagnosis was upgraded to the proficient level, his level has significantly improved.
When conducting in-depth analysis and troubleshooting of the patient's causes, he could clearly feel the huge progress.
It's completely different from before.
Chest pain, diarrhea, and also related to valvular insufficiency... What is the disease?
He asked the patient whether he had any chest pain before diarrhea.
I started experiencing slight chest pain on the second night of diarrhea. Today, already the third day, my chest pain has worsened significantly.
He racked his brains and thought hard.
Suddenly, a light flashed in my mind.
Valvular insufficiency is very harmful. In addition to causing regurgitation, worsening of cardiac function, hemoptysis, chest pain, and syncope, the biggest hazard is virus invasion.
