Chapter 143 Diagnosis: Aortic Dissection (Part 2)
"Okay, I got it!"
When Wei Ping heard this, he went straight to the scene.
I saw only six people surrounding a middle-aged man.
The middle-aged man had a Mediterranean hairstyle, his face was pale, and he was covering his chest with his hands, looking very uncomfortable.
Among these people, they are easy to identify by their clothes.
Half of them were family members, a middle-aged woman, and two teenagers around fifteen or sixteen years old, who should be their children.
The other half are medical staff.
Among them is Guo Yongping.
At this time, a woman with disheveled hair, who looked to be in her forties, pointed at Guo Yongping and said:
"Didn't you say that angina would be relieved by taking nitroglycerin sublingually? Why hasn't my husband gotten better? You quack, I want a three-fisted doctor to see me! I don't trust you!"
Guo Yongping was not in a hurry.
Then she said, "Your husband's current condition may be an acute myocardial infarction. He needs interventional treatment as soon as possible!"
Acute myocardial infarction and striate myocardial pain both present with precordial pain, but the causes, duration, and effects after taking nitroglycerin are different.
The symptoms of the former cannot be relieved after taking it sublingually, while the symptoms of the latter often are relieved within a few minutes after taking it sublingually.
Guo Yongping's judgment is also based on facts.
"I don't believe you! Let Dr. Sanquan come and see us. We only trust him!" the woman said again.
"I'm the deputy director here. If you don't trust me, who do you trust?"
Guo Yongping retorted at this time.
The title of this deputy director is quite intimidating.
The middle-aged woman was frightened.
Yes, the deputy chief physician must be more powerful than the three-punch doctor, right?
You can tell from his appearance that he has very little hair on his head.
He must be a great expert.
But I just took the medicine, but I still don’t feel any better.
He can't do this. This method of elimination makes people very uncomfortable.
"What's wrong?"
Wei Ping walked towards here.
Guo Yongping said, "Go get an electrocardiogram directly."
"Mom, he's Doctor Three Punches. I recognize him. He's our school's idol!"
At this time, one of the young men pointed at Wei Ping and said.
"Is this Doctor Sanquan? Great, please come over here and help my husband!"
As for the man lying on the bed, his complexion looked a little better.
Maybe it’s because of Wei Ping’s arrival.
"Tell me, what's wrong?"
"At this moment, it hurts..."
The man said, clutching his chest.
"Describe the pain."
"I felt like my whole body was being torn apart, like a knife was cutting my chest."
When Wei Ping heard this, he felt something was wrong.
At the same time, he asked, "Does it hurt between your shoulder blades?"
He touched the other person's shoulder with his hand.
"pain……"
Wei Ping probably knew what the disease was.
But just to make sure, he immediately turned on the perspective.
APP prompts: "Perspective experience +1, 289/1000"
He quickly checked the man's arteries.
At this time everyone was confused.
Why do you keep staring at men?
Guo Yongping said, "This is a myocardial infarction. We need to provide emergency treatment quickly and administer thrombolysis and anticoagulation treatment immediately. Don't waste time!"
After all, time is of the essence when it comes to patients.
He concluded that it was a myocardial infarction and that immediate treatment was required.
Common treatment options include percutaneous coronary intervention, thrombolytic therapy, and emergency surgical bypass surgery.
But if not, then the patient suffers.
"etc!"
Wei Ping said.
He has discovered the disease.
At this time, there was a hole in the intima of the opponent's aortic wall, a dissection hematoma had formed in the middle layer of the arterial wall, and the intima of the aorta had begun to peel off.
"I suspect it's aortic dissection. I need to get a CT angiogram as soon as possible to confirm it."
Aortic dissection is the most dangerous disease in cardiac surgery and is known as "a time bomb that can explode at any time."
The incidence rate is about 5 to 10 cases per million people per year, with the peak age at 50 to 70 years old and the male to female ratio being about 2 to 3:1.
With the development of society, the incidence of aortic dissection in China has been increasing in recent years, and it has become a common disease in cardiac surgery. The mortality rate of untreated acute aortic dissection can reach 80%.
Aortic dissection presents with an acute onset. Pain is the most common symptom of acute aortic dissection, accounting for 74%-90% of cases and is often the first symptom. The pain is sudden and severe, difficult to relieve, and can feel like a tearing or lancing pain. It is most often located in the anterior chest area, but pain in the interscapular region is also common.
Everyone was confused at this time.
The woman asked, "What is aortic dissection? What is this disease?"
Obviously, they didn't know what the disease was.
But other medical staff knew that if the disease was acute, it would be very dangerous.
As for Guo Yongping, he is not wrong either. This disease is very easy to misdiagnose!
The clinical misdiagnosis rate of aortic dissection is high, and it is easy to be misdiagnosed as myocardial infarction, pulmonary embolism, etc., so special attention should be paid in early treatment.
At present, thrombolysis and anticoagulation have been widely used in the treatment of acute myocardial infarction. For patients with acute chest pain, if aortic dissection is suspected, do not rush to use thrombolysis and anticoagulation treatment, otherwise the consequences will be unimaginable.
Just now Guo Yongping was about to use thrombolysis and anticoagulant treatment.
If he is really allowed to use it, the patient will probably be in great trouble.
This created huge difficulties for subsequent treatment.
For aortic dissection, CT angiography (CTA) is convenient and safe and is the preferred examination method. It can observe the dissection septum separating the aorta into the true and false lumens and the involvement of the main branch vessels.
My dear, there is more to this chapter. Please click on the next page to continue reading. It will be even more exciting later!
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