Chapter 167: Step by step dismantling, final determination (first update)
"Then, when he entered the venue, the first thing he noticed was hoarseness. Pulmonary artery dilation causes mechanical compression, which can easily compress the left recurrent laryngeal nerve and cause hoarseness."
Su Hezhi nodded.
He expressed his approval of Wei Ping's words.
"There is indeed such a reason, is there any other reason?"
Everyone was stunned.
Unexpectedly, Su Hezhi actually agreed with what Wei Ping said.
What kind of operation is this?
Could it be that all of Wei Ping's judgments were true? No one could accept this! Such a young doctor must be fooling around.
But some people still disagree and think that Su Hezhi did it on purpose.
"Yes, and then he had severe dry mouth symptoms. Before the lecture started, he had already drunk half a pot of water. His pot was quite large, probably around 2 liters. Drinking water so frequently is very abnormal, but it is also consistent with the underlying condition of pulmonary arterial hypertension. Of course, this could also be diabetes!"
Symptoms related to underlying diseases that cause pulmonary hypertension, such as connective tissue diseases, may cause Raynaud's phenomenon, joint pain, dry mouth, hair loss, and skin sclerosis.
Everyone fell silent as Wei Ping continued his explanation.
The condition is gradually becoming clear.
"Then why does he have angina pectoris?" someone asked.
"As I said earlier, this is a symptom of mechanical compression caused by pulmonary artery dilation. Compression of the left main coronary artery causes angina pectoris. Compression of the left recurrent laryngeal nerve causes hoarseness, and compression of the airway causes a dry cough."
This disease is generally divided into three stages: early, middle and late.
The performance of each issue is quite different.
Early stage: Dyspnea is the first and most common symptom, manifested as progressively worsening shortness of breath after activity or even dyspnea at rest and decreased physical strength.
Middle stage: symptoms of insufficient blood supply to important organs and other tissues of the heart, brain, and body appear, such as syncope, angina or chest pain, fatigue, and decreased exercise tolerance.
Late stage: When right heart function is compromised, corresponding symptoms of right heart failure may appear, such as loss of appetite, nausea, vomiting, upper abdominal distension and pain, swelling in the lower abdomen, pleural effusion, peripheral cyanosis, and neurological symptoms. Ultimately, right heart failure or even death may occur.
To sum up, men should be in the early to middle stages.
If treated promptly, everything is still possible.
Su Hezhi's expression was also changing.
Wei Ping ignored everyone's thoughts and what they said, and continued:
"Combined with severe right heart failure, symptoms include lower limb edema, abdominal distension, poor appetite, diarrhea, and liver pain! I just noticed swelling in his lower legs, suggesting heart failure!"
Wei Ping analyzed step by step, proving bit by bit that his diagnosis was correct.
"Also, people with a history of exposure to risk factors, such as printing factory and gas station workers exposed to oily substances, a history of living in high altitude areas, a history of using special medications, and a history of drug abuse, can all develop this disease. And I saw some colored ink on his fingers, so he must be someone who works in a printing factory!"
"Yes, doctor, you are amazing! I work in a printing factory and have been working there for more than ten years."
The man said at this time.
The condition began to become clear.
Some people's complexions are getting worse and worse.
Especially some people who just questioned Wei Ping.
What they just said was too full.
Now I know, I might be slapped in the face. And it's really loud.
There are some director-level people among these people.
They blindly believed in Su Hezhi.
However, these symptoms do not completely prove that it is pulmonary hypertension.
"Your observation is very detailed. Is there anything else? I think this is the reason why you were finally diagnosed." Su Hezhi asked slowly.
"Just now, when I listened with a stethoscope, I heard a hyperactive second heart sound from the pulmonary valve, a systolic murmur in the tricuspid valve area caused by tricuspid regurgitation, and a gallop rhythm in the fourth heart sound from right ventricular hypertrophy!"
After these words were spoken, Su Hezhi fell silent.
He was wondering if it was pulmonary arterial hypertension, but besides this disease, what other diseases would have these symptoms?
But everything points to pulmonary arterial hypertension.
But the people around were no longer calm.
"Has this stethoscope been used as an electrocardiogram? Is this guy trying to bluff?"
"I can't believe there are still people who use stethoscopes so vigorously! Impossible, that's impossible!"
"Besides, the stethoscope is already outdated and can only be used as an auxiliary device. He actually used it as a reason to diagnose the disease. It's ridiculous!"
Wei Ping didn't want to say anything, especially to those who said that the stethoscope was outdated, because they were too dependent on modern instruments.
This thing is still not outdated.
"Let me hear it!"
Su Hezhi said at this time.
Everyone just shut up.
So, Su Hezhi may have believed Wei Ping's words.
Wei Ping handed his stethoscope to Su Hezhi.
He never had the idea of embarrassing Su Hezhi, because human life was at stake and he didn't want to see pulmonary hypertension being misdiagnosed.
You should know that the misdiagnosis rate of pulmonary hypertension is very high.
Pulmonary hypertension is easily misdiagnosed as a common heart disease. According to one statistic, the misdiagnosis rate before hospitalization is as high as 94%.
The incidence of idiopathic pulmonary hypertension is approximately 1-2 per million people per year, with a higher incidence in women, and the average age is 36. Among patients with pulmonary hypertension, 60% present with dyspnea as the chief complaint, and 98% experience shortness of breath after exertion during examination.
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