The patient had edema in both lower limbs and slightly distended jugular veins, which are manifestations of late-stage right heart failure. These numbers and symptoms are still under control after the patient continues to receive some medication. This shows that the patient’s condition is as bad as one can imagine, and his heart function has reached the dangerous level four.
For critically ill patients like these, no matter how good the ward is, even if it has a TV and a refrigerator, it is useless because they cannot afford it.
Du Yeqing took out a stethoscope from his white coat pocket and handed it to Du Haiwei.
Du Haiwei shook his head. As for listening to the heart and lungs, he is not as professional as a cardiothoracic surgeon. The description of the cardiothoracic surgery hospital here is enough.
"During the physical examination this morning, the breath sounds in both lungs were coarse, with no rales, a hyperactive second heart sound in the pulmonary valve area, a systolic murmur in the precordial area, and the cardiac border was enlarged to the left." Du Yeqing added to the patient's physical examination data.
A head nurse and a nurse were standing at the scene, holding a fetal heart monitor and placing it on the patient's belly to check the baby's heart rate.
This is the diagnostic and treatment work that obstetricians and gynecologists are good at. Du Haiwei walked closer to listen to the fetal heart rate data.
The baby's fetal heart rate is OK and within the normal range. Judging from the patient's abdominal circumference and the medical records, the fetus should now be over thirty-four weeks old. At 26 years old, this patient is not considered old for a pregnant mother. On the contrary, she is at the right age to become pregnant and have a child. Even if the mother is not elderly, she may still have other diseases that directly endanger the health of the mother and the child.
Du Haiwei looked up and wanted to talk to the patient himself to ask about his condition, but then he saw that the patient was breathing medium-concentration oxygen and was obviously in a state of hypoxia. His mind was not very clear, and it would be impossible to get any information from him in this situation.
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The group finished seeing the patient and left the ward.
Since several young medical students had not had the opportunity to browse the patient's medical records before, they could only look at the patient's condition on the spot and make their own guesses.
Du Mengen pulled the corner of Xie's clothes and asked her, "What do you think is wrong with her?"
There is no one else to ask, so why ask her? It is obvious that the teacher's son is only interested in her answer.
When people asked her, she must have some idea in her mind after seeing the patient, just like the other doctors who were listening. Medical students normally communicate on an equal footing. Xie Wanying calmly asked the other party, "What do you think?"
"This is what I think." Du Meng'en could not hold back his academic insights and began to talk freely. "The patient is in the late stage of pregnancy and is not an elderly mother. It is very likely that she has a congenital disease and is not suitable for pregnancy but insists on getting pregnant, which leads to this situation. Looking at the patient's symptoms and signs, I personally think that she is very likely to have primary pulmonary hypertension."
After hearing what he said, other people thought: After all, he is the son of a famous teacher and a top student studying in a well-known medical school. It is rare for him to be able to make such a quick judgment without looking at the medical records and only looking at the patient's condition.
Having said that, some of this patient’s significant clinical manifestations were not too difficult for doctors to judge. Right heart failure is common clinically, especially in pregnant women, and is a typical manifestation of pulmonary hypertension.
What is pulmonary hypertension?
Before we can explain hypertension, we must first talk about what normal pulmonary artery blood flow pressure is like.
The normal pulmonary artery has a low pressure because the pulmonary circulation is not like the systemic circulation. The lungs are close to the heart, and the blood vessels without systemic circulation are far from the heart and have more blood vessels, which can provide a good buffer zone. Under this premise, the pulmonary circulation is able to accommodate all the blood pumped out by the heart at one time.
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