Another important factor is that, as Lin Hao suspected, the child’s clinical symptoms were “too mild” and many of them did not match the description of the disease in the textbook.
It is written in the textbooks that the clinical symptoms of this type of children are: difficulty breathing, hypoxia cyanosis, heart failure, etc. If they are not treated with surgery as soon as possible, they will soon die from a serious neonatal heart disease.
Of course, it is written in the textbooks that children with hypoplastic left heart can be easily missed because the above symptoms may reappear after a few hours or within a day or two.
Looking back at the birth history of this child, this is indeed the case. The birth records show that there were no major problems with dyspnea or heart failure. Given that routine examinations for newborns do not include electrocardiograms and echocardiograms, it is unreasonable to accuse the obstetric hospital of missing the child when the child was asymptomatic in such a short period of time.
When the obstetric hospital noticed that the child had some breathing problems, it did not fail to act responsibly, but instead performed the best possible examination on the child as soon as possible. So the problem was not failure of responsibility, but the limited technical capabilities of the grassroots hospital.
The obstetric hospital showed the newborn's ultrasound cardiogram, but did not give a diagnosis. It was just a preliminary suspicion that the child had heart malformation and heart disease. To make an accurate diagnosis, it was necessary to find a specialist in a specialist hospital to make a judgment.
Let me explain one more thing: it is not easy to diagnose hypoplastic left heart. The main reason is that this disease is very rare in clinical practice in China, and the incidence group is mostly abroad.
Clinical doctors cannot make diagnoses based on textbooks. There are too many similar diseases in the clinic, and too many special cases that confuse each other. Clinicians need to learn real cases in the clinic and have a clear understanding before they can make diagnoses. Therefore, the primary hospital was unable to make a diagnosis and sent the first child here.
Two days had passed, and the child's symptoms were still so "mild". The young doctor, who had never seen such a case, must have had doubts in his heart when making the diagnosis. As a result, Dr. Cheng did not dare to say a word for a long time, and could only wait for his superiors to express their affirmative or negative opinions.
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Now it is not a missed diagnosis but a possible misdiagnosis.
Is hypoplastic left heart really such a serious disease?
If not, it needs to be handed over to the anal atresia surgery. You see, Dr. Wu, who is in charge of the anal atresia surgery, came out and said that either let my surgery be done first.
If it is this disease, there is no need to say anything. The heart surgery may have to be performed tonight. Non-cardiology doctors know that hypoplastic left heart is more likely to kill the child in a short time than anal atresia with fistula.
"Yingying, what do you think?" Lin Hao turned his head and asked classmate Xie.
Unlike them, Xie had been staring at the child's ECG monitor early in the morning and might have had some answers in mind.
Like other students, Xie Wanying had not seen the echocardiogram report yet. She could only make a judgment based on her own observations and said, "I estimate that this child's left ventricular cavity is relatively small and has mitral atresia."
Sounds like a sign of hypoplastic left heart.
Let’s go back to the original question, what is left heart hypoplasia?
The reason why hypoplastic left heart is called a syndrome is that it is not one abnormality but a combination of multiple abnormalities.
Medically, the heart can be divided into the left heart system and the right heart system. The left heart system includes the left atrium, left ventricle, and atrioventricular openings such as the bicuspid valve and aortic valve and connected blood vessels such as the ascending aorta.
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