"Dean, I didn't hear anything abnormal anyway, and as far as I know, myocardial infarction is difficult to detect through auscultation. Generally, electrocardiogram and cardiac enzymes are needed to confirm the diagnosis. Did you hear something wrong?

"

Chen Qi nodded and said seriously:

"Yes, because I suspected that there might be a heart problem, so I listened carefully and found that the patient's heart rate was very fast. Because the heartbeat was too fast, you ignored the appearance of the third heart sound at the apex of the heart.

A third thought appears at the apex of the heart. As a doctor, everyone should know what this means. Yes, it means myocardial or papillary muscle ischemia. This is a very meaningful positive symptom.

That’s why in college, teachers emphasize the importance of physical examination. Sight, touch, and hearing are the basic skills of our medical students. We can’t rely solely on machines to see the doctor, we must use our own brains to see the doctor.

If you don’t have your own opinion, just like this patient, you all missed a very important positive indicator due to carelessness. There are so many doctors and experts in the two hospitals present, but only Professor Tong and I heard that something was abnormal, and outsiders knew

It’s very embarrassing.”

Facing professors and experts from top hospitals in the country, Chen Qi spoke mercilessly, which made many doctors at Xijing Hospital blush.

Professor Tong nodded approvingly at Chen Qi, then looked back at his disciples and disciples, and sighed softly.

"You guys, your stethoscope is just a decoration. You only care about touching your belly. You forgot that I reminded you that the pain may be caused by problems with other organs nearby. You didn't listen at all, right?"

Director Liang, Director Zhou, Director Yan and other professors from Xijing Hospital all scratched their heads in embarrassment.

Others didn't dare to ask anymore, but Lan Lijuan was not afraid. She had never been afraid of Chen Qi since she met him in 1977, so she asked:

"Chen Qi, your judgment of myocardial infarction based on just hearing the third heart sound is too arbitrary, because there is also a physiological third heart sound, which does not necessarily mean there is a disease. Even if it is pathological, it may

It could be mitral regurgitation, ventricular septal defect, patent ductus arteriosus, why do you only think of a myocardial infarction?"

"Well, Dr. Lan asked this question very well!"

Chen Qi gave a thumbs up, and everyone in the restaurant chuckled. No one knew that these two were related by parents-in-law.

"As for the patient Cui Tongzhi's abdominal pain, through a systematic examination, we can rule out inflammatory diseases, perforation or rupture, organ obstruction or expansion, etc. It may also be poisoning, pulmonary embolism, aortic dissection, including our

Abdominal pain due to previously diagnosed epilepsy.

Take aortic dissection, for example. The onset of this disease is very similar to acute myocardial infarction. They both present with severe and sudden chest and abdominal pain. However, the two diseases are easy to identify, that is, by doing electrocardiogram and cardiac enzymes. Aortic dissection

There will be no abnormalities, but myocardial infarction will.

So from the perspective of differential diagnosis alone, electrocardiogram is also a very necessary examination."

Lan Lijuan was still dissatisfied and asked: "But you still haven't answered why myocardial infarction causes abdominal pain?"

Chen Qi scratched his head: "Okay, okay, I'll answer it right away. In fact, this question is easy to answer. Professor Tong, how about you answer it."

Professor Tong laughed twice: "It seems that Dean Xiao Chen also wants to test me, an old man. Okay, then I will tell you my views."
Chapter completed!