Is the interlayer broken?

Thinking of this, everyone began to feel cold sweat!

Part of the ascending aorta is in the pericardium. Once a rupture occurs here, the arterial blood will soon fill the entire pericardium, forming a pericardial tamponade on the heart!

And this behavior is exactly the most dangerous and also the reason for the highest mortality rate!

So, after hearing Chen Cang say that pericardial filling, no matter Yu Yonggang, Li Baoshan, Xu Ziming and others, they couldn't help but feel cold!

what to do?

Even Yu Yonggang, the director of the emergency department, was powerless in the face of such a patient!

Because even Xu Ziming from the Department of Cardiology, it is difficult to form a series of clear rescue ideas at this time!

Sometimes, many diseases come in a hurry, and roll in with the most serious complications and postures, just like a flood, and the patient is just a small boat on the sea!

"Doctor Chen, will the pericardial tampon be lifted?"

Chen Cang took a deep breath. At this time, the echocardiography was not clear because the pericardium was full of blood!

I can only see a lot of blood filling the pericardium.

What is the patient's state at this time?

Can it be lifted?

Should it be lifted?

Will it induce other risks?

No one can guarantee it!

Unless it is checked clearly!

But check now?

Where to check?

What kind of inspection is done?

To be honest, any inspection now is like a death sentence!

However, without a clear diagnosis, how can we make a systematic and accurate judgment of the patient's condition?

How can we formulate a complete set of effective treatment plans?

For a time, the patient had entered a vicious cycle!

The unclear diagnosis leads to the inability to formulate a plan, and the inability to formulate a plan leads to the continued deterioration of the condition. The continued deterioration of the patient does not have time to undergo other examinations and treatments.

Interlayer separation?

Or is the interlayer rupture?

No matter what it is, it is a very dangerous thing.

Even, there may be a multiple risk factor that is mixed with two types.

Thinking of this, Chen Cang directly handed the pericardial puncture needle to Xu Ziming.

He stared at him and said, "Director Xu, take it, I will let you draw blood if you want it!"

Xu Ziming had a serious expression and nodded seriously!

Chen Cang went around the other side of the patient and brought a stethoscope with one hand, pressed the head of the stethoscope in different positions in the anterior part of the heart, and the other hand was placed on the patient's wrist!

He took a deep breath and calmed himself down at such a critical moment!

At this moment, in the room, the nurse said nervously:

"Heartbeat 60 times per minute!"

It seemed that everyone was at a loss.

Things were too sudden and the disease was developing too fast!

Perhaps many people don’t understand why most Marfan syndrome cannot live in their thirties because of this now!

The condition develops too fast, like a tornado!

There is no time to rescue!

Chen Cang closed his eyes and the people around him quickly calmed down.

I dare not disturb Chen Cang.

At this moment, Chen Cang still heard a faint diastolic murmur accompanied by systolic murmurs in the aortic valve auscultation area through the pericardium!

After hearing this sound, Chen Cang was immediately delighted!

This is a diagnostic sign!

The murmur is caused by the dissection of the aortic root displacement, prolapse, and the valve annulus dilate. After the endometrium ruptures, it protrudes into the lumen in a flap, causing blood vortex.

At this moment, Chen Cang felt peripheral signs such as widening pulse pressure and edema on his wrist!

Thinking of this, Chen Cang was immediately delighted!

Ascending aortic vascular dissection tumor is certain.

However, there was no serious rupture of the aortic blood vessels, but because the blood vessels in the ascending aorta caused blood to seep through the wound and enter the pericardial cavity!

Symptoms of pericardial tamponade occur.

However, the aortic dissection has not been completely ruptured, but the dissection hematoma is very serious.

Otherwise, it would be impossible to produce such a series of pathological reactions.

The four-dimensional image in Chen Cang's mind constantly simulates the situation in the patient's chest cavity through various imaging results.

Through various diagnostic information, we gradually figured out the patient's condition at this time bit by bit.

Thinking of this, Chen Cang hurriedly said to Xu Ziming: "Puncture!"

"Can you wear it?" Lao Yu was a little worried.

Chen Cang nodded: "Yes! No problem!"

After saying that, Chen Cang turned around and continued to say to the nurse: "Propranolol intermittent intravenous administration and sodium nitroprusside intravenously lowered blood pressure!"

...

Chen Cang kept issuing various temporary rescue doctor orders.

Now is not the time to worry about who is the director.

Because Chen Cang knew that he was the person who knew the patient's condition best now.

It is necessary to stabilize the patient's critical symptoms at this time and prepare to send them to the operating room!

If surgery is performed here, the patient's mortality rate is as high as more than 95%.

Emergency surgery is simply not enough to support such a huge, cumbersome and sophisticated surgery!

For a moment, everyone began to mobilize.

Doctor's orders are constantly being executed.

Xu Ziming had already been ready for puncture.

Under echocardiography, the fluid in the pericardial cavity is slowly extracted.

After one minute, the puncture is completed.

250 ml of blood was pulled out.

Various drugs have also begun to be injected into the patient's body.

"Can you lower your blood pressure like this? The patient is already a little hypotensive?" At this time, the leader of the second group Hou on the side couldn't help asking.

Indeed, is propranolol combined with sodium nitroprusside too much?

Everyone is a little worried!

Although the patient's aortic dissection has appeared now, the patient is already in shock. If hypotension causes hypoperfusion, can he insist on going off the operating table?

This seems to have entered another contradiction.

Hypertension can easily induce aortic dissection rupture!

If hypotension occurs, will patients cause ischemia and hypoxia in cerebral tissue due to hypoperfusion?

This is a difficult and complicated disease!

Every doctor's order needs to be considered and then considered!

Chen Cang shook his head and immediately denied: "No!"

"The patient's blood pressure is not the real blood pressure!"

As soon as these words came out, everyone around was stunned!

Does blood pressure have real blood pressure and false blood pressure?

Xu Ziming's eyes suddenly lit up, and he asked in confusion: "Is the patient's dissection hematoma spreading?"

Chen Cang nodded!

"Yes, I just clearly felt peripheral signs such as widening pulse pressure and edema pulse on the radial side of the patient. Moreover, the heart sound also showed a sudden diastolic murmur in the aortic valve auscultation area with systolic murmurs!"

"This shows that the patient has no rupture of blood vessels. The reason for pericardial tamponization is that the dissection of the aortic root displaces the aortic valve, prolapses, and dilates the valve annulus. After the endometrium ruptures, it protrudes into the lumen in a flap, causing blood vortex."

"Also, the patient's ascending aortic dissection did seep out of blood, causing this manifestation of cardiac tamponade."

When I heard Chen Cang's words, the surroundings suddenly became quiet!
Chapter completed!