Electrocardiogram is a capability that an emergency doctor and even every doctor must possess.

After three years of training in the emergency room, Chen Cang is familiar with the 1-lead to 6-lead logo of the human body, which is more familiar with the four qwer buttons of the computer keyboard when playing League of Legends in college!

Basically, as soon as you put your position on it, you can tell where to put it on at a glance, regardless of whether you are wearing clothes or not.

Because the most common disease in the emergency department is myocardial infarction, this type of patient has an acute disease and may experience anytime.

So after Chen Cang went to the Second Provincial Hospital, he spent half a year doing electrocardiogram and reading electrocardiogram.

At this time, the electrocardiogram machine was placing aside, and it was obvious that the patient had just had another electrocardiogram.

At this moment, the three of them stared at the electrocardiogram machine slowly stabilized and prominently reported.

Meng Xi kept thinking about the electrocardiogram just now in her mind. She always felt that she had seen it, but she couldn't remember it, and she always had some impressions.

Without st elevation, it is not necessarily a non-st segment elevation acute coronary syndrome!

Electrocardiogram is a screening, which allows all diseases to be screened through one examination. After screening, further diagnosis and treatment can be carried out in a targeted manner.

In fact, sometimes the patient's disease is like you do an application problem, and it requires logical thinking to judge.

If a patient comes to have chest pain, all the causes of chest pain should appear in your mind first.

Then verify or exclude your experience, examination, test, image data, etc.

This is the current medical diagnosis and treatment process.

Speaking of this, Western medicine is like this, so how does traditional Chinese medicine diagnose and treat?

Perhaps everyone thinks that traditional Chinese medicine is mysterious and mysterious. In fact, traditional Chinese medicine is also a kind of logical thinking ability, not the so-called nonsense.

In ancient times, people didn’t know much about the human body, and the physiological and biochemical tests were not mature. You can’t do surgery even if the patient comes! After all, in that era, you might not have any illness, and the infection will disappear once the surgery is done...

This is normal.

Traditional Chinese medicine studies the relationship between internal lesions through the external manifestations of the human body.

And his diagnosis and treatment process is to look, listen, ask and touch.

It is called a god by looking at it. This means that many famous doctors are experienced and knowledgeable. They can get a diagnosis by seeing the patient's words, actions, face, shape, tongue, etc. at a glance.

After various manifestations of observation, hearing, questioning and touching, and after hundreds of years of summary of cases, the ancients formed traditional Chinese medicine diagnosis.

Through looking, listening, asking and touching, we can verify one by one, and we will always obtain a suitable pathogenesis, so that we can diagnose and treat it and achieve the goal of seeing the small and knowing the best!

Sometimes, I have to sigh at the greatness of the ancients.

...

The electrocardiogram just came out, and Chen Cang was about to give it to Meng Xi, but after holding it in his hand, he was suddenly stunned!

Because this electrocardiogram...is a bit different!

First, the j point of the v1-6 lead on the chest is lowered by 1-3mm, the st segment moves downward in an upward oblique shape, and then the t wave is symmetrical and pointed!

Secondly, the qrs wave is normal and not wide at all.

Finally, the patient's AVR lead st segment is slightly lifted.

After Chen Cang looked carefully again, he suddenly thought of a possibility!

Could it be... thinking of this, Chen Cang's face changed!

If you continue to think about it carefully, it is very likely!

After a few seconds, Chen Cang thought about the patient's condition and age, etc. and thought about the possibility of the patient.

Turning around, Chen Cang quickly turned around and handed the electrocardiogram in his hand to Meng Xi.

Meng Xi took it and looked at it, and couldn't help but frown, but it was still not much different from what was just now.

Is it really a nste-acs (non-st-segment elevation acute coronary syndrome)?

Chen Cang originally thought that Meng Xi, as a female doctor from abroad, should have some understanding, but seeing her appearance, she seemed a little hesitant and suddenly became a little anxious.

Thinking of this, Chen Cang said directly: "Teacher Meng, I think the patient's electrocardiogram is very similar to de-winter syndrome! Further examinations must be arranged as soon as possible to facilitate further treatment!"

There is no hesitation. Now is not the time to hesitate, because this electrocardiogram is a super acute phase manifestation of myocardial infarction with st-segment elevation! This is called: de-winter syndrome.

After Chen Cang said this, the two of them were stunned!

After hearing this word, Ge Huai paused a little, and it looked familiar!

Because this electrocardiogram is rarely summarized in China, it was a retrospective study of 1,532 cases of acute coronary syndrome occlusion in the left anterior descending branch proximal occlusion, and found that 30 patients did not experience typical st-segment elevation. So after the study, several special electrocardiogram waveforms were found, and then published in the New England Journal of Medicine in the form of a paper.

This is called de-winter syndrome!

However, this syndrome has a short time to appear, and not many people may have been found in domestic literature, so many doctors do not know much about it.

Meng Xi's face changed when Chen Cang reminded her, de-winter?

right!

Very similar!

It's probably!

Thinking of this, Meng Xi quickly took the ECG order and continued to compare and read.

Meng Xi became more frightened the more she looked at, and the more she looked at, the more she became more frustrated.

Turning around and looking at Ge Huai, he quickly said, "Doctor Ge, hurry up and give a doctor's advice, improve the relevant examination, prepare to sign... Do coronary angiography as soon as possible..."

If the diagnosis is confirmed, coronary intervention will be performed in time, and infarction-related blood vessels are activated, and it is imperative to rescue the surviving myocardium!

Currently, the indication of thrombolysis for myocardial infarction is mainly defined based on the amplitude of the st segment elevation and whether there is a new complete left bundle branch block. Although de   Winter syndrome is a complete or subtotal occlusion of the proximal branch of the anterior branch, the electrocardiogram does not meet the indication for thrombolytic treatment.

Theoretically, thrombolysis treatment may have therapeutic effects, but it is still a "super indication" medication at this stage. Looking at the stemi guidelines at home and abroad in recent years, this type of patient has not been mentioned.

What does it mean? When receiving treatment, any disease needs to be tested according to the treatment.

This de-winter syndrome is not within the evidence of thrombolysis treatment, so if something goes wrong, it is the doctor's responsibility.

But medical care is the development of traditional Chinese medicine, so who can guarantee that there will be no problems?

As a doctor, you must exercise the scalpel in your hand rigorously!

When Ge Huai heard this, he quickly got up and started various arrangements!

Time passed by minute by minute, and Chen Cang followed Meng Xi and Ge Huai to get busy!

When the image data of the coronary angiography came down, the three of them immediately looked solemn!

It's true!

It's really de-winter syndrome!

Since it has been confirmed, interventional surgery is needed next.

Meng Xifeng and his team quickly started treatment of the patient, without delaying a minute or a second. By eleven o'clock, the patient finally completed the operation.

The operation went smoothly!

A living life has received a perfect treatment in this way.

The three of them couldn't help but feel a lot of emotion!

At this time, Chen Cang's ears sounded:
Chapter completed!