NovelTags Chapter 698
Chapter 698
I followed the nurse to the ICU.
It turned out to be the family of the patient before, who wanted to ask Lin Feng about his mother's condition.
I looked at the patient's treatment records.
Lin Feng began to introduce the patient's situation to the patient's family.
Just said two words.
The doctor in the rescue ward ran over with a nervous look.
After coming to Lin Feng's side, he said anxiously: "Doctor Lin, it's not good." The little girl with myocarditis was not doing well, her blood pressure could not be measured, and her pulse could not be touched. "
The voice just fell.
Lin Feng was instantly shocked, and immediately asked, "Blood pressure is gone?" The pulse is gone? "
"Well, yes. We didn't measure it several times! Seeing Lin Feng's reaction so great, Doctor Gui Pei was very puzzled in his heart.
Then what else to hesitate!
Lin Feng didn't care to greet the patient's family members here, turned around and ran towards the rescue ward.
On the way, Dr. Chong Guipei asked: "There is no blood pressure, what are you running out for, you are not inside to give the patient cardiopulmonary resuscitation!" Is someone pressing? "
"Nope! I didn't press it! Doctor Guipei was even more confused, and he didn't understand what Lin Feng was saying.
Lin Feng was also in no mood to pay attention to Doctor Guan Pei.
Came to the rescue ward and snatched the door in.
Seeing the little girl lying decently on the hospital bed, although her face was not good, there was definitely no cardiac arrest, and the heart rate was still displayed on the ECG monitoring more than 110 times.
Moment.
Lin Fengbian reacted.
What Dr. Guipei said just now is that you can't measure blood pressure and can't feel your pulse!
It's not that blood pressure and pulse are gone.
Then he lowered his voice and asked the nurse: "What is the patient's situation now?" "
An elderly nurse next to him said to Lin Feng: "Dr. Lin, the patient's two arms have been measured, and the blood pressure cannot be measured. I also touched the radial artery, I didn't feel any pulsation, I changed a few people to touch, and I didn't touch it! So I asked Xiao Lin to go out and call you! "
"Just now we also had a large cuff and tied it directly to the patient's leg, this time it can be regarded as measuring the blood pressure. But this amount is the blood pressure of the popliteal artery of the thigh, which does not represent the blood pressure of the upper arm! "
A person is good, how can blood pressure not be measured, how can it not be possible to touch the radial artery!
"Have you touched it carefully?" Lin Feng asked.
The older nurse directly gave Lin Feng an expression that you try.
Lin Feng also did not ink, and directly started.
The finger gently pressed on the radial artery of the little girl's left hand, indeed did not feel the pulse, and then increased the pressure again, but still did not feel the pulse pulse, and couldn't help muttering in the mouth: "Strange!" "
The little girl's palms were cold.
Apparently poor blood flow.
The radial artery cannot be felt, and the cuff tied to the upper limb cannot measure blood pressure.
Just why is that!
The heart rate is obviously normal, and the heart sound beats OK, but the blood pressure is indeed undetectable.
Now the upper limbs are undetectable, but the blood pressure of the lower extremities is there.
That means it's a problem with the blood vessels of the upper extremities, not the heart.
It is very likely that the patient's upper limb blood vessels are occluded, and the blood cannot pass, so the pulse cannot be felt, the blood pressure cannot be measured, and the limbs are cold.
Then he turned back to Doctor Guipei and said, "You kid spoke clearly, he almost didn't scare me to death!" "
"Dr. Lin, I didn't say anything wrong! It's you who are too nervous! Doctor Guipei chuckled.
Truly.
Lin Feng was nervous about this little girl.
The main thing is to see that this little girl is too young, obviously she has just graduated from school, and the good years have just begun.
Immediately Lin Feng asked, "Given the patient's current condition, what kind of illness do you think it will be!" "
Seeing Lin Feng's question, Dr. Guipei immediately said seriously: "The patient should be a local problem of blood vessels, such as thromboangiitis obliterans, an inflammatory disease of blood vessels, which will lead to chronic occlusion of blood vessels, manifested as local skin temperature reduction, paleness, and cold fear of limbs." In severe cases, there will be pain in the limbs, a weakened pulse, or even disappears, and of course, blood pressure may not be measured. "
Lin Feng nodded, and then said: "Well, there is this possibility!" However, your thromboangiitis obliterans is more common in young men who like to smoke, such as Haonange, pheasant, etc. "
"Dr. Lin, people who smoke are not necessarily gangsters! Few of our directors of surgery do not smoke! Doctor Guipei said with a smile.
"Don't talk about that! The patient's situation is not so simple, it is impossible to have viral myocarditis and this vasculitis at the same time. Lin Feng said immediately.
"Dr. Lin, or is it possible that there is an arterial embolism?" The patient has fever, chest tightness and chest pain, not necessarily viral myocarditis! It may also be infective endocarditis! There is a bacterial infection in the endocardium, which may form a local thrombus, and if it falls off and runs along the blood vessel, it may be plugged into the arteries of the upper extremities, resulting in poor blood flow, no pulse, and no blood pressure? Doctor Gui Pei knew that Lin Feng was testing him, so his brain spun quickly and he said in detail the symptoms he had in mind.
Lin Feng smiled and said to Doctor Guipei: "This possibility is there!" But I have two points of non-support, first, when I first auscultated, the patient's heart did not have an obvious murmur, it did not look like there was a cardiac vegetation. Second, even if it is infective endocarditis, even if there is a blood clot, even if the thrombus is shed, it cannot be blocked in the upper limb artery! Why not block other arteries? "
Hearing this, Dr. Guipei smiled embarrassedly: "It seems to be!" What a coincidence! "
"But your analytical skills are still good!" Lin Feng said immediately.
"Doctor Lin, what is your opinion?" Doctor Guan Pei immediately asked with a smile.
"Ahem!"
After coughing lightly, Lin Feng said with a smile: "Oriental beauty disease! "
"What, Oriental Beauty Disease? Dr. Lin, you're not going to bluff me, are you? Doctor Guipei said suspiciously.
Looked at.
Lin Feng said: "Oriental beauty disease, that is, multiple arteritis! This is an inflammation of the large arteries, which can lead to narrowing or occlusion of blood vessels, the most easily involving the aorta and other branches. For example, axillary artery, brachial artery, radial artery, so the patient's pulse can not be felt on both sides, and blood pressure cannot be measured. "
"This disease and the cause of the onset is not clear, may be related to autoimmune disorders, the immune system now does not fight bad people, specifically hit themselves, but also pick blood vessels to beat, so something happened!"
"And some people found that this patient is related to high estrogen levels, so young women are especially prone to disease, especially young women in Asia, so this is also called oriental beauty disease!"
The little girl on the hospital bed was in better spirits, and she was very happy listening to Lin Feng's conversation with Dr. Guipei.