ECG is an ability that an emergency doctor and even every doctor must have.


    After three years of emergency exercise, Chen Cang is more familiar with the human body''s 1-lead to 6-lead signs than the qwer four keys on the computer keyboard when he played hero League in college!


    Basically, as soon as you put yourself in a good position, you can see where to stick at a glance, regardless of whether you wear clothes or not.


    Because one of the most common diseases in the emergency department is myocardial infarction, which may occur at any time.


    Therefore, after Chen Cang went to the second provincial hospital, he spent half a year doing and reading ECG.


    At this time, the ECG machine is on the side. It is obvious that the patient has just done another ECG.


    At this moment, all three stared at the ECG machine and slowly stabilized the prominent report.


    Meng Xi kept thinking about the ECG in her mind. She always felt that she had seen it somewhere, but she couldn''t remember. She always had some vague impression.


    Without ST elevation, it is not necessarily non ST elevation acute coronary syndrome!


    ECG is a screening. All diseases are screened through one examination. After screening, further diagnosis and treatment can be carried out.


    In fact, sometimes the patient''s disease is the same as you do an application problem, which needs to be judged by logical thinking.


    If a patient has chest pain, you should first have all the possible causes of chest pain in your mind.


    Then verify or eliminate it through your experience, examination, laboratory test, image data, etc.


    This is now a medical diagnosis and treatment process.


    Speaking of this, western medicine is like this, so how is the diagnosis and treatment process of traditional Chinese medicine?


    Perhaps we all think that Chinese medicine is mysterious. In fact, 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 interior of the human body, and physiological and biochemical tests were immature. You can''t operate on patients! After all, in the original era, you may not be ill. Once you cut, the infection disappeared


    This is normal.


    Traditional Chinese medicine studies the relationship between and internal diseases through the external performance of the human body.


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


    Looking and knowing is called God, which means that many famous doctors are experienced and knowledgeable. They can get a diagnosis at the first sight of the patient''s words, deeds, complexion, shape, tongue and so on.


    After hundreds of years of case summary, the ancients formed traditional Chinese medicine diagnostics.


    Through looking, smelling, asking and verifying one by one, we can get a suitable pathogenesis, so as to make diagnosis and treatment, and realize the purpose of seeing and knowing!


    Sometimes, I have to feel the greatness of the ancients.


    ……


    The ECG just came out. Chen cangzheng was going to give it to Meng Xi, but after holding it in his hand, he was suddenly stunned!


    Because this ECG... Is a little different!


    First of all, the J point of precordial v1-6 lead is depressed by 1-3mm, the ST segment moves upward and downward, and then the T wave is symmetrical and sharp!


    Secondly, QRS wave is normal and not wide at all.


    Finally, the ST segment of the patient''s aVR lead was slightly elevated.


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


    Is it... Chen Cang''s face changed when he thought of this!


    Continue to think carefully, it is likely to be!


    In a few seconds! Chen Cang considered the patient''s condition and age, and thought of the possibility of the patient.


    Turning around, Chen Cang quickly handed the ECG in his hand to Meng Xi.


    Meng Xi took it over and couldn''t help frowning. It was still not different from that just now.


    Is it really NSTE-ACS (non ST segment elevation acute coronary syndrome)?


    Chen Cang originally thought that Meng Xi, as a foreign female doctor, should know something, but looking at her like this, she seemed to be hesitant and anxious.


    Thinking of this, Chen Cang said directly: "Mr. Meng, I think the patient''s ECG is very similar to de winter syndrome! Further examination must be arranged as soon as possible for further treatment!"


    Without any hesitation, this is not the time to hesitate, because this ECG belongs to the hyperacute stage of ST segment elevation myocardial infarction! That is, the so-called de winter syndrome.


    After Chen Cang said these words, they immediately got confused!


    After Ge Huai heard this word, he paused a little. He looked familiar!


    Because this ECG is rarely summarized in China, de winter, a cardiologist in Rotterdam, the Netherlands, retrospectively studied the ECG of 1532 patients with acute coronary syndrome with proximal left anterior descending artery occlusion, and found that 30 patients did not have typical ST segment elevation. After the study, several special ECG waveforms were found, and then published in the form of papers New England Journal of medicine.


    This is the so-called de winter syndrome!


    However, the occurrence time of this syndrome is still short, and there may not be many references in the domestic literature, so many doctors do not know it very well.


    Meng Xi was reminded by Chen Cang, and his face suddenly changed, de winter?


    yes!


    Very much!


    Probably!


    Thinking of this, Meng Xi quickly took the ECG list and continued to compare it.


    Meng Xi was more frightened and flustered.


    Turning around and looking at GE Huai, he hurriedly said, "Dr. Ge, hurry to give the doctor''s order, improve the relevant examination, and prepare to sign... As soon as possible..."


    If diagnosed, then timely coronary intervention, opening infarct related vessels and rescuing surviving myocardium are imperative!


    At present, the indications for thrombolysis in myocardial infarction are mainly defined according to the extent of ST segment elevation and whether there is a new complete left bundle branch block. Although dewinter syndrome is a complete or sub total occlusion of the proximal anterior branch, the ECG does not meet the indications for thrombolysis.


    Theoretically, thrombolytic therapy may have therapeutic effect, but it is still a "super indication" drug at this stage. In recent years, such patients are not mentioned in STEMI guidelines at home and abroad.


    What do you mean, any disease, when receiving treatment, needs to be treated according to the evidence of treatment.


    This de winter syndrome is not within the evidence of thrombolytic therapy, so it is the responsibility of the doctor if something goes wrong.


    But medical treatment is the development of traditional Chinese medicine. Who can guarantee that there will be no problems?


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


    As soon as GE Huai heard this, he quickly got up and began all kinds of arrangements!


    As time went by, Chen Cang became busy with Meng Xi and Ge Huai!


    When the coronary angiography image data came down, the three immediately looked dignified!


    right enough!


    It''s really de winter syndrome!


    Now that the diagnosis is made, it is necessary to urgently arrange interventional surgery.


    Meng Xifeng and his team quickly started the treatment of the patient without delay. At 11:00, the patient finally completed the operation.


    The operation went well!


    A fresh life, in this way, got a perfect treatment.


    The three could not help feeling thousands of things!


    At this time, Chen Cang heard:


    [Ding! Meng Xi''s popularity + 15!]