On Thursday night, Chen Cang''s night shift.


    An old man came in askew: "doctor, I want to buy some medicine."


    Chen Cang was stunned and hurriedly got up: "what medicine?"


    The old man is a little panting and shortness of breath.


    "Ah... Ah... Aspirin enteric coated tablets!"


    The old man thought for a long time before he said it.


    After that, the old man continued, "by the way, I also want to have an ECG. I''m not flustered recently."


    Chen Cang looked at the old man''s face and was stunned!


    The old man is tall, but he is also fat. He doesn''t walk steadily. It''s troublesome to move step by step.


    However, this is not the most important thing. The most important thing is that the old man''s face is yellow and swollen, and his cheeks are dark red!


    This may not seem typical to others.


    But Chen Cang looked at the old man''s shortness of breath. He thought he wanted to do an ECG and immediately frowned!


    Look at his purple lips and dark tongue


    A name is just around the corner!


    Wind heart disease!


    That is, the face of the elderly with rheumatic heart disease is a typical mitral valve face, also known as the face of rheumatic heart disease.


    Chen Cang hurriedly greeted Xiao Lin: "Xiao Lin, help the old man in with me."


    Kobayashi put down his work, quickly nodded and helped the old man into the rescue room.


    The old man was relieved when he lay in bed.


    Chen Cang couldn''t help asking, "old man, have you ever had any diseases before?"


    The old man took a few breaths. Kobayashi had great eyesight and quickly brought oxygen to him.


    Then he said, "I... I have had heart disease, rheumatic heart disease for many years."


    As soon as Chen Cang heard it, it was true.


    Then, Chen Cang quickly picked up the stethoscope and put it on the tip of the old man''s heart to listen to the heart beat.


    My heart beats fast and slow, and my heart sounds vary in strength.


    Suddenly Chen Cang frowned. The old man may have atrial fibrillation.


    There was not only atrial fibrillation, but also Chen Cang could hear a gradually increasing rumbling murmur in the late diastole at the apex of the heart, which was a typical auscultation manifestation of mitral stenosis.


    Then, at this time, Kobayashi also pushed the ECG machine over.


    An ECG was pulled out.


    Chen Cang looked at the ECG and frowned.


    This situation is not very good. Let alone the problem of rheumatic heart disease, atrial fibrillation may cause serious illness and complications at any time.


    Thinking of this, Chen Cang quickly said to the old man, "are there diseases such as hypertension and hyperlipidemia..."


    The old man nodded: "yes, there are... But I''ve been taking medicine all the time. I can control it. I lived in the hospital in autumn. It''s cerebral infarction. After I leave the hospital, I''ve been taking medicine for maintenance. What aspirin..."


    The old man''s consciousness is very clear. When he speaks out, he is slow but organized.


    That''s a good thing!


    The blood pressure was normal, but Chen Cang thought he should remind the old man.


    But after the old man bought the medicine, he decided to go and staggered home.


    Chen Cang looked at the old man and was worried.


    Kobayashi said with a worried face, "Dr. Chen... Will something happen to him?"


    Chen Cang frowned: "it''s hard to say."


    At about 9 o''clock, suddenly the emergency telephone rang.


    "There is an old man in Anju community 9012 who suddenly has bad words and inconvenient movement, so he needs to be rescued in time."


    Chen Cang nodded quickly. Xiao Lin didn''t stop at all. He got up and went out.


    The second-line attendant also got up quickly to watch the shift for Chen Cang.


    Combined with the patient''s situation, Chen Cang''s diagnosis should be cerebral infarction, but bleeding can not be ruled out. As long as the cerebral infarction is not a large vascular obstruction in the brainstem, it is generally not life-threatening, but bleeding is not necessarily.


    When the car arrived, Chen Cang went upstairs with Xiao Lin and driver Lao Yang.


    Chen Cang and Xiao Lin were stunned when they saw the old man!


    Isn''t this... The old man who just came to the emergency room to buy medicine?


    The old companion panicked. After Chen Cang comforted him, he hurried back to the hospital with him.


    Just sent to the hospital, Chen Cang suddenly heard the prompt sound of the system.


    [Ding! Serial mission - truth trigger!


    The last link: save the elderly and explore the causes. After the task is completed, you can get rich rewards!]


    Chen Cang was stunned when he heard it.


    Is this the final task?


    By now, Chen Cang has considered not only the rich copy rewards, but also what the truth is!


    Is volb cough water the key cause?


    This time, the clue is very straightforward. The possibility of cerebral infarction is 70-80%, and there are so many primitive diseases such as hypertension and rheumatic heart disease.


    Because of this, it is even more difficult to judge, because even without cough water, the elderly are also very likely to get sick.


    However, this is not the time to tangle with this. After Chen Cang hurriedly brought the old man.


    Go straight to the MRI.


    The results showed multiple intracranial ischemic foci, but these were old, but there was a new acute cerebral infarction in the right frontal lobe!


    Generally speaking, brain MRI (magnetic resonance imaging) is the first choice for suspected cerebral infarction, and brain CT is the first choice for suspected hemorrhage. These examinations are more targeted for diagnosis.


    Chen Cang called doctor an of Neurology for consultation. While treating, he must also find the cause of the disease.


    When he learned that the old man had rheumatic heart disease and mitral stenosis, Dr. an also frowned.


    Directly tell the patient''s wife: "the blood flow in the normal heart is smooth and unimpeded. When the mitral valve is narrow, the blood cannot flow from the left atrium to the left ventricle at a normal speed. The blood silts and rotates in the enlarged left atrium, and the flow rate slows down, which may form small blood clots, thus burying the hidden danger of stroke."


    "At the same time, mitral stenosis for a long time can lead to changes in cardiac structure, such as the expansion of left atrium, which is closely related to atrial fibrillation, which is the most common cause of cardiogenic embolism."


    Now it seems that the truth has come out.


    The patient has these reactions of blood viscosity. When the mitral valve is narrow, the thrombus is easy to form, and the attack of atrial fibrillation directly gives the thrombus a place to go.


    Everything is a very reasonable explanation!


    At this time, Dr. an suddenly looked at Chen Cang and said, "director Chen, what should be considered now is not acute cerebral infarction. Cerebral infarction only needs to improve the blood circulation in the ischemic area as soon as possible. Anticoagulation and thrombolysis can be carried out at the same time."


    "But... The key is the mitral valve."


    "If the patient''s mitral stenosis is not treated and the primary disease is not controlled, this cerebral infarction will occur, and it will not occur twice at a time."


    Chen Cang nodded. Indeed, according to the old man, there have been two cerebral infarction in autumn.