It's fine, old man. "Zheng Ren unplugged the old man's vein and helped him up from the ground.
"Sit down and rest for a while. Your illness has been diagnosed," Zheng Ren said with a smile.
"What illness?" The old man was a little cautious but also a little confused.
From the looks of it, he was really afraid of being diagnosed with a mental illness. Even the way he looked at Zheng Ren was strange, with a hint of hostility.
"Swallowing syncope or swallowing syncope is a rare type of neuro-mediated syncope. It's related to life-threatening slow arrhythmia and low blood pressure and is usually not easy to diagnose in time," Zheng Ren said. "The tilt test proved that it's a problem with the vagus nerve."
"…" The old man did not understand a word.
"Let's not talk about the illness. Let's talk about how to treat it first," Zheng Ren said.
"Old Luan, do you think you're hurt?" Su Yun came to Luan Yingjie's side and helped him up. In a resentful tone, he said, "I'm diagnosing your old man. Why are you causing trouble?"
"Uh …" Luan Yingjie covered his wound in pain, not knowing whether to laugh or cry.
"You almost killed your father. It's not like you didn't see what happened just now. Seriously, you're just causing trouble." Su Yun continued to stab him.
"That … I'm sorry." Luan Yingjie did not know why he had to apologize after being kicked.
However, his old man was sitting there perfectly fine. His actions just now seemed a little strange.
It was not a big deal to lower his head and admit defeat!
"This illness requires a pacemaker," Zheng Ren said. "Double-chamber pacemaker. After that, you can eat whatever you want."
"There's nothing wrong with my heart." The old man was puzzled. "The electrocardiogram is there. Why do you need a pacemaker?"
"Your heart is fine, but when you eat, your esophagus will dilate, involving the vagus nerve, and there will be a sudden cardiac arrest for a few seconds," Zheng Ren said with a smile.
The old man still did not believe it, but because Zheng Ren did not say it was a mental illness, his attitude was much better.
Some elderly people at this age believed in everything, and some did not. It was obvious that Luan Yingjie's father belonged to the latter.
After all, it was a surgery. No matter how small the pacemaker surgery was, it was still surgery.
Zheng Ren smiled. Obviously, he had considered this point.
"Old man, how about this?" "It's fine if you don't agree to the pacemaker. Boss Luan will take you to the hospital tomorrow for a 24-hour ambulatory electrocardiogram."
"Hmm?"
"We'll be able to discover the problem in a day," Zheng Ren said. "When the time comes, we'll find a few experts to take a look before you make a decision. What do you think?"
These words made the old man feel extremely comfortable.
He gave his diagnosis with certainty, but he did not force himself to make a decision. Instead, he asked him to do another check-up and carefully find someone else to take a look. This young doctor really knows how to conduct himself.
"Yes, I think that's better." The old man immediately agreed.
"If there's nothing else, we'll be leaving," Zheng Ren said. "Boss Luan, if you decide to undergo surgery, come find me. It's different from ordinary surgeries. During the surgery, we need to test the effect of esophageal distension on the heart. "
"Okay, okay." Luan Yingjie quickly stood up when he saw the two of them getting up.
His legs gave way and he fell to the ground.
"Look at you, can't you be more careful? How old are you? What if you break your bones? "Su Yun retorted instead of helping him up.
Luan Yingjie smiled bitterly. 'Wasn't it all because of your kick?'
"Don't mention it. We're leaving." The housekeeper went to help Luan Yingjie up, so he turned and left.
"Boss Zheng, what happened just now?" Zhou Litao asked.
"Chief Zhou, take your ambulance back to the hospital. Give us a ride," Su Yun said with a smile.
"It's nothing. What happened just now?" Zhou Litao had been struggling with the disease of patients who fainted after eating.
"Esophageal distension inhibits the heart, which is the underlying pathophysiological mechanism of syncope. This case was reported in BMC.
Disord, "Zheng Ren said. Zheng Ren said, "The author also summarized 101 cases of swallowing or swallowing syncope reported since 1793."
1793 … 101 cases. Zhou Litao was speechless.
"This type of syncope is more common in men and the elderly. The average age reported is 57.5 years. 54.5% of patients will faint from anything they eat, be it water or solid food, "Zheng Ren said." Usually, it's triggered by esophageal disease. "
"So that's how it is." Zhou Litao silently noted down the patient's condition. He felt a little excited as he held the piece of paper in front of his chest that recorded Boss Zheng's diagnosis and treatment.
"Implantation of a pacemaker is the most common treatment method. 98.1% of patients with a pacemaker implanted reported relief of syncope symptoms. More than half of the patients had a permanent pacemaker implanted," Zheng Ren said. "Therefore, it's highly likely that pacemakers are still useful."
"Implantation of a pacemaker …" Zhou Litao pondered the function of a pacemaker.
"Next is the treatment of gastrointestinal diseases. For example, four patients had hiatal hernias repaired. There were also patients who received successful vagus nerve ablation, long-term proton pump inhibitors, and radical esophageal cancer surgery. "
"You scared me just now." Zhou Litao came back to his senses at this time. He touched his chest, still feeling a lingering fear.
"I'm not afraid." Zheng Ren smiled. "I see you have atropine in your first-aid kit. With this medicine, there won't be any big problems."
"Huh?"
"Atropine was commonly used before the introduction of pacemakers. Limited data showed that the efficacy was up to 90%," Zheng Ren said. "If it wasn't for five minutes of observation and to see how low the patient's blood pressure could drop, I would've directly injected atropine and it would've worked in 15 seconds."
"But the blood pressure is too low," Zhou Litao said.
"Yes, my baseline is 35 millimeters of mercury. If it's lower than that, I must inject atropine," Zheng Ren said. "The patient's condition is quite good."
"Boss, you're really good at keeping your cool. My baseline is 40 millimeters of mercury. Since you didn't say anything, I endured it, "Su Yun said." But I was anxious, so I kicked Old Luan and felt much better. "
"Don't be so violent. Aren't you afraid of something happening?"
"I saw the atropine too. How could anything happen with atropine? Besides, I'm a cardiothoracic doctor. Defibrillation, compression, and a hundred other methods can save him. What's there to be afraid of? "Su Yun said.
Zhou Litao felt a little ashamed.
He had been a little flustered at the time.
Although he knew that the tilt test could be dangerous if it was positive, he had never encountered it before. Moreover, his diagnosis was much worse than Boss Zheng and Brother Yun's.
'I'll have to read more when I get back,' Zhou Litao thought.
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