After returning to the intervention department, Lin Yuan reported everything she knew to Boss Zheng. She had had an episode in the past but had recovered after taking the medicine to treat facial paralysis. There were no sequelae. She had even reported the migraine that she thought was not important to Boss Zheng.
The longer she spoke, the more symptoms she had, the more serious she would seem.
She did not emphasize that she did not have first-hand information when the patient was undergoing surgery. Lin Yuan knew that it was useless no matter how much she emphasized it to a person like Boss Zheng.
"Su Yun, what do you think?" Zheng Ren asked.
"He doesn't smoke or drink. What's the point of having such a good life at such a young age? It's the joy of life. Do you want to go to nightclubs when you're old? "Su Yun nagged.
For him, who smoked and drank, Yang Lixin was the epitome of his opposite, "evil."
"I didn't ask the medical history well. If Sister Yue went, she would definitely know more details." Lin Yuan took advantage of the fact that Boss Zheng had not lost his temper to self-reflect and admit his mistake.
This method was very useful at home. Every time she meowed, no matter what happened, she would be able to get over it. Although Boss Zheng did not buy it, Lin Yuan still habitually meowed first.
Perhaps in that case, Boss Zheng would be more lenient.
"You asked a good question. The condition is basically clear." Zheng Ren smiled faintly.
"Uh …"
This sentence was even more unacceptable to Lin Yuan than being scolded.
The condition was clear? Clear my ass! Where was it clear that he did not smoke, did not drink, and often stayed up late? Or was it something else?
"Oh? You suspect patent foramen ovale? "Su Yun asked." Is it because of a migraine, plus a suspected cerebral infarction and a cerebral infarction? "
"If it's just a little, there's no way to diagnose it. If the two points are combined, the possibility of patent foramen ovale is very high, "Zheng Ren said.
The diagnostic criteria and clinical symptoms of patent foramen ovale flashed in Lin Yuan's mind.
It was clearly written in the book that patent foramen ovale was mostly asymptomatic. It was difficult to hear a murmur. The electrocardiogram and chest X-ray were normal. Therefore, it was not easy to find and was not valued by people.
Lin Yuan even thought of what was written many years ago. On average, one in four to five people had patent foramen ovale.
Because most patients did not have any symptoms, it was very likely that the disease would not be discovered for the rest of their lives.
For a long time, patent foramen ovale was thought to be "insignificant" because it did not cause shunting between the two chambers and had no effect on cardiac hemodynamics.
Was that how Boss Zheng diagnosed it?
Su Yun glanced at Zheng Ren. He frowned and said, "Boss, did you start to suspect it when he was young and had a cerebral infarction?"
"More or less, there has to be a reason, right?" "The probability of a patent foramen ovale causing a migraine is very high. A considerable number of patients have migraines, but it's very difficult to diagnose. It's all caused by the patent foramen ovale."
"Contradictory cerebral infarction. So that's what you've been suspecting." Su Yun smiled. "So you asked Xiao Lin to ask about his medical history?"
"Yes, as long as he has a migraine, there is a high probability that he will be diagnosed as a spear cerebral infarction. Performing a transesophageal ultrasound … is still relatively difficult. We might need to do a foaming test."
"Boss Zheng, please wait a moment." Lin Yuan immediately stopped Boss Zheng's words. If he continued, he would even have a treatment plan. The discussion of a case had already come to an end.
Yet, he had no clue at all.
Lin Yuan knew about paradoxical cerebral infarction. Generally speaking, cerebral infarction was caused by arterial thrombosis. However, some people did not have emboli in their arterial system, but the emboli in their venous system could pass through the patent foramen ovale and embolize the blood vessels in the head.
This was also a theoretical basis for the medical community to tend to treat the patent foramen ovale once a paradoxical cerebral infarction was discovered.
"You want to ask what the relationship between a migraine and a patent foramen ovale is?" Zheng Ren asked.
"Yes."
"There is no theoretical explanation in the clinic now," Zheng Ren smiled and said. "However, there are a few guesses. First, an inexplicable migraine. It may be that some neurotransmitters in the venous system bypass the inactivation and filtration function of the pulmonary blood vessels through this patent foramen ovale and directly reach the cerebral circulation system. After combining with some receptors in certain nerves, it causes the symptoms of migraine."
"Second, under conditions such as deep breathing, coughing, and exercise, the incomplete foramen ovale opens. The venous system microthrombosis enters the cerebral circulation through the foramen ovale, aggravating the spread of cortical dilatation inhibition. This is also the initial phenomenon of migraine."
Lin Yuan sighed in his heart. It seemed that his diagnosis was not good enough.
"When encountering an unknown cerebral infarction, the most recent theory is more inclined to check the heart," Zheng Ren continued. "The patent foramen ovale is also a predisposing factor."
Cerebral infarction required a cardiac ultrasound, and it was also related to migraine … Lin Yuan sighed deeply again.
It was said that one should not treat a headache. He did not expect to be taught another lesson today.
Su Yun said, "Do you want to do a B-scan yourself?"
"There's no need," Zheng Ren said. "Do you know anyone in the neurology department?"
"I've dealt with the chief resident before, but you also know the people in the internal medicine department. I don't have much contact with them," Su Yun said. "Do you want me to remind you?"
"Well, do a transesophageal echocardiography or a foaming test. In short, do whatever is convenient. Check the situation of the patent foramen ovale. If there is, the probability of it happening again in the future is very high. Just find an interventional doctor in the circulatory department to block it. "
"Look at how much of a hindrance it is to intervene. This used to be a narrow-minded job." Su Yun glanced at his boss. All his resentment was piled on his boss.
"The circulatory department mainly does interventional cardiac surgery now. Who do you think is to blame for this?" Zheng Ren said.
"I'll ask them if they have checked it first. Don't be so friendly here. The neurology department has already prepared to do a checkup after the surgery. How embarrassing would that be?" Su Yun changed the topic and changed the direction.
"That's fine too. As long as you don't miss this point, it's fine. If it happens one after another and is not cleared once, the patient will be miserable in the future. "Zheng Ren did not care and said casually.
It was not a bad idea to just fool around with this matter. The patient's diagnosis that might have been overlooked was reminded by Su Yun and did not arouse any suspicion. Lin Yuan had done a good job.
Well, in a few days, Lil Fugui would be leaving. He had to teach her the surgery well. If there were any mistakes, he would use the hemostatic forceps to hit her.
Lin Yuan did not know that because of a migraine, he had actually received Boss Zheng's' attention '.
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