"Yes," Zhao Yunlong said.
He immediately picked up his phone and sent a WeChat message to the doctor on duty, asking him to send over the echocardiogram pictures and report.
A few minutes later, his phone rang. He took a look and handed the phone to Zheng Ren.
In the CDFI report, the patient's tricuspid regurgitation bundle area was more than 8 square centimeters, which was considered severe tricuspid regurgitation.
The pulmonary artery pressure and other indicators were abnormal, but it was not consistent with tricuspid regurgitation.
This was indeed a little strange.
Generally speaking, the heart valve was like the bow of the door of an old house. After it was opened, it would be pulled back to prevent blood from flowing back.
This kind of situation was most common in the elderly because of muscle atrophy and aging, resulting in the valve not closing tightly.
If it was young people, it was common for congenital heart disease, infection, intravenous drug use, and so on.
Zheng Ren asked about the patient's medical history again, but there was no relevant medical history. This was also what Zhao Yunlong found strange, so he planned to discuss it internally tomorrow.
He could not go on stage directly if he did not understand the disease.
Once he went on the operating table, if there was an undiscovered disease, the surgeon would face more trouble. As an experienced surgeon, there was no way Zhao Yunlong would not understand this.
He would rather not go on stage than to figure out everything.
Therefore, he was very cautious.
Su Yun also took a few looks. Countless questions circled in his heart. This patient was really abnormal.
He did not want Zhao Yunlong to drink more. If Zhao Yunlong had a hangover during ward rounds and internal consultations in the department tomorrow, he would be scolded to death by the chief physician.
"Are the other test results out?" Zheng Ren suddenly asked as he rested his chin on his hand and pondered.
"I'll ask them to send all the pictures over," Zhao Yunlong said.
This time, Zhao Yunlong directly created a group and asked the doctor on duty to send the pictures to the group.
Looking at the test results, Zheng Ren and Su Yun finally became obedient.
Especially Su Yun. The black hair on his forehead moved without any wind, as if his brain was operating at a high speed, causing a slight change in the air flow.
Zheng Ren looked at the reports one by one and immediately found the problem.
Not only did the patient have changes in heart steatosis, but he also had severe fatty liver. Moreover, the liver was larger than a normal person's liver on the ultrasound.
That was strange.
The patient was only in his thirties. Even if he drank too much and ate a lot of fat, it was very difficult for him to have severe fatty liver and cause his liver to become larger.
This was the same as tricuspid regurgitation. It was not a problem that young people of his age should have.
Zheng Ren racked his brain and compared the data. After ten minutes, he said slowly, "Do a blood acyl carnitine test tomorrow."
"Huh?" Zhao Yunlong was taken aback.
"Based on the patient's test results and the clinical symptoms you mentioned, I suspect that it is a primary carnitine deficiency." Zheng Ren said, "Cardiomyopathy, lipid deposition myopathy, fatty liver, and the patient's blood sugar is only 3 mmol/L, so it can be roughly determined."
Zhao Yunlong was a little confused. He knew about this disease, but he had never seen it clinically.
Su Yun was deep in thought. After thinking for a few seconds, he asked, "Can the hospital do the SLC22A5 allele test?"
"Yes, but it will take time."
"Does anyone else in the patient's family have a similar situation?"
"When I asked about the patient's medical history, the patient's description was unclear. I've already asked the patient's father and mother to come over. I'll ask them in person tomorrow." Zhao Yunlong's clinical work was meticulous. If Su Yun could think of it, he could also think of it and had already arranged it.
"Boss is right. Considering that it is a primary carnitine deficiency, surgery is not recommended. The vein will be given a period of time, and then it will be fine as long as it is taken orally. Right, Boss? "Su Yun asked.
"Yes." Zheng Ren nodded.
This was a fatal disease, but as long as it was discovered in time and supplemented with diet and carnitine, the quality of life would not be affected.
"The free carnitine is significantly reduced. If it is less than 10μmol/L, coupled with the reduction of various acyl carnitines, we can basically judge it," Zheng Ren said. "When the genetic test returns, we will start to supplement the carnitine. The symptoms will be alleviated."
Fang Lin felt a little emotional as he listened to Zheng Ren and Su Yun solve the questions in Zhao Yunlong's heart one by one.
He was not called the rising star of the cardiothoracic surgery department in the Imperial Capital for nothing. He was not surprised that Su Yun could diagnose it. However, this diagnosis was first given by Chief Zheng. Then, Su Yun deduced it and found a few bases.
Chief Zheng was indeed very strong.
Regardless of whether it was right or wrong, it was enough to be able to suggest that the next step needed to be checked and tested step by step. Many people, including himself, looked at these test results with dewdrops on their heads.
"Old Zhao, when we go to Yizang later, do you still want to drink?" Su Yun asked.
"I have something to do tomorrow," Zhao Yunlong insisted.
"Tsk, what a disappointment."
"Who knew that such a patient would be admitted today." Zhao Yunlong ignored Su Yun's disdain. It seemed that he was already used to it. He was thinking about the patient's condition. The more he thought about it, the more he felt that Zheng Ren was right.
It was very likely that it was a primary carnitine deficiency. After using L-Carnitine, the patient's tricuspid valve insufficiency symptoms would also be relieved. There was no need for surgery to treat it at all.
This was discovered early. If it was a few years or ten years later, or the patient would have an acute outbreak, metabolic acidosis and hyperammonemia, it was possible that the person would be gone.
Even if it was not gone, the possibility of treatment in the future was not high.
This disease was similar to diabetes and required long-term medication. However, compared to the complications, long-term use of L-Carnitine did not seem to be a big deal.
After eating for a while, after a 'consultation during the meal', everyone's interest was also reduced. Especially when Zhao Yunlong refused to go to Yizang to drink, Su Yun felt even more bored. After chatting for a while, they dispersed.
They each called a car and went home.
The night was shrouded in darkness, and the lights were waning. Zheng Ren sat in the car, took out his phone, and reported to Little Yiren that he was ready to go back.
On the other side, Xie Yiren and Chang Yue had already laid down and were in the group chat.
Chu Yanran was on duty tonight. Sea City had received a car accident and was undergoing emergency surgery. She did not have time to chat. It was Chu Yanzhi who told everyone.
"Boss, guess how many people will come to see you for TIPS surgery tomorrow?" Su Yun suddenly asked.
"Who knows?" Zheng Ren did not care.
"I guess someone will invite you to give a lecture tomorrow. Are you ready?"
"There's no need at all. If there's a need, just go. On your side, it's more important to prepare the agreement. "
"There's no problem with the agreement. What do you think about the lecture fee and freelance surgery?"
"Uh …" Speaking of money, Zheng Ren really did not want it. However, he knew that free things were usually not cherished.
If he wanted to promote the learning of TIPS surgery as soon as possible, there were still a few nodes on his side that had not been cleared. Moreover, he had to find a detailed way to increase the enthusiasm of doctors from other hospitals so that they could apply TIPS surgery to clinical practice as soon as possible.
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