Chapter 2299 Headaches Need to Be Cured of the Heart (Leader Aaxxee Plus 3)

Back in the intervention department, Lin Yuan reported everything he knew to Boss Zheng. There was one attack before, and it was cured after taking the medicine for facial paralysis, without any sequelae; she even reported the migraine that she thought was unimportant to Boss Zheng.

The longer the time, the more symptoms, and the more serious it seems.

And she did not emphasize that the patient underwent surgery, and she did not get first-hand information. For a person like Boss Zheng, no matter how much he emphasizes, it's useless, Lin Yuan knows it well.

"Su Yun, what do you think?" Zheng Ren asked.

"Don't smoke, don't drink, what do you do with such a good life and rest at a young age. Life is fun, do you want to go to nightclubs when you are old?" Su Yun babbled.

For him who smokes and drinks alcohol, Yang Lixin is a typical example of his opposite "evil".

"I didn't ask well about the medical history. If Sister Yue went, I would definitely know more details." Before Boss Zheng got angry, Lin Yuan did a self-criticism and admitted his mistake.

This method is very useful when you are at home. Every time you meow, no matter what happens, it will be over. Although Boss Zheng didn't like this, Lin Yuan still habitually called out first.

Perhaps if this is the case, Boss Zheng may be a little lighter.

"You've asked a good question. The illness has basically been clarified." Zheng Ren smiled faintly.

"Well……"

This sentence is more unacceptable to Lin Yuan than being scolded.

The condition is clear? Clear a wool! Where is it clear that you don't smoke, don't drink alcohol, and often stay up late? or something else.

"Oh? Do you suspect a patent foramen ovale?" Su Yun asked, "Is it because of a migraine, plus a suspected cerebral infarction, a cerebral infarction?"

"If there is one point, there is no way to diagnose it. If 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 is clearly stated in the book that the patent foramen ovale is mostly asymptomatic, it is difficult to hear murmurs, and the electrocardiogram and chest X-ray are normal. Therefore, it is not easy to find and is not valued by people.

Lin Yuan even thought of what was written in the information many years ago, on average, one out of 4-5 people has the disease of patent foramen ovale.

Because most patients are asymptomatic, it is very likely that the disease will not be discovered for a lifetime.

For a long time, it has been believed that patent foramen ovale generally does not cause two-chamber shunt, and has no effect on cardiac hemodynamics, so it is considered "insignificant".

Is that how Boss Zheng made the diagnosis?

Su Yun glanced at Zheng Ren, and he frowned and said, "Boss, did you start to suspect that young people have cerebral palsy?"

"Basically, there must be a reason." Zheng Ren said, "The probability of migraine caused by a patent foramen ovale is very high. A considerable number of patients have migraines, but it is difficult to diagnose because of the patent foramen ovale. caused."

"Contradictory cerebral infarction, so you have always suspected this." Su Yun smiled, "So you asked Xiao Linzi to ask about the medical history?"

"Well, as long as there is a migraine, there is a high probability that it can be diagnosed as paradoxical cerebral infarction. It is still relatively difficult to do a transesophageal ultrasound, and a foaming test may be required."

"Boss Zheng, wait a moment." Lin Yuan immediately stopped Boss Zheng's words. If this continues, there will be no treatment, and the study of a case has come to an end.

But I have no idea at all.

Lin Yuan knew about paradoxical cerebral infarction. Generally speaking, cerebral infarction is caused by arterial thrombosis. But some people have no emboli in the arterial system, but the emboli in his venous system can embolize to the blood vessels of the brain through the patent foramen ovale.

This is also a theoretical basis for the current medical profession to treat patent foramen ovale once a contradictory cerebral infarction is found.

"You want to ask what is the relationship between migraine and patent foramen ovale?" Zheng Ren asked.

"yes."

"Currently, there are no theoretical explanations." Zheng Ren smiled and said, "However, there are several conjectures. First, the unexplained migraine may be caused by some neurotransmitters in the venous system passing through this open egg. The round hole bypasses the inactivation and filtering functions of the pulmonary blood vessels, and directly reaches the cerebral circulation system, where it combines with some receptors of certain nerves to produce migraine symptoms."

"Secondly, under the conditions of deep breathing, coughing, exercise, etc., the unclosed foramen ovale opens completely, and the tiny thrombus in the venous system enters the brain circulation through the foramen ovale, aggravating the spread of cortical spreading inhibition, which is also the origin of migraine. Discovery."

Lin Yuan sighed inwardly, it seemed that his memorization of diagnostics was not good enough.

"When encountering a cerebral infarction of unknown cause, the recent theory is more inclined to check the heart." Zheng Ren continued, "A patent foramen ovale is also a predisposing factor."

Cerebral infarction, a heart ultrasound is needed, and it is also related to migraine... Lin Yuan sighed deeply again.

Everyone said that you can't treat your head and feet if you have a headache, but you didn't expect to be taught another lesson today.

Su Yundao: "Do you want to do a B-ultrasound yourself?"

"No need." Zheng Ren said, "Do you know anyone in the Department of Neurology?"

"I have dealt with the hospital manager before, but you also know the internal medicine department, and the contact is not deep." Su Yundao, "Shall I remind you?"

"Well, do a transesophageal echocardiogram, or do a foaming test, in short, how convenient it is, to check the condition of the patent foramen ovale. If there is, the probability of recurrence in the future is very high, so go to the circulatory department The intervening doctor just block it to death."

"Look at how much the intervention has delayed things. It used to be a heart-warming job." Su Yun glanced at his boss, and all the grievances were piled on the boss.

"The circulatory department is mainly doing cardiac interventional surgery. Who do you think is to blame for this?" Zheng Ren said.

"Let me ask from the side to see if they have checked. Don't let us be hot here. The neurology department is already preparing for surgery and examination. How embarrassing." Su Yun changed the topic and changed another direction.

"It's fine, as long as you don't miss this point. If you have seizures one after another, and you don't get through once, the patient will be miserable in the future." Zheng Ren didn't care, and said casually.

It's not bad for this matter to be fooled like this. Su Yun reminded the patient that the diagnosis that might be ignored did not arouse any suspicion. Lin Yuan did a good job.

Well, after a few days, Fu Guier will leave, and I have to teach her the operation well. If there is any mistake, I should use the hemostatic forceps to tap it.

Lin Yuan didn't know that because of a migraine, he was "valued" by Boss Zheng.