Chapter 2606 [2606] Doubt Here
The most common aortic disease can be the aortic aneurysm just mentioned. Like myocardial infarction, some patients with aortic aneurysm have atypical and strange symptoms. Including jaw pain can be aortic aneurysm. "Cervical spondylosis" can be myocardial infarction, cerebral aneurysm, and cervical vertebral aneurysm can also be aortic aneurysm. Because the areas affected by these diseases, anatomically, can partially overlap with the neurovascular range involved in cervical spondylosis.
What is an aortic aneurysm? The aorta is the largest arterial vessel in the human body. The "tumor body" on this blood vessel is an aortic aneurysm. The word "tumor body" here is enclosed in quotation marks, indicating that this tumor body is different from what we often refer to as tumors. It is an enlarged, balloon-like tumor formed by pathological expansion of blood vessels. It is not considered a tumor, but we still call such an aneurysm a true aortic aneurysm. Pseudo-aortic aneurysm is a tumor thrombus formed by blood flowing out of the blood vessel after a true aortic aneurysm ruptures.
Speaking of aortic aneurysm, another disease that is easily confused with it in clinical practice is called aortic dissection. What is the difference between aortic dissection and aortic aneurysm? This means that the wall of the aorta is divided into three layers, the intima, media and adventitia. A ruptured aortic aneurysm is a rupture of the three membranes. Aortic dissection is a rupture of the intima and adventitia. After the intimal rupture, blood flows to the media and tears the aorta from top to bottom. To put it vividly, tear off the inner and outer skins of the rubber tube and inject water in the middle.
The etiology of these two diseases can be the same as atherosclerosis and hypertension. Both cases were fatal with acute rupture and massive hemorrhage.
How to suspect Axi's mother's aortic disease, not the blood pressure fluctuation that Axi's mother's doctor friend said is not a big problem. This is about the "strange symptoms" of the patient's recent high and low blood pressure.
"When she took the blood pressure, the nurse took it, right? Did you measure the blood pressure without fixing one side of the body, right?"
Xie Wanying went to Beidusan's obstetric clinic. It is impossible for obstetric doctors to measure the blood pressure of patients in person, because there are too many patients. The overly simple medical examination of blood pressure is done by nurses. The doctor did not tell which side blood pressure must be measured, and the patient stretched out a hand for the nurse to measure. Blood pressure measurement is generally a practice item for trainee nurses in Beidu San, and there is no awareness of this kind of fixed blood pressure measurement of one limb.
Axi's mother's blood pressure suddenly rose, and she was prescribed antihypertensive medicine. After taking it, it dropped. How much did it drop? Fifty or sixty down?
Liu Li, who prescribes the medicine, has a weak heart. How can she, a young doctor, prescribe a large amount of antihypertensive medicine for pregnant women, and drop it suddenly? No wonder the more she thought about it, the more something went wrong. She just didn't expect that it might be due to the difference in the blood pressure of the patient's two limbs.
Young doctors and young nurses are all learned from a fall. When experienced medical staff feel that the blood pressure is wrong, they should re-measure the blood pressure of all limbs on both sides. The reason why the vigilance of the medical staff was low this time was because Aki's mother's blood pressure did not burst. The clinically terrible high blood pressure has been said before, jumping to more than one hundred and two hundred, and when it is low, it can reach sixty or seventy. Axi's mother didn't have it. When it was high, it was less than two hundred, and when it was low, one hundred and twenty was nothing.
On the other hand, Liu Li felt that there was something wrong with Axi's mother. Axi's mother said that her hands and feet were more likely to feel cold recently. I don't know if it is because the fetus is getting bigger and the waist is getting more and more uncomfortable.