Yuan Ping'an is a man who does not believe in evil. Everyone says that Sun Lien is not a bad face. As long as the patient he takes over is not a rare disease, it must be an atypical symptom. Although the correct cause can be found in the end, it is a bit troublesome to encounter such a patient after all. Other doctors generally do not ask Sun Lien to consult unless they have no choice.

Yuan Ping'an had a different view. He felt that Sun Lienlai had a consultation and found a rare disease in the patient, which was a good thing.

Regardless of whether Sun Lien was coming to the consultation, the disease itself will not change due to the doctor's diagnosis. A rare disease was diagnosed, at least it clarified the direction of treatment or control. This is of course a great thing for patients - it is better than being misdiagnosed as an ordinary disease and then being treated ineffectively for multiple treatments, which makes the condition further develop.

"What's the problem?" Although Yuan Ping'an is still the attending physician of the emergency department, he has completed the support task. He has been a one-year residence and has enough weight as a backing. He will definitely win the next time he is rated as an associate senior. Therefore, in the emergency department, everyone basically treats Yuan Ping'an as an associate senior. If there weren't a particularly troublesome patient, he wouldn't be asked to go for consultation. Because of this, Yuan Ping'an decided to simply call Sun Lien to take a look.

"Male, twenty-five years old. After the exercise, the one who called Yuan Ping'an was a young doctor. Sun Lien had seen him twice in the emergency department - probably a new intern or a rotation of training? "The patient complained that he had long-term weakness, but he had never been to the doctor."

"Ah?" Yuan Ping'an was a little surprised when he heard this, "Why haven't you been seeing a doctor?"

It is not uncommon for patients to delay treatment for various reasons. However, this kind of thing usually happens when "the test results indicate that they are sick, but the patient does not feel it themselves." It is rare for patients like this to have obvious discomfort but have delayed "long-term" visits without medical treatment.

"I don't know this..." The young doctor felt a little embarrassed, "I was not by my side when I asked about my medical history. It was Dr. Cao who asked me to invite you over."

What Dr. Cao must be talking about is Cao Yanhua. Logically speaking, patients with chest tightness after exercise are likely to be in the work scope of the doctor in the Chest Pain Center. However, Cao Yanhua would ask Yuan Ping'an to participate in the consultation... This is a bit strange.

Sun Lien, Yuan Ping'an and others soon rushed to the rescue room and saw Cao Yanhua frowning beside the bed.

"This patient... I think I should have received it from your diagnosis center." Dr. Cao Yanhua first looked down at the test report and said, then looked up and saw Sun Lien, "Oh? Team Leader Sun, are you here?"

"Brother Cao, can we be more normal?" Sun Lien responded with a smile, "or will you have to call an official position in the future? I have to change your words and call you Team Leader Cao?"

Cao Yanhua is the leader of the rescue team of the chest pain center of the Emergency Department of the Fourth Hospital. Although he is definitely not a high-ranking official, he is also a leadership position after all. That's why Sun Lien said this.

"Okay, okay, normal." Cao Yanhua nodded with a smile, and then returned to his seriousness. "The patient's condition is not right this time, so I'll ask you to come and have a look."

When he said "the patient was not right", Cao Yanhua took two steps to the side and used a relatively low volume. It can be seen that he didn't want the patient to hear his "evaluation".

"What's the problem?" Yuan Ping'an began to ask after a long sentence, "Is this a... chest pain?"

"The problem lies here." Cao Yanhua nodded, "The patient has no previous history of hypertension and no family chest pain. I just checked the blood lipids, and all of them are normal - but the heart ultrasound suggests that the patient has different degrees of reflux in the left and right atrium, mitral valve and tricuspid valve. I just had a coronary CT and angiography examination, which showed that the left main trunk was 99% narrowed and the tribular lesions; the anterior descending branch was 99%, and the timi blood flow was level 1; the circumcision branch was 99%, and the timi blood flow was also level 1."

The condition is very serious. But... it is not difficult to diagnose. Severe coronary stenosis is basically equivalent to announcing that the patient needs stent or bypass surgery. From the perspective of the three stenosis, either the patient himself has a natural right circulatory advantage, or compensatory hyperplasia appears in the right coronary artery.

"After all the angiography, why didn't I get rid of the stent?" Yuan Ping'an and Sun Lien had the same question. Generally speaking, after undergoing coronary angiography, the doctor will directly install coronary artery stents for the patient during the angiography. If you save this, do it again. This is a relatively easy-to-accept treatment plan for patients and doctors.

"Because of uncertainty, the cause of stenosis." Dr. Cao took out a blood lipid test, "The blood lipid is a normal level. 25-year-old patients at this level generally do not have coronary stenosis."

Coronary artery stenosis is most likely to occur in patients with excessive blood lipid content. This is one of the biggest consensus among doctors in practicing medicine. The more unhealthy patients live, the more likely they are to have this problem - the high blood lipid content in the body, causing fat to agglomerate on the walls of the coronary artery or other arteries at a rate far beyond the normal. Once the deposited and aggregated fat begins to change into sclerotic plaques under the action of the immune system, it will begin to cause changes in the blood flow dynamics in the blood vessels.

The blood vessels of the human body are the same as river channels. A stone at the bottom of the river that cannot be pushed by the river can cause the silt and sand to accumulate rapidly near the stone. After the hardened plaque appears, layers of fat will inevitably adhere to the plaque and be attacked by the immune system again, thus becoming a new plaque.

When the plaque is thick enough to block most blood vessels, coronary artery stenosis occurs. A narrow coronary artery will cause insufficient blood supply to the myocardium, resulting in a large number of symptoms including chest pain. In the most severe cases, it will cause ventricular fibrillation and atrial fibrillation, and even the heart stops.

This is why Dr. Cao Yanhua requested consultation - the patient's blood lipid content is normal and his blood sugar is within the normal range. This means that in a river with not much silt and sand, three islands suddenly appeared with sand gathering.

Before we figured out the reasons for the formation of the island, Dr. Cao Yanhua really didn't dare to dredge the river channel by directly digging the island. If the existence of these three river center islands means that the patients have more serious underlying problems, it will inevitably lead to misdiagnosis.

"This is a matter..." Yuan Ping'an frowned, and he began to recall the reasons why sclerosis plaques are prone to induce. "The blood lipids are normal, are there any checks for coagulation and immune antibodies?"

Clotting abnormalities are also a major cause of coronary heart disease. If blood error begins to aggregate on the blood vessels, it is indeed possible to cause severe coronary stenosis. Immune antibodies are another direction - vasculitis.

Vasculitis may occur in all blood vessels in the human body. This kind of inflammation with varying causes will eventually lead to damage and inflammatory reactions in the inner wall of the blood vessel. The damaged inner wall of the blood vessel will directly lead to abnormal blood flow, thereby inducing blood aggregation or blood lipid deposition.
Chapter completed!