After Tang Xianhu communicated with Tang Lou for a while to ensure that Tang Lou had a full understanding of the Mayo Clinic, he said: "Tang Lou, Dr. Patricia will be arriving soon. I'll go greet him. There will be one in a while.

Special cases will be transferred from lower-level hospitals

, I will arrange a consultation with Patricia, and then he will perform the surgery and perform the operation. After a while, I will invite the doctors from the department to observe and learn, and you will come with me. After the operation, I will arrange for you to meet with Patricia.

"

"Okay, Director Tang. I'll go back first. There happens to be another case that needs to be designed with a surgical plan. I'm also looking forward to seeing what the level of the doctors from the Mayo Clinic is like."

After Tang Lou finished speaking, he left Tangxianhu's office.

And, Tang Xianhu also walked out to greet Dr. Patricia who came from the Magic City.

Ten minutes later, Tang Xianhu arranged for Patricia to start a consultation with Director Huang and Professor Liu.

The patient was sent from a lower-level hospital. The situation was very complicated and urgent.

After receiving the patient's treatment, he looked at it in the consultation room:

The patient, a 48-year-old female, went to the hospital because of "chest tightness and shortness of breath after activity for 20 days, accompanied by palpitation, weakness in the limbs, and inability to lie down at night, which worsened for 1 week"; she had no history of hypertension or cerebrovascular disease.

Physical examination: Chest percussion was voiceless, and respiratory sounds in both lungs were clear; the relative dullness boundary in the precordial area was enlarged in percussion, and no obvious heart murmur was heard in the auscultation area of ​​each valve.

Transthoracic echocardiography: The left atrium was probed into an echogenic mass of approximately 45 mm × 40 mm, with large mobility. Part of the tumor entered the left ventricle through the mitral valve during diastole, and retracted into the left atrium during systole, with a narrow pedicle attached.

In the interatrial septum, there was mild tricuspid regurgitation and moderate pulmonary hypertension of 65 mmHg; the possibility of myxoma was considered.

...

...

After reading the information and the preliminary diagnosis from the lower-level hospital, several doctors quickly came up with preliminary ideas.

There were all the big guys present, and of course Director Huang was the one to suggest this: "The initial suspicion is that it is myxoma. Myxoma can occur in various chambers and ventricular cavities of the heart. The most common one is this patient's case, located in the left atrium.

.”

Professor Liu also agreed: "Yes, through the impact data, it can be observed that there are shadows in the patient's pulmonary artery orifice and ventricular cavity. The typical appearance of myxoma is similar to gelatin-like tissue, often in the shape of lobes or grape beads.

The sizes vary and can vary from 1 to 1. The tumor tissue is very fragile and easily broken. After falling off, it can cause peripheral arterial embolism or cerebral vascular embolism. A very small number of myxomas can undergo malignant transformation and become myxosarcoma."

While several big shots were having a consultation, the resident doctor in charge of the bed under Director Huang rushed over. As soon as he came in, he immediately reported to Director Huang: "Director Huang, the patient suddenly suffered from epilepsy. Now his limbs are twitching and his mouth is white.

Mo, we are now undergoing symptomatic treatment..."

After listening to the resident doctor's report, Director Huang and others immediately rushed to the patient. The American doctor Patricia also followed closely behind, holding the patient's impact information in her hand. She seemed to have thought of some possibility, but her face was not too expressionless anyway.

nice.

Soon, several people arrived at the ward. Director Huang took the lead and started to deal with it. Patricia on the side also started to observe. Looking at the cooperating medical staff of Zijingang Hospital and the equipment in the ward, he was still a little disappointed.

.

After all, the biggest feature of the Mayo Clinic is that it has sufficient medical staff. For example, Mayo's operating rooms are divided into central, northern, and pediatric. Among them, in central Patricia, although there are only about 50 operating rooms, it has more than 120 anesthesiologists, and

Various residents, STAFF and A.

In addition, Mayo's equipment and medicines are of the highest quality. Some medicines are not even available in other hospitals in the United States. As long as Mayo doctors think they are useful, they can propose them to the hospital and eventually use them in clinical practice.

middle.

This also ensures that Mayo can always be at the forefront of medical development. Therefore, after seeing the situation in Zijingang, Patricia shook her head inadvertently, feeling a little contempt in her heart.

Afterwards, Director Huang and Professor Liu began to conduct further physical examinations on the patient. Seeing Zijingang's very backward diagnosis methods and judgment of the condition, Patricia stood aside and remained silent.

Although empirical diagnosis can sometimes achieve an accurate judgment through a doctor's individual diagnosis, at the Mayo Clinic, they do not rely solely on short-term on-site observation.

When Patricia was at Mayo, for the diagnosis of many patients' conditions, in addition to her own judgment, she would also rely on Mayo's large, efficient and multi-professional data analysis department.

Mayo's data analysis department specializes in analyzing the massive amounts of information collected in medical information systems, aiming to improve clinical processes and outcomes.

For example, in the case of this patient, in addition to on-site diagnosis, patient information will also be entered into the system for later big data analysis. It can be said that many diseases that cannot be diagnosed in China can be solved through Mayo's database through complex and efficient methods.

calculation to get the most accurate diagnosis.

In the ward, various latest physical examinations were quickly completed.

"The patient's breathing gradually deepened and accelerated, breathing 30 to 40 times/min, oxygen saturation 95% to 99%, blood pressure 150 mmHg/82 mmHg, deep coma, limbs clammy, auscultation of bilateral lungs with low breath sounds, dull heart sounds, and no

The pulse of the dorsalis pedis artery of both lower limbs was palpable. Bedside echocardiography: no isoechoic mass was seen in the left atrium, and the left ventricular ejection fraction was 56%; the myxoma was considered to have fallen off."

"Further brain CT is needed. The patient's left lateral ventricle was compressed and deformed, and the left ventricular ejection fraction dropped to 39%..."

Twenty minutes later, further examinations were finally completed, and all the doctors returned to the consultation room, with Patricia following behind. In her mind, she made a comprehensive and objective analysis and evaluation of the entire process of Zijingang Hospital.

Of course, based on further physical examination, he also made his own judgment.

Director Huang was still the first to put forward the idea: "The patient has developed multiple blood vessel embolisms all over his body. Combined with the disappearance of the echo group in the left atrium, it can be basically determined that the myxoma was shed and caused systemic circulation embolism. However, the occurrence of epilepsy and subsequent shock is still unknown.

Determine what the cause is.”

After Director Huang finished speaking, Professor Liu also put forward her opinion, which was basically the same as Director Huang, but put forward another idea of ​​her own: "The patient's left atrial myxoma caused multiple blood vessel embolism due to cleavage, and it cannot be ruled out that it has invaded the brain.

, lower extremity blood vessels, renal arteries and coronary arteries, which is why epilepsy occurs. Moreover, disseminated intravascular coagulation in the late stage of shock will aggravate embolism in multiple locations. In short, the patient's condition is very dangerous, and it is very likely that he cannot undergo simple surgery.

save."

Professor Liu's tone was a little low. If the myxoma was in the early stage before it ruptured, the left atrium myxoma could still be resected. But in this situation, even if the myxoma in the left atrium was removed, it had already ruptured and the destination of the scattered parts was unknown.

It may enter the blood vessels of the brain, lower limbs, and renal arteries, and it is impossible to start.

After listening to Professor Liu's analysis, Tang Xianhu also agreed, and the three doctors from Zijingang Hospital all looked at Patricia at the same time.

Of course Dr. Patricia has unparalleled skills and experience. She cleared her throat and said directly: "I agree with Professor Liu's point of view, and based on my experience, the patient's myxoma is very likely to cause multiple cerebral vascular embolism, and
Chapter completed!