Another important factor is that, as Lin Hao suspected, the child's clinical symptoms were "too mild" and many of them were inconsistent with the description of the disease in the textbook.
It is written in the textbook that the clinical symptoms of this type of children are: dyspnea, hypoxia, cyanosis, heart failure, etc. It is a type of severe neonatal heart disease that will soon lead to death if surgery is not performed as soon as possible.
Of course, it is written in the textbook that children with left heart hypoplasia can easily be missed because the above symptoms may reappear hours later or within a day or two.
Looking back at the birth history of this child, this is indeed the case. The records when the child was born showed that there was no major problem of dyspnea and heart failure. Considering that the routine examination of newborns does not include electrocardiogram and echocardiogram, in such a short period of time
When the child is asymptomatic, it is unreasonable to accuse the maternity hospital of missing the diagnosis of the child.
When they realized that the child had breathing problems, the obstetrics hospital did not breach its responsibilities. Instead, it conducted the best possible examination on the child as soon as possible. So the problem was not a breach of responsibility, but the limited technical capabilities of the grassroots hospital.
The neonatal echocardiogram displayed in the maternity hospital did not give a diagnosis. It was just a preliminary suspicion that the child had a heart malformation or a heart disease. To make an accurate diagnosis, you need to find a specialist from a specialized hospital to make a judgment.
To illustrate another problem, it is not easy to diagnose left heart hypoplasia. The main reason is that this disease is very rare clinically in China, and the number of affected people is large in foreign countries.
Clinicians do not rely on textbook guides to make diagnoses. There are too many similar diseases in clinical practice, and there are too many special circumstances that confuse each other. Clinicians need to learn real cases in clinical practice and be aware of them.
Only then can we make a diagnosis. Therefore, the grassroots hospital failed to make a diagnosis and send the son to him.
Two days have passed, and the child's symptoms are still so "mild". A young doctor who has never seen such a case must be mumbling in his heart when making a diagnosis. Therefore, Dr. Cheng did not dare to say anything for a long time, and could only wait for his superiors to express their affirmation or approval.
Is negative.
Now it is not a missed diagnosis but a possible misdiagnosis.
Is it really such a serious disease as left heart hypoplasia?
If not, it needs to be transferred to anal atresia surgery. You see, Dr. Wu, who is responsible for anal atresia surgery, came out and said that either my surgery should be done first.
If it is this disease, needless to say, the heart surgery may have to be performed tonight. Doctors outside the cardiology department know that hypoplasia of the left heart is more likely to kill the child in a short period of time than anal atresia with fistula.
Life.
"Yingying, what do you think?" Lin Hao turned around and asked thanking his classmate.
Unlike them, classmate Xie may already have some answers in his mind by keeping an eye on the patient's ECG monitor early in the morning.
Like other students, Xie Wanying has not yet seen the echocardiogram report. She can only make judgments based on what she has observed, saying: "I estimate that this child's left ventricular cavity is relatively small and he has mitral atresia."
It sounds like a sign of left heart hypoplasia.
Back to the original question, what is left heart hypoplasia?
The reason why left heart hypoplasia is called a syndrome means that it is not one abnormality but a combination of multiple abnormalities.
In medicine, the heart can be divided into left heart system and right heart system. The left heart system includes the left atrium, left ventricle, as well as atrioventricular openings such as the bicuspid aortic valve and connected blood vessels such as the ascending aorta.
