However, she had no clinical experience in other departments and could not figure out the cause.
"What kind of disease is this kind of huge difference in blood pressure between the two sides?" Liu Li asked. She knew that for normal people, the blood pressure of the right upper limb is usually one to twenty higher than the blood pressure of the left upper limb. It is extremely rare to have a congenitally large blood pressure gap between the left and right hands. If it exists, it should be discovered early through previous examinations.
"Several of us discussed this case in the afternoon. Everyone's thinking is that either we worry too much, or it is better to worry too much. Maybe the problem is not big. If the problem is worst, my personal guess is this, she She had this aortic aneurysm before, but the aneurysm was small and the symptoms were not obvious, and it was mixed in with her symptoms of cervical spondylosis. From the orthopedic surgeon adding electrocardiogram to the patient, we can know that the patient had some chest and back pain before, otherwise No more examinations. The aortic aneurysm did not rupture to the outer layer and has recently evolved into aortic dissection, so the symptoms caused by it make you very worried, Mr. Liu Li." Xie Wanying finished her words in one breath.
With this bad discussion result, you definitely need to contact Teacher Liu Li as soon as possible. I was just about to meet Teacher Tan, so I wanted to ask Teacher Tan for his opinion. I didn't expect Teacher Liu Li to come to dinner, so Teacher Tan took the initiative to talk about it.
Now she looked at Teacher Tan¡¯s expression as she spoke. In fact, the results of their classmates' discussion were written on the back of the medical record copy paper, and both Teacher Tan and Teacher Cui saw it. The two teachers seemed to agree with her opinion and let her speak.
Liu Li¡¯s head was exploded: What? !
Aortic aneurysm, aortic dissection, massive bleeding? What is the acute case fatality rate? More than 20 or 30?
"Well, her electrocardiogram and color Doppler ultrasound showed no abnormality." Liu Li asked, how could she remember that these two diseases could be detected using the above methods.
"The detection rate of these two diseases by electrocardiogram is too low. The previous cardiac color ultrasound could not detect it, indicating that the aortic aneurysm and dissection should occur in the section from the descending aorta to the abdominal aorta. If we had to do a color ultrasound at that time , what needs to be done is a transesophageal echocardiogram instead of an ordinary transthoracic echocardiogram. The gold standard for diagnosing this disease is CTA. She cannot do CT angiography when she is pregnant, so she can only do MR." Xie Wanying said, "Fortunately, Liu Teacher, it is right for you to lower her blood pressure first to control the rupture."
Liu Li didn¡¯t feel that she deserved to be praised. Liu Li¡¯s mind went blank, indicating that she was not familiar with these two diseases at all and had almost zero professional knowledge.
"I don't blame her. I don't know if there is such a rare maternal case in Beidu Sanyao every year." This type of patient would be the same if you encounter them in Guo Xie Guozhi.
Looking at his cousin¡¯s appearance, Tan Kelin frowned sternly.
Cui Shaofeng stood up and called Director Liang of the Obstetrics Department. This kind of difficult case requires leadership to suppress the situation, and it is not feasible for a young doctor like Liu Li to handle it.
When I called him, Director Liang must have been frightened on the other side and asked the young doctor to quickly notify the patient and his family members to come to the hospital.
Liu Li didn¡¯t eat, so he hurried out of the restaurant and took a taxi back to the hospital, calling the patient¡¯s family first.
"Eat." Tan Kelin picked up the chopsticks and instructed his apprentice.
Xie Wanying, who was following Teacher Liu¡¯s figure with her eyes, was stared at by Teacher Tan and turned back to eat.
"The order of diagnosis and treatment in clinical practice does not mean that when a patient is encountered, they all rush to save them, which will lead to chaos, and chaos will lead to mistakes. The attending doctor will deal with it first, and then call other people to help if it cannot be dealt with. There is no need to worry about overdoing it.