Great Medical System in a Veterinarian-Chapter 499 - 221: Contrast Agent Allergy—Kind Words Can’t Persuade the Stubborn Dead
"Of course I had tests done at our County Hospital!"
Aunt Zhu Panxiang shook the large jade pendant on her chest as she spoke.
"Oh? What tests did you have? A cardiovascular CTA?"
He asked.
Huang Xiangning was a bit surprised.
She really didn’t expect it; the other side is quite knowledgeable, knowing about cardiovascular CTA and all.
This kid said he doesn’t want to be a human doctor, though.
Is it because of Old Shen?
Old Shen might be saying one thing on the surface and doing another behind the scenes, saying he supports studying to be a human doctor but actually telling Xiaochuan to uphold the veterinarian flag?
Originally, Huang Xiangning didn’t think Old Shen was like that, but she discovered he recently met with an old flame behind her back, so she couldn’t help but suspect.
Looks like I need to ask him some time.
If Old Shen really did such a thing, she’d take out the washboard bought at their wedding!!
Make him kneel until he begs!!!
Lost in thought, Granny Zhu seemed to be having a standoff with Zhang Lingchuan!
"I didn’t do a CTA, but I had several ECGs, and they all showed myocardial ischemia. I consulted with our local doctors, and they think it’s coronary heart disease. My cousin also looked and said it’s likely a heart problem. What, is that not enough? You little doctor, shut your mouth! Don’t waste my time! Vice Director Huang, could you please arrange a coronary angiography for me? I want a full check-up!"
Granny took out several ECG reports from her bag.
"Ms. Zhu, don’t be anxious, this Dr. Xiaochuan is quite capable and won’t waste your time. Right, Xiaochuan, how’s your assessment of the ECG?"
Huang Xiangning was also not in a hurry.
She glanced in the direction of Zhang Lingchuan, inquiring how he assessed the ECG.
"Hmph! What can he see!"
Hearing Huang Xiangning defend Zhang Lingchuan, the aunt was quite displeased.
She immediately spoke disdainfully.
However, since she was dealing with a director, she couldn’t lose her temper, so she continued to look down on Zhang Lingchuan.
After all, he seemed like a new doctor.
No credentials, no skills.
Always questioning this and that.
No idea why Vice Director Huang is protecting him so. 𝐟𝕣𝕖𝐞𝐰𝕖𝚋𝐧𝗼𝚟𝐞𝕝.𝗰𝐨𝐦
What could someone like him possibly achieve?
"These three ECGs show precordial lead T wave inversion, which indeed indicates myocardial ischemia. Along with the patient’s symptoms, it’s quite easy to diagnose coronary heart disease.
And that’s the most likely possibility."
Zhang Lingchuan said while examining the ECG at the moment.
Since he entered the hospital, he had to learn relevant knowledge.
Otherwise, he’d have no idea when he’d slip up.
Including how to read an ECG, among other things.
Currently, looking at these three ECGs, it indicates myocardial ischemia. Coupled with the patient’s obesity and chest pain, a coronary heart disease diagnosis is possible.
But myocardial ischemia can actually occur due to various factors.
For instance, obesity can also cause myocardial ischemia.
"So do you think Ms. Zhu has coronary heart disease and should undergo checks related to it?"
After hearing what Zhang Lingchuan said, Huang Xiangning queried.
"No, I don’t think it’s necessarily coronary heart disease. It’s just myocardial ischemia, with obesity being one of the factors. Just myocardial ischemia plus chest pain isn’t enough to diagnose coronary heart disease, especially since the chest pain she’s experiencing is somewhat different from that associated with coronary heart disease."
Zhang Lingchuan continued.
His system detection results clearly indicated it wasn’t coronary heart disease.
It was intercostal neuralgia.
The myocardial ischemia was likely due to obesity, and the patient also had diabetes.
"You little doctor! Are you daft? The evidence is right here, and you’re still nitpicking! If we were in my town, I’d smash up your shop! Absolutely incompetent doctor!"
She was furious.
Granny Zhu was completely enraged.
Absolutely incompetent.
However, Huang Xiangning gestured for everyone to continue.
This was typically a normal teaching process.
It generally wouldn’t take much of the patient’s time.
Patients like this are quite uncommon.
But it didn’t stop her from thinking Dr. Xiaochuan had a valid point since there are multiple possibilities for chest pain.
For instance, angina from coronary heart disease is mainly chest pain after exertion, whereas her chest pain appears both with and without exertion, making it not typical of coronary heart disease symptoms.
Usually, conditions like stomach ache, intercostal neuralgia, costochondritis, or cardiac neurosis could also be causes.
They could do further tests to determine the specifics.
Despite her earlier tests lacking, having done only an ECG.
Actually, when checking for coronary heart disease, an ECG doesn’t reveal much.
Generally, a coronary CTA is done first. Think of it as a heart-enhanced CT, with 95% accuracy for coronary heart disease.
The downside is the 5% chance of imperfection or oversight.
The upside is it’s non-invasive, convenient, and generally safe for patients.
Another option would be the cardiac catheterization Ms. Zhu mentioned.
This type of angiography is very accurate but involves an invasive procedure.
In simple terms, it involves inserting a catheter into a blood vessel, and even the most skilled doctors can cause some vascular damage during the procedure, requiring a hospital stay of two to three days post-operation.
But nowadays, many people prefer angiography.
In reality, the most appropriate approach for checking coronary heart disease is to start with a CTA.
Once potential issues are confirmed, then proceed with angiography.
Testing doesn’t always need to be a one-step process, because there might not always be a...
