Chapter 1758 Esophageal Dilation

"It's okay, old man." Zheng Ren pulled out the old man's venous access and helped him up from the ground.

"Sit down and take a break, your illness has been diagnosed." Zheng Ren said with a smile.

"What's the diagnosis?" The old man was a little cautious, but also a little puzzled.

From the looks of it, he was really afraid of diagnosing himself as mentally ill. So much that he looked at Zheng Ren wrongly, with a faint hostility.

"Swallowing or swallowing syncope is a rare type of neurally-mediated syncope, which is associated with life-threatening bradyarrhythmias and hypotension, and is usually difficult to diagnose in time." Zheng Rendao: "It has been proved by a tilt test that it is a vagus nerve problem. ."

"..." The old man didn't understand a word.

"Don't say what the disease is, let's talk about how to treat it first." Zheng Ren said.

"Old Luan, did you say you were hurt?" Su Yun came to Luan Yingjie's side, helped him up, and said in a complaining tone, "I'm diagnosing your old man, what are you doing there."

"Uh..." Luan Yingjie clutched her wound in pain, not knowing whether to laugh or cry.

"You almost killed your father. It's not like you didn't see the situation just now. It's nothing to cause trouble." Su Yun continued to stab.

"That... I'm sorry." Luan Yingjie didn't know why he was kicked, but instead wanted to say sorry.

But his old man was sitting there upright, but his actions just now seemed a little strange.

Bow your head and admit it, it's not a problem!

"This disease requires a pacemaker." Zheng Ren said: "Dual-chamber pacemaker, you can eat whatever you want after you're done."

"My heart is fine." The old man wondered, "Where's the electrocardiogram, what pacemaker?"

"Your heart is fine, but when you eat, the esophagus dilates and the vagus nerve is involved, causing cardiac arrest for a few seconds." Zheng Ren smiled.

The old man still didn't believe it, but because Zheng Ren didn't say he was mentally ill, his attitude was much better.

Some elderly people of this age believe everything, and some believe nothing. It is obvious that Luan Yingjie's father belongs to the latter.

After all, it is an operation, and the operation to lower the pacemaker is still an operation, no matter how small it is.

Zheng Ren smiled, obviously he had taken this into consideration.

"Old man, why don't we do this." Zheng Ren said gently: "It's okay if you don't agree to get a pacemaker. Tomorrow, let Boss Luan take you to the hospital and take a 24-hour dynamic electrocardiogram."

"Um?"

"In one day, you can find the problem." Zheng Ren said, "Find a few experts to have a look, and then you can make a decision, how about it?"

These words made the old man feel extremely comfortable.

I definitely said the diagnosis opinion, but I didn’t force myself to make a decision, but let me do another inspection and carefully ask others to take a look. This little doctor is very good at being a man.

"Well, I think this is better." The old man immediately agreed with Zheng Ren's opinion.

"Then we'll go if it's all right." Zheng Ren said, "Boss Luan, if you decide to have an operation, come to me. It's different from normal operations. During the operation, you need to test the effect of esophagus swelling on the heart."

"Okay, okay." When Luan Yingjie saw Zheng Ren and Su Yun get up, he quickly stood up.

His legs softened and he fell to the ground.

"Look at you, you can't be careful. How old are you, what if you fall and break a bone." Su Yun didn't help, but sprayed.

Luan Yingjie smiled wryly, wasn't this kicked by you?

"You're welcome, we're leaving." Zheng Ren saw that the nanny went to help Luan Yingjie up, turned around and left.

"Boss Zheng, what happened just now?" Zhou Litao asked.

"Mr. Zhou, take your ambulance back to the hospital and take us for a while." Su Yun said with a smile.

"It's alright, what happened just now?" Zhou Litao has been struggling with the disease of the patient who fell into a coma after eating.

"The inhibitory response of esophageal dilation to the heart is the underlying pathophysiological mechanism of syncope in patients. This case is reported in the BMC Cardiovasc Disord." Zheng Rendao: "The authors also reviewed 101 cases of swallowing or swallowing syncope reported since 1793. The report is summarized.”

1793...101 cases, Zhou Litao was speechless.

"This kind of syncope is more common in men and the elderly. The average age of the case reports is 57.5 years old. 54.5% of patients eat anything that can cause syncope, whether it is made of water or solid food." Zheng Rendao: "Generally, it is the esophagus. disease-induced."

"So that's the case." Zhou Litao silently wrote down the patient's condition. He felt that the piece of paper that recorded Boss Zheng's diagnosis and treatment was exuding heat on his chest, which made him a little excited.

"Pacemaker implantation is the most commonly used treatment method. 98.1% of the patients were implanted with a pacemaker and reported that their syncope symptoms were relieved, and more than half of the patients were implanted with a permanent pacemaker." Zheng Rendao: "So there is a high probability Proving that pacemakers are still useful."

"Place the pacemaker..." Zhou Litao pondered the role of the pacemaker.

"The second is the treatment of gastrointestinal diseases, such as four patients who had repaired hiatal hernias. There are also patients who have received successful vagal ablation, long-term proton pump inhibitors and radical surgical resection of esophageal cancer."

"You scared me just now." Zhou Litao turned around at this time and touched his chest, still having lingering fears.

"Don't be afraid." Zheng Ren smiled and said, "Seeing that you have atropine in your first aid kit, if you have this medicine, there is no big problem."

"Um?"

"Atropine was commonly used before pacemakers were introduced, and limited data show that the efficacy is still up to 90%." Zheng Rendao, "If it wasn't for the observation of five minutes and to see how low the patient's blood pressure can be, push it directly. Atropine, 15 seconds to see results."

"But the blood pressure is too low." Zhou Litao said.

"Well, my psychological bottom line is 35 mm Hg. If it is lower than this value, I must inject atropine." Zheng Ren said, "The patient's condition is still cooperative, and it is very good."

"Boss, you can really hold your breath. My psychological bottom line is 40 mm Hg. Seeing that you didn't speak, I will endure it." Su Yun said, "But I was anxious, kicked Lao Luan, and felt much better."

"Don't be so violent." Zheng Ren said leisurely, "Aren't you afraid of accidents?"

"I also saw atropine. With atropine in there, how could something go wrong. Besides, I am a doctor of the heart, defibrillation, compression, a hundred ways to save him, what to be afraid of!" Su Yun said.

Zhou Litao was a little ashamed.

I was really a little flustered at the time.

Although I know that if the tilt test is positive, it may be dangerous, but after all, I have never encountered it, and the diagnosis is much worse than that of Boss Zheng and Brother Yun.

The basic level is still not enough, and I have to read more books when I go back, Zhou Litao thought to himself.