Chapter 364: : Master pointing!

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The old man went to the consultation room with Wu Yushu.
Wu Yushu sat down opposite Chen Cang: "Doctor, hello."
Chen Cang nodded and asked openly: "Well, hello, why are you uncomfortable?"
Wu Yushu tells the truth: "I got up this morning and felt that my chest was dull and it was difficult to breathe. It was much better to sit up. This situation also happened before, every year, but it will be fine after a while."
Having said that, Wu Yushu continued: "I usually smoke a lot, at least one pack of cigarettes, and occasionally two packs, for more than ten years.
Chen Cang was about to ask, and Wu Yushu said suddenly again: "Yes, I feel that my stomach has swelled recently, and my appetite is also very poor. Isn't my stomach motility bad?"
"Occasionally, there is chest pain, and it is not comfortable here!"
Wu Yushu touched the flank of the right side near the liver.
The patient's condition is more numerous and the symptoms are various.
However, the main symptoms are dyspnea.
After hearing this, Chen Cang felt that this was very similar to old chronic branch and chronic obstructive pulmonary disease.
but……
Respiratory suffering and orthopaedics are not just respiratory diseases.
May also have a great relationship with the heart.
Heart failure can also cause these symptoms.
Chen Cangdun thought for a moment, picked up his stethoscope, and decided to rule out the heart disease first, so he said to Wu Yushu, "You lie in bed, I will give you something."
Wu Yushu nodded.
Chen Cang picked up his stethoscope and heard it in several auscultation areas of the heart.
I feel that the first heart sound is somewhat weakened, and there are some murmurs in the second auscultation area of ​​the aortic valve ... Early extra sounds in the third and fourth intercostal spaces of the left margin of the sternum.
What does this mean?
Chen Cang also did not understand.
Heart auscultation is really a college question.
Chen Cang can only understand some fur.
There must be some problems. Thinking of this, Chen Cang has touched the apex of his heart and felt the strongest point. It feels a bit difficult to reach.
what's going on?
Chen Cang started the percussion of the heart, and the heart dullness circle was a bit large.
How to do?
At this time, Chen Cang suddenly had an idea.
Since the patient is a heart disease, that's easy to say.
He is a man with a hidden career in the three major skill trees of cardiology, cardiac surgery, and scientific research.
Pointing at the skill book of Happy Internal Medicine, Chen Cang immediately found that in the first-level operation, that is, the basic skill column has many skills such as cardiac auscultation and cardiac percussion.
Chen Cang immediately rejoiced.
Choose to redeem a heart auscultation now!
Just for a moment, Chen Cang suddenly flowed through his mind, and countless information and diagnosis about cardiac auscultation appeared in Chen Cang's memory.
Chen Cang felt like he had been baptized and taught about cardiac auscultation.
Ding! Cardiac auscultation: Master; passive skills in diagnostics.
At this time, when Chen Cang auscultated again, all kinds of information suddenly appeared in his mind.
Keep fit with the patient's situation.
After listening, Chen Cang frowned slightly: "I suggest that we first make an electrocardiogram and then cooperate to make a chest radiograph."
"You are in a more complicated situation, and it may not be a simple dyspnea."
When Wu Yushu heard it, he suddenly hesitated slightly.
"No, doctor? I still know my condition very well, and I am very clear about my constitution. This situation will be better in two days."
"I have had this before."
Having said that, Wu Yushu continued, "I'm still going to work now, yes, I still have a bit of bloating and poor appetite. Isn't the stomach power insufficient?
"Otherwise, you can help me get some medicine! The medicine that strengthens the stomach."
While talking, the man would get up and stand up.
At this time, the old man put his hand on Wu Yushu's wrist and said, "Young people don't want to be so anxious."
Suddenly, the old man frowned suddenly: "Why not take his blood pressure?"
The man suddenly froze, his blood pressure has been normal?
However, measuring blood pressure doesn't matter.
And Chen Cang looked at the old man, hesitated for a moment, okay, take a look at the blood pressure.
Fasten a man's cuff, this measurement, Chen Cang was dumbfounded!
Low blood pressure!
And, the most important thing is ...
Not a problem with blood pressure!
It's another thing.
Thinking of this, Chen Cang's face changed!
He found that the two systolic blood pressures were not the same. Chen Cang suddenly became cautious. While watching the man's breathing, he carefully measured his blood pressure.
When he heard the first Korotkoff sound, he quickly remembered the current systolic pressure, then carefully observed Wu Yushu's breathing pattern, and then tested again!
He suddenly found a serious problem!
That is, when Wu Yushu inhales, Korotkoff's voice disappears, and it appears when he breathes!
A name appeared in Chen Cang's mind: Qi Mai!
At this time, Chen Cang quickly turned his attention to the old man who had just let him take his blood pressure.
Suddenly my eyes were full of awe!
This is a bull!
Definitely awesome!
But this time is not the time to consider this, Chen Cang needs to continue to improve the inspection.
The appearance of the strange pulse made Chen Cang have to inspect Wu Yushu again.
What is Qimai?
Qimai is a special kind of pulse!
Refers to the phenomenon that the pulse significantly weakens or even disappears when inhaling, and then appears or returns to its original state when exhaling.
It is not so simple to feel this kind of pulse.
Why does Chen Cang feel that the elderly are powerful?
Because the old man just said, "Go and take your blood pressure!"
This sentence can be said to be meaningful!
And there is a lot of knowledge about doing things!
First, observing the odd pulse with a sphygmomanometer is often more obvious than palpation with a finger.
Any doctor with some experience can find abnormalities when he takes blood pressure seriously.
Don't underestimate blood pressure ~ EbookFREE.me ~ A small blood pressure measurement can completely discover many strange diseases and phenomena.
The odd pulse is not the odd pulse in the eight veins of the odd classics, but a peculiar pulse, also called the "suction pulse".
That is, when you inhale, it stops.
This is a relatively dangerous disease. There are only a few causes. One is a large amount of pericardial effusion with pericardial tamponade. The other is constrictive pericarditis and a series of diseases of the heart muscle. And a large amount of pleural effusion may also occur, which requires further diagnosis.
However, no matter what kind of disease, the appearance of strange pulses is always not good!
The old man asked Chen Cang to take his blood pressure. I did not expect such a big discovery. Thinking of this, Chen Cang couldn't help but be grateful.
This is a great person!
Absolutely, not only did he feel the strange pulse all at once, but he calmly asked Chen Cang to measure his blood pressure.
In a few words, Chen Cang found the core elements of diagnosis directly.