Chapter 1299 If he is not a genius, then what is he!
Foramen ovale not closed?
Suddenly hearing this term related to heart disease, all the doctors present had flickering eyes and instantly began to construct their own basic medical structure in their minds, hoping to find out what disease Feng Chunli had through Li Xiangnan's words!
Gui Jing and Ming Zhangju standing aside are obstetricians and gynecologists!
This disease that appeared in children made them both feel as if they were facing a formidable enemy. They subconsciously squeezed over from the back and asked anxiously, "Dean, what is this patent foramen ovale you mentioned? Is it a common disease in children's heart disease?"
Li Xiangnan naturally anticipated the two doctors' surprise.
Although the foramen ovale is one of the structures of the human heart and doctors are very familiar with it, because B-ultrasound and color ultrasound are not yet popular, and even CT machines have just entered clinical use in China, ordinary obstetricians and gynecologists have never encountered such a disease, let alone heard of the cause of the open foramen ovale.
"Patent foramen ovale is a congenital heart structural abnormality, a disease caused by the failure of the heart passage that should close naturally after birth."
Li Xiangnan explained briefly and heard the rustling sound of pens scratching on white paper. He saw Gui Jing and Ming Zhangju also eagerly writing down the knowledge points in their notebooks, and reminded them: "After hearing what I said, do you think that only children will have such diseases?"
Everyone looked at each other, even the knowledgeable Wang Defa and Lei Jin at the back looked at each other.
“Isn’t it?” Wang Qi, who was standing next to the two of them, suddenly raised his hand. “I remember the cardiology knowledge I learned before said that the foramen ovale will close with age…”
"That's right!" Li Xiangnan nodded and glanced at him. "Under normal circumstances, that's true! But what you don't know is that one in four adults suffers from patent foramen ovale, which is one of the most common congenital heart abnormalities in adults."
"what?"
There was a cry of surprise in the house.
Jun'ichi Kishimoto, who was standing beside the bed, looked at Li Xiangnan in shock as he spoke so eloquently, and was impressed by his rich knowledge.
"Under normal circumstances, the foramen ovale will close in infants and young children before the age of three. Even if it does not close, most people will not cause pressure imbalance or abnormal blood shunt between the left and right atria, so they are all asymptomatic patients!"
"But once there is an obvious right-to-left abnormal shunt in the blood flow in the heart, it may cause related clinical syndromes such as stroke, migraine, decompression sickness, etc. The specific manifestations are unexplained headaches, dizziness, dyspnea, and..."
At this point, Li Xiangnan pointed at Xiao Chunli on the bed and sighed, “Xiao Chunli is vomiting like this!”
At this time, a series of surprised voices rang out in the room, and Junichi Kishimoto, who was standing by, was extremely surprised and asked, "Then how did this unclosed cannula cause the child to vomit?"
Many doctors were suddenly stunned, and quickly stopped writing, looking at their dean, their eyes full of desire for knowledge.
"From what we know so far, Xiao Chunli has had symptoms of hypoxia several times, which means that her heart's foramen ovale has not closed. After she was three years old, a large amount of blood shunting from right to left occurred, causing a decrease in systemic blood oxygen saturation and hypoxemia. This is the reason why she vomits frequently!"
Swish!
A sudden and violent sound of note taking began.
There was no need for Li Xiangnan to pause now, as everyone was afraid of missing out on what he said.
"That's it! That's it!"
Gui Jing's eyes were shining brightly, as if a monk who went to the West to seek Buddhist scriptures had finally obtained the supreme scriptures in the Mahayana Buddhist Temple.
Ming Zhangju, who was standing by, also said excitedly: "Thanks to the dean, my knowledge in this area has increased! If such symptoms occur again in the future, we will have a direction to look for!"
There were many people around her who were writing as furiously as she was. They would occasionally look up and their gaze would stay on Feng Chunli's black and white image for a few seconds, then they would suddenly lower their heads and quickly write down Li Xiangnan's teachings with their own thoughts on paper.
Li Xiangnan held an ultrasound probe and kept moving it around Feng Chunli's heart, watching calmly and analyzing how to treat her.
At this moment, he also noticed that Jun'ichi Kishimoto, who had been very excited, was standing aside, watching his actions with a frown on his face. There seemed to be an unspeakable hesitation on his face, and he seemed to be hesitant to speak.
He turned his head and asked, "Teacher Kishimoto, do you have anything you want to ask?"
"President Li!" Kishimoto nodded and said with some embarrassment: "I don't know whether I should ask this question or not. If I offend you, please forgive me..."
"But it doesn't matter!"
Li Xiangnan felt that as long as it was about the illness, it could be discussed openly and there was nothing that could not be said.
"How did you determine through B-ultrasound that Feng Chunli had a patent foramen ovale? You know, this is the first time you have diagnosed a patient in your country. I really want to know, do you have any reference?"
As soon as these words were spoken, the slightly noisy B-ultrasound room suddenly became silent.
All the doctors looked at Junichi Kishimoto and woke up in shock.
Yes, it was correct that the dean diagnosed Chunli with patent foramen ovale, but the question is, how did he diagnose this condition using the B-ultrasound machine?
Everyone became curious!
Because if you don’t master this skill, then if you encounter this symptom during medical treatment in the future, will you be able to diagnose the condition?
"Teacher Kishimoto, your question is very sharp, but it is indeed crucial!"
But Li Xiangnan was not angry. He knew that the reason why Kishimoto was embarrassed was because in Japan, it was actually very impolite to rashly ask such technical questions.
Technology is the foundation of human survival.
It is said that a master can only lead you to the door, but practice is up to you. Even the closest master will often hold back when teaching his apprentices.
Kishimoto asked this kind of question in front of so many people, which would be embarrassing for him in the other party's opinion!
"President Li, I'm very sorry. If you don't want to talk about it, you don't have to..."
"why not?"
Facing Kishimoto's apology, Li Xiangnan smiled and said openly: "You can ask our doctors and nurses. I teach everyone medical skills and knowledge, and I never hide anything! When our Longguo masters teach their apprentices, they always teach them everything they know, and they are always selfless!"
Kishimoto was shocked, and there was something strange in his eyes when he looked at Li Xiangnan.
Li Xiangnan smiled and said directly: "Come closer and see it clearly."
"Teacher Kishimoto taught us that we should first optimize the quality of the two-dimensional image by adjusting the gain, depth, and focus position to ensure that the atrial septum structure is clearly displayed."
"In addition, we need to select a special high-frequency probe to improve the resolution in order to observe fine structures. For example, the phased array probe for the heart is used in this part!"
"Also, I noticed that when I was scanning just now, I did this with one movement..."
As he spoke, Li Xiangnan gently rubbed Feng Chunli's throat in front of everyone's gaze, and a slight cough came out of her mouth.
"This was done intentionally to induce her cough, which can temporarily increase the right atrial pressure, promote the appearance of potential right-to-left shunts, and increase the detection rate of tiny defects, which can increase the detection rate of patent foramen ovale to 60%-78%!"
Everyone suddenly realized that the pens in their hands were faster than their eyes.
“So overall, what’s the rationale for this?”
Li Xiangnan deliberately left the meaning blank to give everyone room to think, and then after a full ten seconds, he reminded:
"We use ultrasound reflection to observe the heart structure, especially the continuity of the atrial septum. If the foramen ovale is not closed, the B-ultrasound may show interrupted atrial septum echo or abnormal blood flow signals. Now you see..."
He pointed to the B-ultrasound monitor beside him. The image label on it just explained this point. Everyone had been taught the relevant identification knowledge by Kishimoto in advance, and after Li Xiangnan's explanation, they all understood.
"I see!"
Amid the rustling sound of notes, Kishimoto was the first to applaud.
Wow!
Then thunderous applause filled the ultrasound room.
"It's wonderful! Dean, listening to your class is simply amazing!"
There was a light of knowledge in everyone's eyes.
But at this moment, Kishimoto, who admired Li Xiangnan very much, captured the solemnity behind Li Xiangnan's calm expression.
He leaned forward and took the opportunity to ask, "Dean Li, haven't you found the cause of the disease now? Why are you still not happy?"
Li Xiangnan turned to look at him and pursed his lips. "It's good that we found the cause of the disease, but... we have to close the foramen ovale!"
"..."
As soon as these words were spoken, the whole room suddenly became quiet again!
Yes, the cause of the disease has been found, but it’s too early to be happy now.
The most important thing is how to cure Xiao Chunli's illness!