Chapter 241
The two department directors froze for a moment at his words, then snatched the report and began examining it closely.
The P wave on the chart did show some oscillation, and the ST segment had indeed shifted downward multiple times.
But after looking it over, they showed no sign of being put in their place.
Instead, they sneered. "He’s over fifty and has high blood pressure. Isn’t a slight oscillation perfectly normal? And after a major car accident, it’s entirely reasonable for symptoms of myocardial ischemia to appear. This has nothing to do with what you’re suggesting, does it?"
Chenyang shook his head. "On the surface, what you’re saying isn’t wrong. But in reality, you’ve overlooked several important points.
First, if the patient sustained no heart damage, and if there are no issues with his stomach, intestines, liver, gallbladder, spleen, or lungs, then why is he vomiting blood and passing blood in his stool?
Second, the fluctuations on the ECG aren’t enough to definitively prove heart damage on their own. But what if you add in his other external symptoms: a persistent low-grade fever, a bluish tint to his eyelids, and shortness of breath?
Finally, and most importantly, I asked the nurse earlier and confirmed the patient has high blood pressure. But after my own examination, I discovered it’s not primary hypertension. It’s pathological hypertension, caused by a cardiac condition.
Taking all of this into account, doesn’t that conclusively prove his symptoms are caused by heart damage?"
"High blood pressure? Isn’t his reading just over 140 and 95?" the director of surgery said with a frown. "For a man his age, that doesn’t really count as high blood pressure, does it?"
Chenyang raised an eyebrow. "How does it not count? You’ve studied medicine for so many years and practiced for just as long. Surely you know that a truly normal blood pressure is 120 over 80?"
"Yes, but the problem is, with age..."
"Even with increasing age, anything above that value is still considered abnormal! Director! I’m speaking frankly, and I hope you don’t mind. I have no intention of arguing with you. I simply want to say that in the absence of any other symptoms, slightly elevated blood pressure can be overlooked and not used as the basis for a diagnosis.
However, when a patient presents with multiple symptoms, we absolutely cannot afford to ignore a single detail. Otherwise, not only will we get stuck in a vicious diagnostic cycle, but the patient will also be left to suffer in agony for much longer!"
Chenyang’s confident but respectful words left the two directors speechless.
They were both veteran doctors.
Their experience and skill in treating patients were worthy of admiration.
At the same time, however, over their long careers, they had also developed some minor bad habits.
For instance, they had a habit of assuming certain age-related symptoms weren’t signs of illness and could be disregarded.
In reality, however, these very symptoms were often the kindling for a serious disease.
The details that were so often overlooked would ultimately become precursors to a patient’s deterioration, and the reason why doctors would suddenly find themselves at a loss!
Of course, understanding these principles didn’t mean they were ready to accept Chenyang’s diagnosis.
The director of internal medicine took a deep breath. "Your reasoning is sound, but we still need to run tests to know if your diagnosis of this patient is correct. We can’t just start a course of treatment based solely on your unilateral claims!"
Chenyang shrugged. "For the sake of rigorous medical practice, another examination is indeed necessary. When it comes to running tests, you two are the authorities. I’m sure you’re much more adept at it than I am."
The director of internal medicine nodded and immediately ordered someone to bring the necessary equipment.
They had to admit that Chenyang had a point and that his argument was logical.
But they still didn’t believe the patient’s condition was caused by heart damage.
A nurse soon arrived with the equipment. Eager to get the results as quickly as possible, the two directors began performing the examination on the patient themselves.
Just as they were busy with their work, a female patient in a hospital gown, supporting herself on a pair of crutches, suddenly came stumbling over.
"How is my uncle?"
"And you are?" Liu Yun asked, her brow furrowed.
"I’m his niece, Lin Xiaoyue. I was one of the people injured in the accident, too."
Lin Xiaoyue’s voice was lovely—so lovely, in fact, that it felt familiar to everyone there.
It wasn’t just her voice that was familiar; her face, too, seemed like one they had seen before.
As everyone was frowning, lost in thought, Angie, who had just arrived to deliver some medication, suddenly said to Chenyang, "Isn’t that the beautiful woman we rescued from under the minivan?"
Chenyang’s eyes widened in realization. "The one who’s Brother Ji’s girlfriend?"
"Right. She... she must be a celebrity, too," Angie murmured, but then she quickly shook her head. "It’s just a guess. I’m not really sure."
Just then, Liu Yun spoke up. "Ms. Lin, if you could please wait just a moment. The directors are examining your uncle right now. I’ll let you know as soon as the report is ready."
"Okay. Whatever is wrong with my uncle, please, I’m begging you—do everything in your power to treat him!"
"Don’t worry. Even if you hadn’t asked, we would still be doing everything we can..."