My Medical Skills Give Me Experience Points Chapter 1385 550: Cause Identified—From Doubt to Belief

In the ultrasound room, Zhou Can was personally standing next to the ultrasound doctor.

What we usually call echocardiography refers to using the principle of short-wave ultrasonic ranging: pulsed ultrasound passes through the chest wall and soft tissues to asure the periodic activity of the underlying cardiac walls, ventricles, and valves. On the monitor, it is displayed as curves showing the relationship between the activity of each structure and ti, and these curves are recorded by a recorder as images.

It can very well assess the size of the heart, the function of the valves, and the left ventricular ejection fraction.

What Zhou Can wanted to examine now was precisely the left ventricular ejection fraction.

"LVEF, decreased, EF 39%."

The ultrasound doctor reported the figure to Zhou Can.

"About the sa left ventricular ejection fraction as in the other hospital." Zhou Can nodded, then said to the patient, "Okay, try to dorsiflex your feet, use so strength."

The patient did as instructed.

"What's the left ventricular ejection fraction now?"

"52%."

The ultrasound doctor's face was full of disbelief.

An ejection fraction of only 39% is on the low side. Not especially severe, but definitely not mild either.

The normal ejection fraction ranges between 50% and 70%.

The patient's left ventricular ejection fraction jumped directly from 39% up to 52%, which was really a bit unbelievable.

If this state could be maintained, the patient would basically be able to return to normal.

"Very good, relax, relax!"

With this, Zhou Can felt even more confident in his diagnosis and guided the patient to relax.

"Bend your lower legs!"

He once again instructed the patient to do as he said.

"What's the fraction this ti?"

"46%."

"Not bad." By the ti the test had reached this point, Zhou Can already basically knew where the cause of the patient's illness lay. "I'm going to squeeze your lower legs; bear with it."

After signaling the patient to straighten and relax both legs again, Zhou Can tried squeezing the patient's gastrocnemius muscles.

"How much?"

"43%, 42%."

These were the test results obtained from squeezing the left and right legs separately.

"All right, thank you for your cooperation! Print out the report, we're done here."

Zhou Can said to the ultrasound doctor.

"Dr. Zhou, is the cause of my illness really in my legs?"

"That's right, it's in your legs. I'll explain it to you when we get back to the ward!"

He couldn't keep occupying the ultrasound departnt's resources.

It was already past quitting ti, and the doctors in the ultrasound departnt were essentially being forced to work overti.

Unlike clinical departnts, the work hours of technical departnts are very punctual. They can clock in and out on ti, and they can rest on Saturdays and Sundays. However, because of the huge service demand, departnts like Ultrasound and CT operate with a shift-covering chanism.

Also, in a large hospital like Tu Ya, the ultrasound units for Obstetrics & Gynecology and Cardiothoracic Surgery are not managed by the general technical departnt, but belong separately to Obstetrics & Gynecology and Cardiothoracic Surgery.

If you want to be an ultrasound doctor, getting into the ultrasound units of these two departnts is generally recognized as the most promising path.

Doctors in the general ultrasound departnt simply have no way to break this barrier and basically spend their whole careers in that small technical circle. Their inco is slightly above average, but there's no obvious upward trajectory.

Unlike doctors in clinical departnts, whose work is indeed more tiring: after hours or on holidays, they can be called back to the hospital to work overti with just one phone call.

And even after they get off work, they still have to worry about the patients under their care, praying those patients don't run into any complications.

If a patient under their care dies or sothing similar happens, they will definitely have to bear responsibility.

This responsibility doesn't necessarily an paying compensation to the family or having their license revoked, but there is an evaluation system, and it has a big impact on the doctor.

If a certain doctor has, say, two patients die within three days, while the senior doctors are cursing, they'll also start keeping a close eye on this doctor and gradually marginalize him. Clinically, they will no longer give him weight.

To put it bluntly, it ans his word no longer carries authority. Any orders he writes must be reviewed by a superior before being carried out, and so clinical treatnt asures will likewise require approval from a superior doctor or will be executed under the direction of another doctor at the sa level.

As for canceling his eligibility for awards and honors, that goes without saying.

Within the Ergency Departnt, Zhou Can carries a lot of weight; during clinical resuscitations, even associate chief physicians have to follow his lead.

...

Beside the temporary bed in the corridor, holding the echocardiography report in his hand, Zhou Can was explaining the cause of the patient's heart failure to him. Director Xue Yan, having heard the news, had already rushed over.

"So you really did find the cause! Impressive!"

Director Xue Yan's face was all smiles.

Every ti a high-difficulty, puzzling case like this is successfully diagnosed or discharged after cure, she feels particularly happy.

As the departnt director, she naturally hopes her departnt will keep getting better.

The reputation and word-of-mouth of a departnt can be built to so extent by treating routine cases, but only to a limited degree. The cases with the greatest impact are still the difficult and complex ones.

"I still don't understand how my heart failure could be related to my legs?"

The patient was full of curiosity about this.

The Brother Wei his family had hired was standing beside the bed, his face full of disbelief.

He had originally thought that Zhou Can was just talking nonsense, but now, after the examination, it turned out the legs really were related to the heart failure.

"There are several powerful muscles in the legs, called the gastrocnemius muscles. Ordinary people may not know their function, but in our eyes as doctors, we call them the body's 'second heart.' Ever since our human ancestors learned to walk upright, a major defect appeared in the human body. The heart ended up further away from the ground, which made it extrely difficult for blood from the lower limbs to return to the heart."

"At the sa ti, it also beca very hard for the blood pumped out by the heart to reach the distal ends of the lower limbs. At this point, after countless years of evolution, the gastrocnemius muscles of the legs developed the role of an auxiliary heart. Every ti they contract, they can squeeze the blood in the legs and push it smoothly back to the heart. And when they relax, they create a natural suction force that draws blood in. With this cycle, they form a pumping function that's roughly similar to that of the heart."