In the movie Manslaughter 2...
Lin Zhilang, this complex protagonist, cannot be defined in terms of good or bad.
He loves his wife and son deeply, is a good husband and father, but is also a fierce gangster in the emergency room kidnapping case.
(Image source: Tencent Video)
An ordinary person who has made a desperate choice for love.
The tragedy begins here:
His son Bugs suddenly fainted on the ground during a soccer match.
After being sent to the hospital, he was diagnosed with dilated cardiomyopathy (hereinafter referred to as "dilated cardiomyopathy").
Dilated cardiomyopathy, simply put:
The heart grows larger, but the total muscle mass does not change, so relatively, the heart muscle becomes thinner, like a balloon, and after the drum is blown, the heart contracts without strength [1].
The blood supply of various organs in the whole body will be abnormal, resulting in a series of disease manifestations.
About half of these cardiopteriasis are unexplained [2].
There is a certain relationship with heredity, which is medically called "familial dilated cardiomyopathy".
However, the incidence of fetal cardiomyopathy is low, which is a rare fetal cardiovascular disease.
At present, there are still relatively few relevant research in the medical community, so there is a lack of effective prenatal diagnostic methods [3].
But there have also been examples found in the mainland before the birth of a fetus:
In December 2016, at the Maternal and Child Health Hospital of Chengxian County, Gansu Province, a 30-year-old pregnant woman found that the heart of the fetus was enlarged during routine prenatal ultrasound, and after the pregnant woman went to the provincial hospital for examination, the family members chose to induce labor, and the fetal autopsy was clearly defined as heart expansion disease [4].
Therefore, although there is no clear means for prenatal diagnosis of cardiopedia, routine prenatal testing is still very important.
If doctors are highly suspicious of cardiopteria in the fetus, some special tests may be done for the condition [5]:
Ask a relative about a history of heart disease
Genetic screening
Screening for related antibodies
For the sake of their own health and that of new life, every pregnant woman should undergo prenatal check-ups on time.
Dilated cardiomyopathy is a common type of cardiomyopathy in children, accounting for more than 50 percent of pediatric cardiomyopathy [6].
After the worm in the movie is sent to the hospital, he is rescued by the efforts of the doctor, but the situation is worrying, and his heart can no longer continue to work.
Film is an artistic means, and the expression of stories that originate from life and is higher than life will attract people.
In real life, heart expansion disease will slowly show obvious manifestations from birth, such as:
Difficulty breathing after exercise, frequent edema of the feet or lower legs, chest tightness and chest pain.
If you find yourself or your child with these conditions, don't hesitate to go to the cardiology department in time.
The attending physician of the worm gave Lin Zhilang and his wife a ray of hope - a heart transplant.
However, the cost of 2 million yuan for surgery is astronomical to an ordinary family, but this did not crush the family, and he tried everything to make up for the operation.
Dilation of the heart affects 75% of children who require heart transplantation due to cardiomyopathy [7].
However, fate made a big joke with Lin Zhilang.
The heart that originally belonged to the worm was "robbed" by someone.
Desperate men, meticulously planned the emergency room kidnapping.
Forcing the police to recover the heart of the worm within two hours, the truth gradually surfaced.
At the end of the movie, Lin Rilang exchanged his life for the heart of the worm.
There are four conditions that need to be met for heart transplantation [10]:
1. Blood type and immune matching, that is, we often hear about the success of matching;
2. Heart size matching, generally measured by the recipient weight ratio, the international consensus ratio is between 0.6 and 3.0;
3. Age matching, the donor age is more than 25 years old among adolescent recipients, and it is more than 5 years older than the actual age of the recipient, and the mortality rate and vascular lesion rate after transplantation are higher;
4. Other states of the donor's heart: whether there is an infection, the ejection fraction of the left ventricle of the donor heart, etc.
Medically speaking, it is not very appropriate for Lin Zhilang to leave his heart to his son.
Even on the basis of successful matching, the difference in age and weight does not meet the standard, and the reality is often that the biological parents are not necessarily successful.
Sometimes, though, life gets warmer than the movies.
From January 2008 to December 2020, the Department of Cardiac Surgery of Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology completed four cases of infant heart transplantation, with an average weight ratio of 3.60 for the recipient, and the donor belonged to the "big heart", while the recipient, the four babies were only 4.75 months old on average. Everything went smoothly, and after the operation, he was observed for 1 to 6.5 years, and his recovery was good [9].
Perhaps, the little worm will take His father's heart and go far to see the world bustling.
(Source: Tencent Video)
Special Author: Liao Yuhan
Doctoral student of Tongji Medical College, Huazhong University of Science and Technology
bibliography
[1] Luk A, Ahn E, Soor GS, Butany J.Dilated cardiomyopathy: a review. J Clin Pathol. 2009 Mar;62(3):219-25.
[2] Felker GM, Thompson RE, Hare JM, etal. Underlying causes and long-term survival in patients with initiallyunexplained cardiomyopathy. N Engl J Med. 2000 Apr 13;342(15):1077-84.
[3]van Zwet CJ, Rist A, Haeussler A, et al. ExtracorporealMembrane Oxygenation for Treatment of Acute Inverted Takotsubo-Like CardiomyopathyFrom Hemorrhagic Pheochromocytoma in Late Pregnancy. A A Case Rep. 2016 Nov1;7(9):196-199.
Li Fanglan,Wang Huimin,Zhang Huiping. A case of prenatal diagnosis of dilated cardiomyopathy[J].Chinese Journal of Perinatal Medicine,2017,20(6):450-451.
[5] Uptodate: Familial dilatedcardiomyopathy: Prevalence, diagnosis and treatment. Ray E Hershberger, MD.Literature review current through: Nov 2021. | This topic last updated: Dec 04,2020.
[6] Lipshultz SE, Sleeper LA, Towbin JA,et al. The incidence of pediatric cardiomyopathy in two regions of the UnitedStates. N Engl J Med. 2003;348:1647–1655.
[7]. Canter CE, Naftel DC. Recipientcharacteristics. In Pediatric Solid Organ Transplantation. 2nd ed. Fine R,Webber S, Harmon W, Olthoff K, Kelly D, eds. Malden, Mass: Blackwell; 2007:chap
Sun Yongfeng,Zhang Jing,Wang Guohua,Zhou Cheng,Dong Nianguo. Review analysis of single center for pediatric heart transplantation[J].Electronic Journal of Practical Organ Transplantation,2021,9(04):273-280.
[9].ZHANG Jing, DONG Nian-guo, SUN Yong-feng, ZHOU Cheng.A single-center experience summary of four infant heart transplants[J].Journal of Clinical Pediatric Surgery,2021,20(06):532-537.
Editors: Guo Qian, Zhang Jie, Zhang Liang
Proofreading: Wu Yihe | Typesetting: Li Yongmin
Operation: Han Ningning | Coordinator: Wu Wei
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