Thanks to the Lilac Garden Forum station friends @ Irori Guanhai shared the quality of the case ~
Patient: 34 years old, male, female troupe performer.
Main complaint: Paroxysmal right upper abdominal distention pain for two years, chest tightness and shortness of breath for two months.
Medical history: at the age of 30, he learned that he had gallbladder stones, had intravenous anti-inflammatory disease during an acute attack, treated symptomatically, and relieved symptoms.
Physical examination: normal body temperature, soft abdomen, deep tenderness in the right upper quadrant, Mo fei's sign (+), percussion in the liver area, normal bowel sounds.
Specialist imaging tests are as follows:
Gallbladder stones, inlaid in the cervical canal, and the gallbladder wall is also significantly thickened on imaging, in line with abdominal symptoms and signs, consider LC. But what is chest tightness and shortness of breath? The ECG results returned, suggesting sinus bradyia. The result of the heart is nothing.
Why at a young age?
Pondering uncertainly, ask the medical history again, and then check the body: there is no obvious cyanosis in the lips, no jugular vein problems, pulmonary auscultation is nothing, and the heart rate is OK at this time, 55 times / min. Let him climb 4 floors and his heart rate reached 89 times.
"The symptoms of chest tightness and shortness of breath have only occurred in the past two months, but if you think about it carefully, it seems to have started after changing jobs..." said the literary young man with Chen Haonan's hairstyle.
Electrocardiogram and cardiac ultrasound basically have no point to cut into, back a "radio".
Holter:
"You said earlier that after changing jobs, what kind of job did you change?"
"Just take a girl group to perform"
「... What group?"
"Girl group, similar to AKB 48"
That night, I sat in front of the computer and opened Station B to learn some of the performance knowledge of the girl group. Then he called the cardiologist: "Frankly, will the male young adults watch the girl group performance cause chest tightness and shortness of breath?"
......
What is the relationship between the patient's chest tightness symptoms and the girl group? How would you diagnose and analyze this case?