Yesterday, Wang Saiying, director of the emergency department of Zhejiang Greentown Cardiovascular Hospital, sent such a circle of friends, revealing a strong helplessness between the lines:
Here's the thing, in the early morning of June 25, Xiao Liu (pseudonym), a young man in his 20s, covered his chest and cried out in pain as he walked into the emergency room of Zhejiang Greentown Cardiovascular Hospital.
The receiving doctor quickly stepped forward, listening to Xiao Liu talk about his chest tightness, chest pain, and cold sweat, before, such a situation has been repeated for about a week, the doctor immediately became alert, and had a basic judgment in his heart - myocardial infarction.
The medical staff immediately opened a green channel and carried out relevant examinations for him. Soon, the ECG confirmed the diagnosis: inferior myocardial infarction, troponin value of more than 20.
"Normally, the value of troponin is lower than 0.5, or even 0.1, and the value rises only after necrosis of cardiomyocytes. Moreover, this indicator does not rise until at least two to three hours after the occurrence of heart muscle cell necrosis. The value reaches more than 20, and we speculate that the time may have been more than 6 hours. Combined with other tests, the patient's condition has been clear, the blood vessels supplying the myocardium are blocked, and the myocardial infarction is blocked. ”
Wang Saiying said that the problem is clear, and the follow-up treatment is actually very simple - open the blood vessels as soon as possible and restore the blood supply. The longer it is delayed, the more necrotic myocardium there is, and the myocardium that has been necrotic cannot be recovered, and can only save as much as possible the myocardium that has not yet died.
The doctor in the emergency room immediately asked Xiao Liu for a preoperative conversation, and when he signed, he was ready to enter the catheter room for vascular opening. But Xiao Liu's reaction surprised everyone.
"Why do you say that a heart attack is a heart attack, and you say that if you put a stent, you put a stent?" Xiao Liu refused the operation, dropped his words, and prepared to get up and leave.
When the doctor saw the situation, he quickly retained the people and began to persuade bitterly.
"You may not feel serious right now, but after the blood vessels are blocked and cause the heart to be ischemia or break the blood, it is easy to induce arrhythmias, and the worst arrhythmia may be sudden death."
"Also, as the area of myocardial necrosis increases, the likelihood of heart failure increases, which is life-threatening!" Even if the short-term impact is small, in the long run, the decline in heart function will seriously affect the quality of life in the future. You're still so young, don't make fun of the future. ”
"It doesn't matter if you don't believe what we say, otherwise you baidu to see?" (As a professional doctor, in fact, it is not recommended that patients find doctors through the Internet, and use online search results as a reference for the condition) Check how many doctors above say the harm of myocardial infarction. ”
The doctors could not be persuaded, called the general duty of the hospital, and the general duty also rushed down to persuade.
"We really didn't exaggerate and didn't scare you anymore. I really don't believe it, it doesn't matter if you don't have surgery here, you can go to other hospitals to see it, it's really for your own good. You can even repeat what we said to the doctors at other hospitals, and if any of the sentences have the intention of deliberately scaring you, we are willing to bear legal responsibility for it. ”
Seeing that Xiao Liu was not moved, the doctors in the emergency room still did not want to give up, and the phone that found Xiao Liu's mother called. Unexpectedly, Xiao Liu's mother's attitude was surprisingly consistent with Xiao Liu's - do not operate!
Feeling that the doctor's refusal to let him go was a violation of personal freedom, Xiao Liu called the police. After the doctor saw Xiao Liu calling the police, his first reaction was not anger, but "Great, at least the police can help us persuade together!" ”
Sure enough, the police arrived at the emergency room, and after understanding the situation, they also began to persuade Xiao Liu, but even so, Xiao Liu still did not agree to the operation. Finally, he signed and left the hospital.
A few hours later, the doctors were still not at ease and dialed Xiao Liu's phone again. "Have you ever been to another hospital?" Hurry up and check it out! "Don't joke about your own body, heart muscle cells can't regenerate, necrotic cells are basically completely necrotic after more than 24 hours."
Xiao Liu's words left the doctor dumbfounded.
"Listen to you, the heart muscle cells have died a lot? Then I don't care to let it die a little more. After saying that, Xiao Liu hung up the phone.
Just now, orange persimmon interactive reporter contacted Wang Saiying, she said that later Xiao Liu did not come to the hospital, the follow-up situation is unknown.
"We have done the best we can as a doctor and the patient insists on not operating and cannot force him to sign. It's just very sad and helpless, why do good young lads not take their bodies seriously. ”
Wang Saiying mentioned that patients like Xiao Liu who have a heart attack but refuse to treat it are not unique, and they have encountered it before, and there are young and old people. Generally speaking, if the elderly do not listen to advice, the doctor will call the children, the elderly will generally believe what the children say, but if it is a younger age, the self-assertion is stronger, and it is more difficult to be persuaded. Just this month, I also met two other chest pain patients, who did not want to believe that they would have a heart attack, refused to use acute phase drugs, refused to review the electrocardiogram, refused to contact their families and go to other hospitals for treatment.
"Myocardial infarction has long been not a 'patent' for the elderly, and there are many young myocardial infarction patients treated by the hospital." Wang Saiying said that young people may have two main reasons for heart attack, bad living habits and genetics. Bad living habits are mainly because of the fast pace of life in modern society, young people are stressed, exercise is small, eat irregularly and eat indiscriminately, stay up late, smoke, drink alcohol, etc., may affect the heart. For young people with a family history of cardiovascular diseases, it is more important to pay attention to regular physical examinations, but most people often feel that they are still young and where there will be problems.
"Sending this circle of friends, in fact, mainly wants to express two points. On the one hand, I want to remind everyone to be as aware of the threat of heart problems as possible, pay attention to them, and treat relevant symptoms as soon as possible; on the other hand, I hope that every patient can believe in science, do not reject themselves outside of medicine, and do not joke with their lives. Wang Saiying said.
Orange Persimmon Interactive City Express reporter Zhang Huili
Correspondent Cheng Dandan
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