Ventricular capture

1.

During ventricular tachycardia, a small number of supraventricular impulses can be transmitted down to the ventricles, resulting in ventricular capture.The electrocardiogram showed that a normal QRS complex occurred in advance after the P wave.

The onset age of rheumatic heart disease is mostly 5-15 years old, and the recurrence is mostly within 3-5 years thereafter.The lesion can involve multiple heart valves, and it is mostly asymptomatic in the early stage, but in the later stage, there may be symptoms of cardiac decompensation such as palpitations, palpitations, coughing and edema.

A near-death experience can occur during an angina attack.

2.

X Medical University Affiliated Hospital, Cardiology Ward, East Ward.Seven o'clock in the morning, bed number 7.

Surrounding the hospital bed are a director and four interns.And in the center of the white coat, the young man on the hospital bed opened his eyes wide and smart, looking at these people curiously.

The reason is simple, he doesn't know any of these doctors.

Since the heart attack relapsed, he has been hospitalized for more than two months.He was already familiar with the doctors, but after the summer vacation, a new round of internships began, and the next ones who took care of him and practiced and learned from him were all new senior medical students.

Doctors and medical students discussed his condition, and he graded them unceremoniously.

The first is the director.The 60-year-old grandfather, with his gray hair combed meticulously, looks like a respectable old orangutan.In the future, you must listen to him honestly, or you will definitely be scolded.

Two female interns with average appearance and average figure, pass.

The third……

The moment his eyes fell on that person, the boy felt his whole body was lit up.

What kind of person is that?

He is the kind of handsome guy who comes out with a tall halo, even wearing a white coat, can make you feel like you are in a five-star hotel, a rich yacht party, a charity reception... It feels like you can only see him so handsome and elegant in such high-end places tall, rich and handsome.He just stood there, not talking, making eye contact or making any movements. Just standing, he could set off all the people around him like sweet potatoes and cabbages.

—oh wait.The boy glanced out of the corner of his eye and saw the last intern.

There is also an emerald cabbage.

The boy's eyes happened to meet his, and the corner of his mouth suddenly twitched, revealing a flamboyant smile.

No, no, although this is also a handsome guy, but compared with the former, even the emerald cabbage has become the kind that grows in the ground with mud. LOW!

The young man turned his head critically and continued to watch Gao Fushuai.At this time, the director pointed to the electrocardiogram taken by the boy yesterday, and suddenly asked: What does this electrocardiogram suggest?

The boy couldn't help looking at where the director pointed.He couldn't understand the sine and cosine functions one by one, he just felt that he was jumping wildly, and he didn't know how sick he was.

C, you say.Director roll call.

It turns out that the emerald cabbage is called C.The boy blinked and looked at Gao Fushuai.Don't know how expensive a son is?

Emerald Cabbage immediately put away her smile, looked at it seriously for a while, and replied seriously: "...he is sick."

The old man in the next bed laughed and coughed.

Even the teenager started to feel embarrassed, and the rest of the interns couldn't help laughing.The director was furious: Of course I know he is sick!

As soon as the words came out of my mouth, I remembered that the patient was still there, so I had to apologize, and changed my words through gritted teeth, I was asking you what lesion was indicated by the electrocardiogram!

Emerald Cabbage stretched out her fingers with a troubled face, and clicked the grid on the electrocardiogram.The boy knew he was doing arithmetic.Each grid on the electrocardiogram represents a fixed unit of time, and counting the grids will tell you the time of heart rate and heartbeat cycle.

However, most doctors know the result at a glance, and this is the first time I see them stretching out their hands to count...

Resisting the urge to shake his head and sigh, the boy continued to smile brightly at Gao Fushuai, and asked the young master's name in countless tones in his heart.At this time, the emerald cabbage finally finished counting, and suddenly realized: Oh!Premature beat!

Several interns laughed again.The director showed a horrific expression, and said helplessly, you'd better be tall, rich and handsome.

Gao Fushuai glanced at him, his long eyelashes drooping slightly, and he answered a series of words that the young man couldn't understand fluently.Final conclusion: Based on the history, this was due to ventricular capture.

His voice is a slightly low-pitched baritone, neither humble nor overbearing, full of self-confidence, the young man was so dazzled, the three words in his mind became five words: Xueba Gao Fu Shuai!

So by the way, he also changed the name of the cabbage-xue scum!Because he is a scumbag, the teenagers look down on him, so even the emeralds are saved.

The director finally smiled.But then he blamed the scumbags with hatred: C, you can’t do this, look at how well your classmates answered! You have to take out more books and look through them, don’t return them to the teacher after the exam!

The scumbag C nodded repeatedly, and glanced at Gao Fushuai with a smile in his eyes.The boy noticed that he gave Gao Fu Shuai a middle finger behind him.Gao Fushuai obviously noticed it too, the corners of his mouth raised slightly, and he pointed his little finger back at him.

So they were good friends?

The teenager was suddenly depressed.

But it doesn't matter, how can a top student and a bad student be together?

My grades were also very good before I left school!Xueba Xueba sees me, you have a future with me!

——Two months before the college entrance examination, the boy with the highest grades in the school was forced to suspend school and be admitted to the hospital due to the recurrence of rheumatic heart valve disease.

The smart and sensitive boy has checked the information long ago. This is an autoimmune disease, no matter how careful he is, it may relapse.And if you reduce the intensity of study, you probably won't be able to get into the school of your choice.

It wasn't until he fainted and was sent to emergency treatment, and when he woke up and learned that the disease had spread to multiple valves, he realized that the problem was not as simple as failing to get into the university he liked.

He may be dying.

3.

Switch to the perspective of C.

Of course C doesn't know that he has been despised by the patient and given the prefix of "student".Of course, even if he knew, he wouldn't care.Conversely, if he cared about this, he wouldn't let his grades plummet.

After entering the university, he did not study hard.To be precise, it was after entering the university with the bamboo horse.

The boy's male god is tall, rich and handsome, and he is the neighbor of the scumbag C, Jia Zhuma.As the teenager guessed, Zhuma is indeed a rich second generation.In the medical family, from grandfather to his generation, there are three surgeons, four physicians, and two head nurses.He and his cousins ​​are both medical students, and maybe they will marry three doctors in the future. C then joked that he was born with a scalpel in his mouth.

This description is a bit scary.

But the bamboo horse is indeed a super scary... a child of someone else's family.

From childhood to adulthood, the parents of the C family pointed at the back of the bamboo horse and taught their children in their ears: Look at him... yes, just like the director scolded him today.

Look at others, such a small piano has passed the tenth grade.

You look at others, and they participated in the competition to win prizes.

Look at other people, they concentrate on studying and never play tricks. After school, they are either practicing the piano or going to cram schools.

The C family is an upstart, usually high-spirited, but always feels inferior in front of the Zhuma family.So they pushed C to the cram school, pushed C to learn the piano, and pushed C to participate in various competitions that he couldn't even pass the preliminary round.

C is carrying a schoolbag, and happily goes to the cram school to seduce the bamboo horse to come out to play.Code the notes into a password, and chat with bamboo horses playing the piano every day.

In a way, C is pretty smart.Although in school he must fail every exam.

It doesn't matter, his family has money.He is so rich that he has been in the same school as Zhuma from elementary school, junior high school to high school.

Until his parents envied and nagged unwillingly:

You look at C, who said that he wants to go to X Medical University!

X Medical University is the best medical school in the country, and its scores are so high that it is suitable for bamboo horses to take the exam.

C suddenly realized that he and Zhuma were not the same people from the bottom of their hearts.They've been together since kindergarten until now because of their parents' vanity and money.Once the parents find that this comparison is meaningless, once the two of them are separated, there will be no chance to meet again.

So C said to his parents tremblingly: I also want to be admitted to X University.

The parents were very happy and spent a lot of money to hire the best teacher for him.He also worked very hard, but his foundation was so poor that even the best tutor in the province shook his head behind his back.

If you can't even get the money back, it's really hopeless.

After Zhuma found out, he smiled and said, your family only knows how to spend money.

Then he started tutoring C.Sacrifice your precious rest time, start from the most basic formulas, concepts, and grammar, and explain the classic exercises you have compiled to C one by one.

In the last month before the college entrance examination, Zhuma almost lived in C's house. C's parents were overwhelmed with gratitude and gave him a lot of things, but Zhuma declined them all with a smile.

The parents of C's family thought anxiously again, could it be that their family has high vision and despise our gift?So I made persistent efforts and went to more advanced brand stores to buy more expensive luxury goods.

Zhuma carried the Italian handmade leather shoes that he didn't need at all, and asked C in confusion, why do you want to go to medical school?Being a doctor can't make that much money, and it's very hard.

C was speechless for a moment, his heart beat wildly for a long time, and he said aggrievedly: Anyway, my family is rich, so the salary is not bad.I think doctors are very handsome, especially when holding a scalpel... Then I said lightly, you just want to go to medical school.

C asked him why he wanted to help him with tutoring. Zhuma rubbed his temples that were slightly swollen and sore due to excessive fatigue, and said with a smile:

Still need to ask?

On the night after the college entrance examination, they went to the bar with their classmates to have a carnival.Everyone was so drunk that they got into the car one by one under the dissatisfied eyes of the taxi driver.Only C and the bamboo horse staggered into the hotel next door.

Before I knew it, I was already in my fifth year of high school and already had an internship.

Zhuma is about to go abroad to study in graduate school.

Zhuma would sometimes say "When we go to the United States...", as if he was sure that he would try his best again and get into a medical school in the United States that was very close to him.

C sat in the duty room, staring at the books spread out on the table in a daze.He has been on this page for a long time, his eyes are scanning around, the Chinese characters come into his eyes but not into his brain, they just stimulate his cerebral cortex meaninglessly and make him mentally tired.

The phone vibrated suddenly, it was a short message from an unknown number.

"Doctor C, are you 1 or 0?"

The excitement of the cerebral cortex was suddenly transmitted to the left brain, C panicked and thought violently, and quickly reflected on where he had exposed his feet.

Before he could reply, the stranger sent another new message.

"Don't be nervous ^^, I'm a 7-bed patient, and the ventricle captured that. I'm 1 嗤 ^0^"

7 beds?

He remembered that when he was doing a physical examination on Bed 7 this afternoon, his junior sister came over to confirm the new mobile phone number with him, and he just reported it again... Has this been missed?

C thought proudly and reservedly, he is still quite popular.

4.

Of course, it is impossible for the boy to tell that C is gay at a glance, so he asked tentatively, even if he guessed wrong, it doesn't matter... Most straight men don't know what 1 and 0 are, so he can tell a lie.

As a result, C was gladly fooled.

Of course, as a sick and weak boy, it is impossible for a boy to be 1. In fact, he doesn't even have sexual experience yet. He thinks deception depends on arrogance!So he put on Yang Dingtian's aura, pretending to tease C.

C was still willing to be fooled, and told him bluntly that he already had a date, no appointment, goodbye.

This is what the young man wanted to know—is the schoolmaster Gao Fushuai straight or curvy?

The interaction between the two of them during the day was not ambiguous enough, it was between a straight man and a gay friend.Now it is almost certain that the two of them are a couple, so the young man can safely... pry the corner of the wall.

The boy in the same ward was an old man in his 70s who went to bed early, and the lights in the ward had already been turned off.The boy turned the brightness of the phone to the darkest, thinking about how to get more information about the male god.As a result, C first sent a message:

"It's twelve o'clock, go to bed quickly and don't worry about everything. Stay up late and be careful of kidney deficiency."

The boy replied unconvinced: "Didn't you sleep too?"

"I'm on duty. We doctors are trading our lives for you. Cherish it."

The young man couldn't help laughing, and said in his heart that you would give it to me instead.On the hand, he typed: "Okay, good night, doctor of kidney deficiency ^^"

"Good night."

Putting down the phone and staring at the ceiling in the dark, sleepiness never came.

He suffers from insomnia.After checking the information, he knew that this was a typical manifestation of autonomic dysfunction, probably caused by long-term mental stress and chronic heart failure.Once I have insomnia, I can't help thinking about it, and the more I think about it, the more insomnia I will have.

He tried to recall Gao Fu's handsome face, but found that he couldn't remember it.On the other hand, the sentence from the scumbag C that we exchanged our own lives for you always lingered in my mind.

He could even hear the scumbag C say that sentence in a grinning and unserious tone.

I don't know when to fall asleep.In his dream, he was in the college entrance examination room, and others were writing hard, but on his desk was an informed consent form for surgery risks.

Parents are uneducated, and they must be scared to death when they see the list of possible dangers.When the time comes, you must sign it yourself, and it is best to sign it without telling them.But what about money?How could it be possible to raise money for the operation without telling them... The examinations and medicines taken in the past two months are more than before, and I don't know how much money has been spent... But they must also know their illness... Maybe they are still hiding it from him with the doctor, maybe there is something terrible that they haven't told him...

I don't know when I will die.

If I can live until July next year, should I try again for the college entrance examination?

5.

C, who feels good about himself, has not been proud of himself for a long time, but sadly finds out that the person who is interested in the 7-bed patient is not him, but his bamboo horse.

7 beds soon launched a pursuit of Zhuma.First of all, he pretended to be cute in front of the bamboo horse. When the bamboo horse checked him, he lay down and let him do the operation.He routinely flattered the bamboo horse every day, and complained that C was too tactful and not good at learning, but what he said was very reasonable, and C really couldn't refute it.

As long as the bamboo horse is present, the boy is an upright, pure, and good boy.As soon as the bamboo horse turned around, he hooked his finger at C provocatively, making C's teeth itch with hatred.

so bad! C angrily complained to Zhuma that this was a moral kidnapping!

C is very worried that the teenager will use his status as a patient to win the sympathy of the bamboo horse and then make a mess.On the contrary, Zhuma was surprised at how he thought so, and made it clear that a patient is a patient, and the doctor's duty is to help, not sympathize.

For more than a month, Bed 7 would send him text messages if he had nothing to do.C is busy in the ward during the day and usually does not reply to text messages.This little bastard would only be talked to when he was on duty at night.After coming and going, the little bastard had a clear idea of ​​his duty arrangement, and would harass him on time when the time came.

C doesn't want to talk to him intellectually, the nitrogen duty is too boring, he can't sleep, and the phone's light flashes when there is a text message, so he has to reluctantly chat with the little bastard.

In this way, the book read more.

Because the little bastard would ask him medical questions from time to time, such as the reason for the seizure of the ventricle, what are the manifestations of heart valve involvement... This little bastard actually has a lot of medical knowledge, so he can't use "the seizure of the ventricle is probably because of a certain People fall in love at first sight hahahaha" This easy answer fooled me.

Thanks to the little bastard, C has recited cardiovascular diseases thoroughly in just one month.

Then one day, he suddenly realized:

In the case of the little bastard, the probability of sudden death seems to be quite high.

Since then, he has never chatted with the little bastard in the middle of the night.He would make a point of going to their ward to check if he was asleep.

Every time the little bastard frowned in disgust, saying that you are like my mother, you are so annoying.

C also thinks that the little bastard, the rival in love, hates it to death, nitrogen... the doctor's duty is to rescue, he has an obligation to help patients avoid the risk of sudden death.

6.

Insomnia is also good.

One night, when the uncle in the next bed was suddenly out of breath, the boy pressed the call bell and watched the doctors and nurses send the uncle to the emergency room, he thought happily:

If the person in the same ward as the uncle is a guy who turns into a pig when he sleeps, the uncle may not be able to save him in time.

When he returned to his ward from the corridor, turned off the light and walked towards his own bed, another terrible thought suddenly flashed in his mind.

What if I fell down now?

The doctors on duty have all rushed to rescue the uncle, and I may not be able to ring the bell by myself when I get sick, maybe...

He felt suddenly very frightened and reached for the nitroglycerin lozenges in his pocket.As soon as I squeezed it in my hand, a burst of pain burst out in my chest.

Suffocation accompanied by retrosternal pain, which can be quickly relieved after sublingual nitroglycerin, is a typical angina.

He shivered and passed the pill to his mouth, but the pain was too severe, his eyes were so dark that he couldn't stand upright for a while, and when he squatted down, his head hit the corner of the bed again.His whole arm was numb, even his shoulders and back. He didn't know if the pill was still in his hand, so he could only open his mouth wide and slap his palm to his mouth violently.

Sublingual administration, sublingual administration, there are abundant venous channels under the tongue, which can avoid the first-pass elimination of the drug by the liver, so as to quickly absorb the drug.If it is administered in the gastrointestinal tract, it will not only waste an hour or two to digest, but the efficacy of the medicine will also be consumed by the liver detoxification.

All C told him.

The young man didn't know what posture he was in right now, his tongue was barely stirring his mouth, not sure if the pill was properly contained under his tongue.

The terrifying experience lasted for an unknown amount of time.The heart muscle struggled to absorb the necessary blood supply, and finally recovered.

The boy opened his eyes, his eyes blurred.He touched the cold tears on his face, and saw that the ward was pitch black, empty and lifeless.

After slowing down, I felt a forehead headache.It's just hit the place.It was still wet when he touched it, and he didn't know whether it was tears being wiped up or bleeding.

I don't want to turn on the light to check myself at all.

If something happens now, no one will come to rescue him.

Even if someone finds him, maybe he can't be rescued.The old man's condition is still milder than his. He is just old and has too many underlying diseases so he cannot be operated on. However, his disease is too serious. It is more likely to die with surgery than without surgery.

The boy staggered back to the bed and lay down under the cold blanket, feeling his face was wet and extremely uncomfortable.

My heart is also very uncomfortable.

He buried his head in the bed and cried loudly.