"President Xue, do you know about the county hospital?" Wu Mian smiled and asked D County Hospital... What do you want to know, Mr. Wu? "

    Xue Chunhe is curious. It''s enough for Mr. Wu to surprise himself to be the medical section chief of bajingzi traditional Chinese medicine hospital. Ask about the county hospital? Is Mr. Wu still going to upgrade along the county and township and experience the novice village again?

    "Be more detailed, the more detailed the better." Wu Mian did not shy away, "on the rescue helicopter, the county hospital refused to accept the patient. This bad breath is about to come out, but you can''t come to beat him. No. tell me about the situation, and I''ll think about it recently."

    "Ha ha." director Xue smiled. He could imagine why Wu Mian was so grumpy at that time.

    On the one hand, there were comrades in arms with severe burns. On the other hand, the hospital refused to accept patients. Even if Mr. Wu went to the county hospital by helicopter, director Xue understood.

    However, with the ability of doctors, it seems very difficult to retaliate against the big capital.

    "Mr. Wu, the county hospital has been restructured and sold to the capital side." President Xue said. "It is said that it is a large capital in the south, integrating more than 30 hospitals in the north to be listed."

    "Make false accounts, and then rush to a high point to sell after the lock period?" Wu Mian smiled. "Other enterprises are even better. They have great courage to take the hospital as a chip."

    "Mr. Wu, we all know the reasons. There''s nothing we can do." director Xue sighed and said, "maybe these public hospitals in the provincial capital can keep them in the future."

    "The ultrasonic probe was placed in the stomach and examined in the lower section of the xiphoid process." Wu Mian suddenly raised his voice and said something inexplicable.

    The director of the emergency department is doing echocardiography. Just after checking the heart, the patient''s heart is OK, but strangely, the ST segment change is real.

    It is estimated that it is a rare symptom. The director of the emergency department is guessing. When he suddenly heard Wu Mian''s words, he subconsciously pressed Wang Chengfa''s stomach with a B-ultrasound probe and prepared to do a lower section of the xiphoid process.

    The next second,

    Witness miracles!

    At the moment when the B-ultrasound probe is pressed on the stomach, the ECG changes, the elevated ST segment disappears, and the ECG returns to normal.

    Suddenly, Wang Chengfa didn''t have time to respond. The B-ultrasound probe was pressed on his stomach.

    When the oscillogram on ECG monitoring returns to normal, it is too late to stop it.

    The director of the emergency department raised the B-ultrasound probe, and the wave of ST segment elevation appeared again on the ECG.

    He was stunned. He thought he was dazzled. He just wanted to press the B-ultrasound probe again. Unexpectedly, Wang Chengfa caught his wrist. "Director, don''t do it. I''m fine."

    Wang Quan couldn''t understand the ECG, but he noticed that it was wrong. He opened his mouth and said, "my father said not to do it. You didn''t hear it! He knew to do the examination, and there was nothing wrong with the examination. A group of..."

    "Shut up!" Wang Cheng said angrily. At this time, he didn''t care to install again. His sick and weak state disappeared, and he drank Wang Quan with full confidence.

    "Echocardiography found that the ejection fraction was 60% - 65%, no segmental wall motion abnormalities, no characteristic octopus can like manifestations and no pericardial effusion. It was not in line with the echocardiographic manifestations of ST segment elevation myocardial infarction. Did you think it was very strange?" Wu Mian asked with a smile.

    The director of the emergency department nodded and stared at the ECG monitoring screen. He really didn''t understand why it was like this.

    "Echocardiography does not support common diseases such as STEMI, pericarditis and stress cardiomyopathy," Wu Mian said with a smile. "That''s because you ignored one point. This is also a problem I said at the National Conference on emergency treatment two years ago."

    The director of the emergency department grinned, "Miss Wu, do you remember me?"

    "You sit in the penultimate row and have been playing with your mobile phone."

    "..." the director of the emergency department almost cried. Mr. Wu, would you please give me some face. At the meeting, we have to have fun. Several people are serious.

    "I said very clearly at that time. If you encounter a problem you don''t understand, you should first think about the right or wrong of the medical history." Wu Mian said with a smile. "At that time, I gave several examples, one is pretending to vomit; the other is pretending to be scalded. It seems necessary to talk about pretending to have myocardial infarction next time..."

    Then Wu Mian paused, looked at Wang Chengfa, stretched out his right hand and thumbed up.

    "Director Wang, cow!"

    "Even I was almost cheated by you. You are a talent."

    "What are you talking about?" Wang Quan scolded.

    "Keep your voice down, and you can lose more people. Speak so loudly, and finally... Director Wang, are you not going home? You have to wait here for me to finish?" Wu Mian looked at Wang Chengfa with clear eyes.

    Wang Chengfa''s face was livid and confused for a moment. He didn''t know what to do.

    "Director Bao Hongchao, I remember correctly." Wu Mian said with a smile, "if you press your hand on the patient''s stomach, you will have the same effect. The change of ECG is not necessarily caused by heart problems, but also by external causes."

    Wu Mian looked at Wang Chengfa and took a step forward. Wang Chengfa immediately felt like a mountain pressing on his head. His chest was stuffy and out of breath.

    How did he know? Wang Cheng found that he was no longer in doubt, but he couldn''t explain why Wu Mian knew his secret.

    "The exact pathophysiological mechanism is still not very clear, but at present, several research institutes are studying it in theory, and there are many possible conjectures."

    "Generally speaking, cardiac displacement is often accompanied by electrical axis change and electrical alternation, which director Wang did not find."

    "Secondly, the visceral cardiac reflex is dominated by the increase of vagal tension, but director Wang has no bradycardia or heart rate fluctuation."

    "Stress cardiomyopathy is mostly related to microvascular spasm or dysfunction, but director Wang''s ECG changes rapidly, and there are no characteristic apical balloon like changes. In other words, we can preliminarily rule out the etiology of microvascular spasm."

    "In pericarditis, no pericardial effusion was found by echocardiography, and the rapid changes of ECG were not consistent. Therefore, from this case, it can be considered that the direct stimulation or compression effect of the expanded gastrointestinal tract on the heart led to the dynamic changes of st-t."

    "Director Wang, you really refreshed my three views." Wu Mian said with a smile, "you know why I can say so much? Because it was said in the papers given by the two research institutions last year and the year before last."

    "I didn''t pass at that time. There were some small problems in the front and back logic. On the one hand, I thought it was ridiculous. According to their logic, it was the gastrointestinal tract expansion that led to the change of ECG. In short, it was when I was full."

    "You''re really full." Wu Mian said with a smile. "Last night, I drove all the way to the provincial capital to avoid mountain fires. How much did you eat?"