A woman in her forties walked in with a frosty face and scolded.
Next to her and behind her was a woman in her fifties, a bit humble, with her head lowered and her gray hair on her forehead a bit messy.
"Check, check, how many times have I done this! If I hadn't seen you raising a child who is still in college, I would have fired you long ago."
"Manager, I... I..." the patient murmured.
"What are you doing? You did a check-up worth more than a thousand yuan, and nothing happened! What else do you have to say!" The female manager raised the film bag in her hand, making a clattering sound, as if to justify what she said. Adding additional evidence.
"Because of you, do you know how much I got scolded?"
Zheng Ren took a glance and saw that the system panel of the woman behind her was red. She was not pretending to be sick. A diagnosis appeared very conspicuously on the system panel - Cardiac Syndrome X.
After seeing the diagnosis, Zheng Ren thought clearly about the causes and consequences.
The female manager ignored the employees behind her and strode towards the emergency medicine clinic. The high heels clicked on the marble floor, like the sound of Zheng Ren clicking a mouse.
The patient was wearing the clothes of a hospital cleaner and looked like a worker from a cleaning company. The person in front should be the manager in charge of the hospital.
The emergency physician took a look at the film and called Zhou Litao. Zheng Ren stopped him, "Mr. Zhou is busy, I'll do it."
"Boss Zheng, I'm sorry to trouble you." The emergency physician was happy to take a break and handed various laboratory tests and film bags to Zheng Ren.
The patient's various examinations were normal, but he complained of chest tightness and shortness of breath after activity. This kind of chief complaint can be considered for other diseases, but when I saw the female manager who brought the patient with a frosty look on her face, it could be a dispute.
Naturally, the further away the better, this kind of thing is not troublesome enough. If in the end more tests were done but nothing was found, the doctor who ordered the tests would face the wrath of the female manager.
Zheng Ren held up the film and asked gently: "What's wrong with you?"
"I… "
"I feel uncomfortable when I work, and my laziness attacks me!" the female manager said angrily.
"Let the patient speak, okay?" Zheng Ren smiled, glanced at the female manager and said.
"Every check-up was fine. I thought I had coronary heart disease all day long, but I think it's mental illness."
Zheng Ren's eyebrows were slightly raised like knives. The female manager relied on the hospital to make ends meet and did not dare to offend any powerful person. Although logistics and front-line clinical work are not the same system, there are many big shots in 912 who can reach the sky.
The doctor in front of me looks young, but who knows what abilities he has and what important tasks he knows. The doctor in the emergency medicine department looked very respectful to him and called him Boss Zheng.
There are many people who can be called boss, but not many.
The female manager swallowed back the rest of her words, not daring to provoke Zheng Ren. She just glared at the patient viciously.
"I have chest tightness." The patient said helplessly: "Especially when I work, the symptoms of chest tightness and chest pain are severe."
"Does it show up every time?"
"No, once every three to five days. I always think it's myocardial infarction. A while ago, a friend of mine disappeared while sleeping at home..." When the patient said this, he seemed to feel something strange and paused.
The female manager held her head high with disdain on her face.
In her opinion, this is either the most typical form of hysteria, and all symptoms are imagined in the mind and do not exist at all. Or just lazy and don't want to work.
If it weren't for the fact that she had to support a child who was in school, she would have been expelled. Otherwise, if you say that a good person can't do this, it's just a slap in the face.
"Do you feel like this when you go to bed at night?" Zheng Renwen asked.
"No." The patient shook his head in confusion.
"Does anyone in the family have a history of high blood pressure or coronary heart disease?" Zheng Ren continued to ask.
"My wife had high blood pressure when he was young, and later died of cerebral hemorrhage."
Zheng Ren scratched his head and said, "I don't count my lover. I have no blood relationship with you. Where are your parents and other relatives?"
"My dad has a history of hypertension, and others... my second uncle seems to have it too."
"What about coronary heart disease?"
Zheng Ren patiently asked about the medical history, and the look of impatience on the face of the female manager who accompanied the patient became increasingly serious.
In her opinion, the patient was just pretending to be ill, and Zheng Ren was just a young doctor. Usually, veteran doctors take one look at the film and make a diagnosis directly after asking a few questions. How can they ask such detailed questions
Besides, there are so many patients in the emergency department, who has the time to ask so carefully.
After a few minutes, Zheng Ren asked about the medical history and then took out the film to watch.
In fact, the female manager of the cleaning company is quite nice. Although she is a little impatient, she has done all the necessary inspections. There are not many people who can be so responsible.
The patient's electrocardiogram was fine. Because it was suspected to be a transient angina attack and the electrocardiogram did not capture abnormal changes, a 64-slice coronary CT was also performed as a supplementary examination.
There is nothing wrong with all the tests. Under normal circumstances, a diagnosis of neurosis is enough.
Zheng Ren didn't think so, after all, Big Pig Hoof gave a clear diagnosis - Cardiac Syndrome X.
"Have you ever eaten nitroglycerin?" Zheng Ren asked.
"I've eaten." The female patient also saw that the manager's face was getting worse and worse, and she whispered in a low voice.
"How's the effect?"
"It basically has no effect..." Her voice became smaller and smaller. In fact, she also felt that she was suffering from neurosis, or as the manager said, it was a disease that she thought up.
But every time the pain occurs, the duration is not certain, and the pain is very obvious.
Who knows who is in pain, but nothing happened during the examination. After seeing a doctor so often, even the patient himself began to wonder if there was something wrong with his mental state. Could it really be caused by menopause... She began to think wildly.
"Uh... let's do an isotope test." Zheng Ren said in a deep voice.
"Isotope test? How much does it cost?" The female manager immediately became angry. She looked at Zheng Ren with contempt and a bit of hatred.
Zheng Ren glanced at her, but was not angry when he saw that look. Instead, he smiled and put the film into the film bag, wondering whether it would be better to do an isotope test or an exercise treadmill test.
In fact, the reliability of these diagnoses is not particularly high. To truly confirm the diagnosis, invasive coronary angiography is still required.
"Don't waste time. We did row 64. This is my maximum authority." The female manager said coldly: "No problems were found. If other inspections need to be done, I don't have the authority and need to report it."
"Well, I'm sorry to trouble you," Zheng Ren said.
"..." The female manager looked at Zheng Ren in surprise. Didn't he know what he meant? !