Chapter 1603: Insight and Reasoning

Where exactly is the suspected clot hiding in this clinical case? Is the heart damaged or not?

"Teacher, look at this." Xie Wanying suddenly pointed to one of the images and said.

Doctor Xu glanced at the image she pointed at and couldn’t see anything unusual at first glance.

"There’s a low-density shadow here that needs to be checked," said Xie Wanying.

Doctor Zhao hurriedly pressed his eyes to the computer screen to take a look.

It really strained his eyes. The low-density shadow is indeed there, though it’s a tiny black spot difficult to distinguish from the surrounding area.

Doctor Xu pushed the student aside, adjusted his glasses, fixed his eyes on the area, examined it for a while, and said, "It’s a bit darker. This area should be the anterior wall of the right ventricle, a crescent-shaped protrusion. We can’t rule out the possibility of a clot or some kind of mass attached here."

"Teacher, also here," Xie Wanying pointed out another abnormal area.

Doctor Xu and Doctor Zhao followed her lead to another point of abnormality on the image.

This time, Doctor Zhao saw it immediately and said, "It looks like a heart attack occurred. The apical area of the left ventricular wall is locally thinned. This patient may have coronary artery damage."

Doctor Xu frowned. The doctors at the Provincial People’s Hospital should have easily seen this. Could it be that since the patient didn’t show typical signs of a heart attack, it was ruled out? Because some patients with normal heart function may also have such image presentations.

Doctor Zhao turned around and asked Student Xie, "How do you find problems so quickly?"

He and the teacher had just started looking for issues, not even five minutes had passed, and Student Xie had already identified two problems. How terrifying could Student Xie’s vision be?

It’s not about her having good vision, it’s a different problem-solving approach.

From the outset, Xie Wanying suspected her cousin’s coronary arteries were damaged, so she focused on finding issues in the coronary artery region of the heart.

After listening to her thoughts, Doctor Zhao’s mouth opened wide like a goose egg, wondering what kind of person she was.

The coronary artery is a network of heart blood vessels, large and small, intertwining around the heart. To search within the coronary artery region means you need to consider damaged arteries first, then identify problems in corresponding heart areas receiving blood from those arteries. Coronary CT scans can barely brush over issues, let alone finding problems in corresponding areas.

Such an incredibly high level of difficulty, yet she considered it relatively easy to find, and located them. Doctor Zhao’s mind couldn’t keep up with Student Xie’s conceptual heart-thinking.

Doctor Xu, very interested, turned to ask Xie Wanying, "How do you have this mindset?"

This traces back to her visit to the Provincial People’s Hospital to see her cousin, during which she stayed with the patient and could continuously observe the clinical symptoms and ECG. The ECG is a tool for clinicians to observe heart activity, and reading ECGs is fundamental skill for clinical doctors.

Her cousin’s ECG exhibited abnormal signs, sometimes arrhythmias, sometimes the ST segment appeared elevated, all indicating issues with heart blood vessels and the cardiac conduction system. Her cousin didn’t have heart disease but got into a car accident, so the root issue must involve heart damage impacting the coronary arteries. Following this line of thought, as long as coronary artery regions are examined according to ECG manifestations, the areas of cardiac impact injuries can be identified.

Doctor Zhao grabbed the examination application report written by the clinicians. Regarding the patient’s ECG description, Doctor Li hadn’t written a word.