novelraw Chapter 328 - 176: Treating Pericarditis, So-Called Finishing Touches (2)
Chapter 328 - 176: Treating Pericarditis, So-Called Finishing Touches (2)
The man described the onset of the illness.
Five Accumulation Powder is a relatively common Chinese medicinal formula, effective for relieving exterior and warming interior, dispersing cold and eliminating dampness, regulating Qi and activating blood, resolving phlegm and breaking accumulation.
Many older people choose it to treat colds after catching one.
The results are quite good.
Moreover, being a Chinese medicine formula, it has minimal side effects and isn’t very picky about body constitution.
"Come, let me listen to your heart and lung sounds. Try to relax and just breathe normally."
Li Jingsheng motioned for the man to unbutton his shirt, exposing his chest, and then pressed the stethoscope probe onto him.
Lung sounds were clear, only slightly coarse, without any dry or wet rales.
However, he heard pericardial friction sounds.
Upon careful auscultation, the pericardial friction sound was a scratching rough sound and was triphasic.
The area... seemed to be located in the precordial region.
The patient began to cough at this time, instinctively leaning forward.
Li Jingsheng heard it even more clearly this time.
After the patient finished coughing, Li Jingsheng tried percussing the patient’s heart and heard a dull sound.
Moreover, it expanded to both sides.
Master Level cardiovascular medicine diagnosis made him instantly realize the patient wasn’t suffering from a cold but had a problem with the pericardium.
During cardiac percussion, he always felt that his auscultation level and diagnostic ability needed improvement, lacking some key details.
"If it’s not a cold, then what disease could it be?"
Li Jingsheng thought it necessary to assist with that grandfather-class X-ray equipment for further diagnosis.
It’s now basically certain that the lesion is in the pericardium.
He dared not to treat most serious heart diseases.
Some with lower risk factors could be worth a try.
After all, now there’s Minor Achievement level pharmaceutical effects and pharmacokinetics along with Master Level cardiovascular medicine diagnosis, it certainly should be applied to make use of their efficacy.
Medical skills become more refined as they are used.
After simple communication, the patient agreed to undergo an X-ray examination.
To be honest, that grandfather-class X-ray equipment struggles not just a little when examining the heart. It’s best to have high-quality X-ray equipment for examining the pericardium and lungs.
He naturally didn’t want to easily lose a business opportunity.
After much effort, he finally got some results.
X-ray chest films showed the heart silhouette expanding to both sides, and the apical impulse was significantly weakened.
At this point, he could basically determine that the patient had pericarditis.
"Are there symptoms of chills?"
"Does that mean feeling cold?" the patient asked, puzzled.
"Yes."
"Not really, it’s just that I have a fever all over, my head feels a bit dizzy, and I don’t have much energy."
"Your illness is likely pericarditis. From the onset time, it should be acute pericarditis. I recommend you see a large hospital, for a more secure approach."
After discovering the patient had pericarditis, Li Jingsheng, due to limited conditions, couldn’t confirm the type of pericarditis.
If conditions allowed, conducting an echocardiogram, electrocardiogram, blood routine, or even pericardial puncture biopsy would be needed to accurately determine the type of pericarditis.
Then prescribe accordingly.
"Can you treat it here? I know the medical skills here are quite good. If you can treat it, please go ahead, I trust you guys."
A forty-year-old man is really not afraid of death.
He chose to treat it at a small clinic to save some medical expenses.
Of course, this also relates to the good reputation of Sunshine Clinic.
"Hmm... Okay, I’ll prescribe you some medicine to try out. If today’s effect is not noticeable after taking, don’t come back and go to a hospital for treatment immediately."
After pondering for a moment, Li Jingsheng actually agreed.
He dared to agree because he had some confidence.
Pericarditis comes in many forms, idiopathic pericarditis being the most common.
Tuberculous pericarditis is usually directly spread from mediastinal lymph node tuberculosis, lung, or pleural tuberculosis.
Clinically, there will be tuberculous systemic reactions and pericardial effusion.
This disease generally lacks precordial pain and pericardial friction sound.
Thus, tuberculous pericarditis can be directly excluded.
Remaining is neoplastic pericarditis; this disease generally progresses slowly, with fever symptoms often most common as long-term low fever, also can be excluded.
Then there’s purulent pericarditis, mostly common with pneumonia, empyema, sepsis, pericardial effusion mostly being purulent, long disease course, rarely presents so acutely.
Lastly, there’s a syndrome caused by heart injury.
This mostly occurs in patients with high-fall injuries, post-operation, acute myocardial infarction, directly can be ruled out.
Finally, there’s viral pericarditis.
Caused by viral or bacterial infection.
Onset is acute, progressing rapidly.
Highly consistent with many symptoms of this patient.
The patient is now just having difficulty breathing, heart rate and pulse are still quite good. It should be early or mild, Li Jingsheng is confident of curing this illness.
That’s why he agreed readily.
Prescribed the patient with Ibuprofen sustained-release capsules.
Nurofen is mainly to relieve patient’s pain, anti-inflammatory, and reduce fever.
Initially prepared to prescribe Ribavirin, this medicine is quite effective for early treatment of viral pericarditis.
Ganciclovir also has similar therapeutic effects.
After comprehensive consideration, Li Jingsheng chose the most commonly used Ibuprofen sustained-release capsules.
"Is it enough to prescribe only one kind of medicine?"
The patient asked somewhat incredulously.
"Medicine is a three-part poison, not in quantity. Take the medicine home, follow the dosage, and have a good rest. I believe it will have a good therapeutic effect."
Li Jingsheng said confidently.
Medicine is about essence, not quantity.
Truly skilled doctors always choose to use less medicine, but good medicine.
This good medicine doesn’t mean expensive, but precise and targeted.