Practicing Medical Skills in a Small Clinic-Chapter 67: Master Level Cardiology Diagnosis

Chapter 67: Chapter 67: Master Level Cardiology Diagnosis

After upgrading, he clearly felt that his ability to diagnose cardiovascular diseases had been elevated to a new level.

He had a whole new understanding and more precise judgment on heart failure, cardiovascular abnormalities, ventricular abnormalities, atrial abnormalities, ventricular fibrillation, congenital heart disease, and so on.

The proficiency level was already equivalent to that of a senior resident.

In the field of cardiology, this was considered quite a strong capability.

At a major hospital’s cardiology department, he could even handle the work of an attending physician in many situations, gradually beginning to have the ability to handle matters on his own.

Trying to diagnose this young man again, Li Jingsheng frustratingly found it still obscure and difficult to understand.

Even after racking his brains, he couldn’t determine what kind of disease the patient had.

The Cardiovascular Medicine department is considered one of the hardest to master, with its talent cultivation period even longer than Cardiothoracic Surgery.

It truly lived up to its reputation.

Despite the large number of associate chief and chief physicians produced by this department, many engaged in research, but those reaching clinical skill at the chief physician level were extremely rare.

An outstanding chief physician in cardiology could achieve a very high status even in a top-tier hospital.

The field of cardiology daunts countless medical students, evidently for good reasons.

Entry is difficult, improvement is difficult, and clinical practice is even more difficult.

Unable to diagnose still, what should he do now?

He felt caught between a rock and a hard place.

Based on his diagnostic experience, he judged that this patient was more than likely going to buy some anti-diarrheal pills, then go home and sleep to see the effect.

To diagnose the cause for this guy, he had already consumed 10 vitality points.

To rise to the next level, he needed to consume 90 vitality points.

For a doctor at a small clinic like him, having this diagnostic skill at the Entry Level was enough.

Now that it had been enhanced to the proficiency level, it was completely sufficient.

Consuming 90 vitality points to upgrade a skill that doesn’t create economic benefits for the clinic, was it worth it?

Even though he had a balance of 247 vitality points left, each one was hard-earned.

vitality points used wisely could upgrade many other skills.

Moreover, even if he upgraded the cardiovascular diagnosis skill to the Master Level, it might still be impossible to diagnose the real cause of this patient’s condition.

The small clinic couldn’t even conduct an ECG, with such limited resources, how could one diagnose?

No matter how high the medical skill level was, it still required supporting examination data, symptoms, medical history, course of the disease, and any familial diseases for a comprehensive diagnosis. It was never the result of a doctor’s mere imagination or conjecture.

Medicine is an extremely rigorous discipline.

And it must be rigorous. 𝓯𝓻𝓮𝙚𝙬𝓮𝙗𝒏𝙤𝒗𝙚𝙡.𝒄𝒐𝓶

Because it involves the life safety of every patient, no carelessness is permissible.

Li Jingsheng decided to first probe the patient’s thoughts.

"Ma Renli!"

"Hmm!"

"Your heart sounds abnormal, which worries me because it may be dangerous. How about going to a large hospital for an examination?"

Li Jingsheng advised him in a rather serious tone.

"It can’t be that serious, can it? Apart from diarrhea, I think everything else is pretty fine. Moreover, the outpatient clinics are closed now anyway. How about this, you give me some anti-diarrheal pills, I’ll remain vigilant and if there’s any discomfort, I’ll promptly seek medical help at a big hospital. But according to my experience, it’s likely just from eating something unclean causing diarrhea, a little medicine should fix it, nothing major."

The young man adjusted his glasses, appearing quite calm.

Most people with some education or medical knowledge would try to self-diagnose when falling ill.

However, amateur diagnostics certainly have a gap compared to professional doctors.

Especially with some uncommon or mildly symptomatic dangerous diseases, they can easily lead to negligence and ultimately, tragedy.

"In that case, why don’t you tell me about your condition again, particularly any details that might have been overlooked. Prescribing you medicine to take home without being thorough, there’s always a risk."

A doctor’s heart is as caring as a parent’s.

Li Jingsheng genuinely felt concerned for this patient.

For some heart diseases, it could be only two or three minutes from onset to death, even shorter.

If hospitalized, immediate rescue might be possible, saving a life.

If something happens at home, especially living alone, there’s no one around to rescue.

Even living with family or friends, if it happens late at night when everyone is asleep, the person might already be dead, body cold and stiff, when discovered.

Even if the attack is noticed, ordinary people lack the resuscitation knowledge, experience, equipment, and medication; the only option is to call 120 and wait for the ambulance. By the time the ambulance arrives, the rescue is usually just symbolic.

Clinically, even knowing a patient is dead, hospitals generally continue rescue attempts for 30 minutes, either at the request of the family or as per regulations.

Although the medical staff would love for a medical miracle to occur, usually, it’s declared clinical death after 30 minutes or more of resuscitation.

Selling this patient medicine would earn Li Jingsheng about eight yuan.

If it doesn’t involve injections, just providing some anti-diarrheal medicine, the profit would really only be that much.

Even someone as ruthless as Boss Zhao wouldn’t earn more than twenty or thirty yuan.

Legally, there wouldn’t be much risk here.

But ethically, as a doctor, knowing the patient’s condition might not be as simple as it appears, possibly even involving a death risk, turning a blind eye at such a time was extremely irresponsible.

It also violated professional ethics.

The patient realized that this Dr. Li was genuinely looking out for his best interests, so he patiently explained his condition again.

The patient only had diarrhea, without bloody stools, melena, vomiting, or similar symptoms.

He experienced bouts of abdominal pain, with signs of migrating upwards.

Upon hearing this, Li Jingsheng noticed the patient holding his stomach with the hand clutching a newspaper, a look of urgency and pain on his face.

It seemed likely he needed to go again.

Diarrhea was awkward like that: indifferent to location, unable to resist the urge. If a toilet isn’t found in time, there’s a high chance of an accident.

In this situation, the patient clearly couldn’t give him more time to think and diagnose slowly.

Ninety it is, he hoped upgrading the cardiovascular diagnosis skills could save this young man’s life.

At the very least, help this guy eliminate some potential life-threatening risks.

He stopped hesitating, knowing that vitality points could always be earned again, but a young life lost would be tragic beyond words.

He directly consumed 90 vitality points to once again upgrade his cardiovascular diagnosis skills.

Cardiovascular Medicine Master Level 100.1/500.

In just over twenty minutes, he had advanced this skill two levels, from Entry to Master Level.

Now he possessed a proper level of a junior attending physician.

Attempting to diagnose the patient again, he found himself full of insight and ideas.

Various cardiovascular diseases related to diarrhea flashed through his mind.

What was even better was that his train of thought had expanded, no longer as narrow as before. Previously, he had simply focused on isolated small areas of concern.

Now, however, he had begun to develop an overall perspective.

He could interconnect more medical fields and body organs, linking symptoms across areas for a comprehensive diagnosis.

"Diarrhea could very well just be from eating something unclean. But the abnormal heart sound, particularly that strange noise, struck me as resembling valvular insufficiency.

The patient frequently works overtime, stays up late, and remains sedentary; all of these have immense health hazards. Once cardia valvular insufficiency occurs, some notable issues could arise.

For example, mitral and tricuspid valve insufficiency might cause regurgitation.

If it’s aortic valve insufficiency, it could lead to symptoms like weakness, dizziness, fatigue, and breathing difficulties.

Pulmonary valve insufficiency goes without saying; it could be life-threatening in severe cases.

Even sudden respiratory arrest could occur..."

With an expanded train of thought, Li Jingsheng no longer just fixated on diarrhea as the sole focus.

He began to investigate from multiple angles simultaneously—abnormal heart sounds, diarrhea, abdominal pain—connecting them all together.