My Medical Skills Give Me Experience Points Chapter 1268 - 499: Double Outlet Right Ventricle, A Competitor’s Blunder
Previously on My Medical Skills Give Me Experience Points...
Zhou Can inspected the young girl closely and detected a prominent swelling in her precordial region, along with a marked thrill situated between the third and fourth ribs at the left sternal border.
The thrill became even more intense when he applied fingertip pressure to that spot.
Auscultating the area with a stethoscope, he clearly heard a sharp murmur—the typical noise generated by myocardial systole.
"Is there an issue with the right ventricle?"
Unsure at first, Zhou Can drew on his accumulated experience to form an initial judgment of the girl’s condition.
He listened intently once more to the intercostal murmur.
His brows knitted together slightly; this murmur struck him as utterly peculiar, one he was certain he’d never encountered before.
Congenital heart diseases come in countless varieties.
What sort of defect could generate a murmur like this?
An echocardiogram would be an excellent next step for the patient.
Given the unique nature of congenital heart disease, a cardiac X-ray was essential too for supporting the diagnosis.
The test results arrived swiftly following the checks.
The patient’s aorta measured 2CM, left ventricle 3.3cm, right ventricle 2.6cm, pulmonary artery 1.2cm; the atria sat normally, ventricles showed right-sided looping, while both aorta and pulmonary artery arose from the right ventricle, arranged anteriorly and posteriorly with aorta ahead and pulmonary artery trailing.
A 2.2cm gap interrupted the ventricular septal echo, positioned in the membranous outflow tract; left ventricular blood flowed into the aorta through this ventricular septal defect; the pulmonary valve echo appeared stronger, its opening constricted to just 0.3cm in diameter.
Now, Zhou Can grasped the source of that bizarre murmur.
The girl suffered from double outlet right ventricle.
With her pulmonary valve so severely narrowed, it was no surprise her blood oxygen levels were terribly low.
Examination revealed a forward flow speed of merely 3.1m/s at the pulmonary valve, a transvalvular pressure gradient of 10.44kPa, and a mild regurgitation signal at the pulmonary valve.
The cardiac X-ray indicated fine pulmonary vascular markings, a concave pulmonary artery segment, plus enlargement in both the right ventricle and right atrium.
By this point, the diagnosis of congenital heart disease stood confirmed beyond question.
The child had double outlet right ventricle combined with pulmonary artery stenosis.
Surgery offered the only cure.
Yet the operation carried high risks and great complexity.
The expenses were far from modest either.
"Your daughter has congenital heart disease, a severe case that demands immediate surgical intervention. The emergency department can’t handle this major procedure; we must consult the Cardiothoracic Surgery Department. I’m heading there myself right now—if you agree, I’ll escort you over."
Zhou Can explained to the family.
Xue Yan from Cardiothoracic Surgery had rung him twice already, pressing him to come soon.
Still, with the girl’s exam results pending, Zhou Can had no choice but to hold off briefly.
Her state was dire, and the duty doctor Xie lacked solid resuscitation skills; one wrong move could cost a precious life!
The family eagerly accepted Zhou Can’s offer to guide them to Cardiothoracic Surgery, touched by his dedication.
Tuya Hospital sprawled enormously; navigating to Cardiothoracic Surgery alone at night would’ve been a nightmare for them.
Sticking to emergency protocols might trap them in endless waiting, possibly until dawn, for a surgeon to fetch them.
Arriving at Cardiothoracic Surgery, Zhou Can handed the child off to a receiving doctor with key instructions, then proceeded to the operating room.
Dinner looked impossible tonight.
Director Xue, aware he’d just finished one surgery and met a congenital heart case, had foreseen no meal and readied two bread slices plus a milk bottle for him.
Zhou Can wolfed them down quickly, easing his hunger somewhat.
A grueling challenge loomed.
This cardiovascular catheterization procedure promised nightmarish difficulty.
…
In the interventional operating room, the patient voiced a peculiar demand.
"Doctor, may I livestream the whole surgery?"
No general anesthesia was needed here.
The patient stayed awake the entire time.
He aimed to stream the full operation, letting followers witness his journey.
"Why livestream right in the middle of surgery? Save sharing your experience for after it ends, with the netizens!"
Xue Yan clearly disliked the notion.
Hospitals typically rejected such pleas outright.
They breached patient privacy and violated regulations.
Patients hold little power against hospitals.
Unless they forfeited treatment.
"I’ve already uploaded pre-surgery videos, telling my over two million fans I’d go live tonight to show the process and my treatment story. Helping me pull off this surgery means huge free promo for your hospital, department, and doctors—a golden ad chance!"
The patient acted boldly without shame.
To boost followers and engagement, he’d forged ahead sans permission.
Only now in the procedure room did he raise it, silent on it back in the ward.
It resembled a bride, after the groom set the wedding banquet, abruptly hiking the bride price at ceremony time, cornering groom and in-laws into yielding.
"Mr. You, grasp that livestreaming the surgery heaps massive pressure on the surgical team. It subtly hinders the operation in countless ways."
Xue Yan persisted in seeking grounds to deny him.
"Pressure fuels drive! Refusing my livestream hints at shaky confidence—dread of surgical mistakes or outright flop driving your stance."