Chapter 1424: Chapter 567: Special Myocardial Infarction Patient, Systemic Arterial Vascular Malformation (Part 2)

Zhou Can, after reviewing, was able to provide a specific rescue plan immediately.

"Contact the cardiac catheterization room at once and send the patient over. I’ll go communicate with the family."

Director Lou was also unusually decisive.

...

After nearly two hours of rescue, Zhang Qilian’s life was saved, but due to the prolonged ischemic period, he would definitely suffer severe sequelae.

Heart failure, arrhythmia, and ventricular aneurysm etc.

The main manifestation is heart failure.

From now on, even taking a few steps would leave him breathless, and his quality of life for the rest of his days would significantly decline.

The solutions could only be the replacement with an artificial heart or a heart transplant.

Myocardial infarction and cerebral infarction both are irreversible damages.

In fact, prolonged ischemia in any body tissues could potentially cause irreversible damage.

However, some areas are relatively special; even if the main blood vessels are blocked, some arterial vessels can still supply blood. In such cases, the body will show severe symptoms, but as long as treatment is timely, most likely there won’t be sequelae.

Zhang Qilian’s interventional thrombectomy was extremely difficult.

His blood vessels were very special.

The interventional doctors were unsuccessful whether through the femoral artery, radial artery, or percutaneous coronary artery.

It was finally Zhou Can who took action, using Level 6 Injection Skill and Level 6 implantation technique, he eventually discovered the problem.

Turns out, in the pathway from Zhang Qilian’s femoral artery to the coronaries, there were two points with severe arterial plaque, causing significant narrowing, especially at a bending point where the blockage was quite severe.

This invisibly made the guidewire passing through the vessel extremely challenging.

If only the femoral artery approach was obstructed, the interventional doctors would not be afraid. They could still use the radial artery approach.

In clinical emergency, the radial artery approach is used more frequently.

Unfortunately, the path between Zhang Qilian’s radial artery and coronary artery was even more severely blocked, with the vessel showing severe malformations. Such a situation is very rare in clinical practice.

At least, it was the first time Zhou Can saw a patient with such severe vascular malformations.

Moreover, when he performed coronary angiography, he found there were also severe malformations in the patient’s coronary arteries.

This made him suspect whether the patient’s entire systemic arterial vessels had this pathological change. Or perhaps, it was a natural physical condition?

The actual reason could only be investigated later.

No wonder the Japanese cardiac surgery expert from the Third Hospital was helpless with such a unique vascular condition.

Through this treatment, Zhou Can gained even more confidence in his interventional treatment skills.

Unnoticed, his interventional skills had surpassed many ’experts’.

When he walked out of the cardiac catheterization room, he had already roughly deduced Zhang Qilian’s entire onset-to-treatment process in his mind.

Likely in court, Zhou Can made a remarkable comeback that was difficult for Zhang Qilian to accept.

At an older age, coupled with severe systemic arterial vascular disease, upon severe mental stimulation, his blood pressure skyrocketed, worsening the vascular blockage, ultimately forming a myocardial infarction.

Some might wonder, when blood pressure rises, the blood circulation in the body should accelerate, leading to more open blood flow, so how could a heart attack occur instead?

The pathogenesis must be analyzed from multiple angles.

Firstly, hypertension can accelerate the progression of atherosclerosis, directly causing arterial narrowing.

With Zhang Qilian’s severe whole-body arterial vascular disease, it is very likely due to prolonged high blood pressure states.

Secondly, poorly controlled long-term blood pressure can easily lead to target organ damage, including left ventricular enlargement.

After left ventricular enlargement, its ejection capacity will weaken.

It’s like a house originally accommodating a family of three, feeling cozy. One day, after expansion, the house’s area greatly increased, remaining with only three people, making it feel empty inside.

The ventricle is similar.

With an enlarged ventricle, the amount of blood entering remains the same, naturally reducing its ejection capability.

At the same time, ventricle enlargement can lead to weakening of the myocardium, which is also a significant reason for reduced ejection capabilities.

If a larger left ventricle is left unchecked, over time it will affect myocardial blood supply; coronary spasm risk then significantly elevates.

With these conditions met, if the patient is stimulated, causing sudden blood pressure elevation, then unstable atherosclerotic plaques may dislodge, forming a thrombus, ultimately causing coronary artery obstruction.

Thus, when communicating with patients who have heart disease, it is crucial to be mindful of language.

Overly harsh words can cause patients’ blood pressure to rise, putting them in danger.

In the event someone is infuriated to the point of death, there is a high chance of encountering legal trouble.

Zhang Qilian suffered a defeat in court, raising his blood pressure, ultimately leading to a myocardial infarction unfortunately.

His own hospital specialized in cardiac surgical treatment, so naturally, he preferred being treated there. Yet, he never expected the Japanese cardiac surgery expert the hospital hired at a high salary to be so incompetent.

At the critical moment, they let him down again.

Despite repeated efforts, they still couldn’t remove the thrombus or clear the blocked coronary artery.

They were helpless.

After discussing with the family and Vice Dean Zhang, they decided to trust Tu Ya’s medical skills and directly transferred the patient to Tu Ya for emergency treatment.

Their decision proved extremely correct.

After over two hours of effort by Zhou Can, two stents were placed along the path from the patient’s femoral artery to the coronary artery, propping open the severely narrowed vessels, allowing the guidewire to pass through smoothly.

The thrombectomy was successfully completed.

Based on Zhou Can’s evaluation standard, he felt the patient would require the placement of at least a hundred stents throughout his body.

Even so, it might still not completely resolve the issue.

Zhang Qilian remained at risk for arterial blockages.

No matter the case, he successfully saved the patient, which would undoubtedly raise his reputation once again.

After leaving the catheterization room, the family members gathered around.

"Doctor, how is my husband?"

Zhang Qilian’s wife appeared very young, maintaining herself very well, with exquisite makeup on.

Were it not for her nasolabial folds and slight crow’s feet, along with eyes that did not match her youthful appearance, Zhou Can would have thought she was in her twenties.

Her skin was not only fair but also particularly lustrous.

Her figure was also very well maintained.

She exuded a gentle and intelligent aura.

Given Zhang Qilian’s ruthless and treacherous nature, and considering his lack of handsome looks, it was surprising that he married such a beautiful wife. It reminded Zhou Can of the saying, "Flowers love to grow on cow dung."

"The patient is temporarily out of life-threatening danger. However, his systemic arterial vascular disease is quite severe. He needs to be extra cautious afterwards and must avoid getting angry. Since he was brought in late and missed the optimal rescue time, post-recovery, he might experience heart failure and cannot undertake heavy work or intense exercise."

Zhou Can and Zhang Qilian are considered adversaries.

But whether during the rescue or now, he exemplifies the sacred and noble nature of the medical profession.

He always prioritizes the patient’s interests.

"Sugoi!"

Upon hearing this, she folded her hands, a joyful smile appearing on her face.

She clearly cared a lot about Zhang Qilian.

Their love seemed quite tender.

She spoke in Japanese just now, evidently a subconscious reaction, revealing that she most likely came from Japan.

Instinctively, he glanced at her legs.

Indeed, there was an evident bow shape.

"Thank you, thank you all!"

She repeatedly expressed her gratitude to Zhou Can.

"You’re welcome! Shortly, you’ll be able to see the patient. He might need hospitalization for about three to seven days."

Zhou Can nodded to her and walked straight off.

...

The next day, after completing his morning rounds in the Emergency Department, Zhou Can specifically went to check on Zhang Qilian’s recovery condition.

Just as he arrived at the cardiovascular ward, he spotted a familiar figure.

Vice Dean Zhang, who was escorted away by security last time, stood outside the ward, talking on his phone.

As vice dean, with the dean now down, his workload must be significant.

Upon seeing Zhou Can approach, a subtle change surfaced on Zhang Mingxing’s face.

It was mostly embarrassment.

"Good morning, Dean Zhang!"

Zhou Can greeted openly with a smile.