It’s a critical time to save lives.
A patient who is repeatedly heartbroken and tiring is getting better.
He asked to watch, but he did not expect to save his life.
I was in the emergency care night and I had a 32-year-old male patient who told me that he had just experienced an imminent death and was very scared.
At the time, he was placing his head on the program (the patient was a programmer), and suddenly he felt a panic and his heart beat as if thousands of horses were coming in.
And he’s sweating like he’s dying.
He was very scared and had to stop and rest. Fortunately, the situation had gradually eased in a few minutes.
Worse still, this has happened several times.
The previous times had not been so serious, so it had never been too important to think that it was overwork.
But this time he did, and his wife drove him to the emergency.
The road had eased down, and by the time I gave him the heart, I could hear nothing.
I stuck his fingertips with blood sugar. It’s normal, no low blood sugar.
He was also given an electrocardiogram, twice before and after, which was normal and without any sign of a heart disorder.
But that doesn’t mean that it’s not a heart problem, and I told him that a lot of heart attacks are sudden, they happen at once and disappear soon.
In this case, the EKG can’t capture the anomaly, and for further examination, only 24-hour dynamic EKG.
He’s panicking. Ask me if he’ll suddenly fail.
I know what he’s saying. He’s asking if I’m gonna die suddenly.
But in front of his wife, he didn’t want to say the word sudden death.
I have to be honest, however, that there is a real possibility of unexpected events, with heavy work stress, frequent nights and such heart performances, which need to be investigated.
He asked me if I could do all the tests tonight.
Of course not. We can’t do a whole series of cardiac tests in emergency cases, dynamic electrocardiograms, cardiac colours, etc. during the day, and we can’t do it at night.
I had to give him a EKG at night, while he was given a few tubes of blood, which was a routine check.
He was so upset, he said that it was too hard, that the whole person was losing it, that his heart was beating fast, that his heart was jumping out of his chest, that he was weak, sweaty and weak.
I know it’s most likely that there’s a hysteria on the symmetry room.
What does that mean?
The normal human heart rate is generally 60-100 times/min, and in the event of such a heart disorder, the heart rate may be 150-250 times/min.
It must have been hard to beat a heart so fast, and there might be severe chest pains, fainting and even shock.
He’s sad, asking me what to do.
I’ll call the cardiologist down for a consultation, see if I have any other comments.
Upon completion of the examination by the cardiologist, the highest possibility of sexual hyperactivity was also considered.
The disease is characterized by a sudden stop, and it happens when you’re at home, but it’s better to take a few minutes off or to get on the road, so the doctor can’t find it.
So what do we do?
Only a few more 24-hour dynamic EKGs can be made, and it is hoped that the next EKGs will be worn at the time of the attack, so that a diagnosis can be made by “persons getting stolen.”
The treatment is either a long-term oral drug control or a radio frequency digestion to burn the abnormal tissue inside the heart.
The patients were said to be in conflict with the need for surgery, saying that they were busy at work and that they might not be able to arrange time for hospitalization.
The physician is not in a hurry either, saying that the diagnosis is not clear and that there is no need for surgery to complete the examination.
Since the patient was in complete better condition at the time, and there was nothing unusual about the results of the blood pump, I did not give him the medication and simply let him go.
Before I left, I taught him a way to stimulate the locomotive:
The next time there’s a similar event, you can hold your breath in deep breath, and then you can do your exhale, as if you’re working in constipation, a move called Valsalva, that stimulates the discomfort, slows down the heart rate, and perhaps stops the heart attack.
I also told him that he needed time to come to the hospital as soon as possible for an examination or to be hospitalized, or else the next one could be worse, or even faint, and that would be trouble.
I thought it was over.
Six months later I saw him again.
It was also a night shift night, and he soon recognized me and asked if I remember him.
I’m pretty impressed with all kinds of patients on duty.
He told me with his face that something like that had just happened at home, and that it took almost five minutes.
He wanted to get to the hospital and get the doctor to help with the EKG, but he did not expect the road to go down again.
“Does this attack help the Valsalva action I taught you? I asked him.
He said it did, but it didn’t seem to work. It took a few minutes before it eased.
I pulled his EKG, and, as we thought, nothing unusual.
He told me that after the last emergency, he came to the hospital the next day and did a lot of tests, including a 24-hour dynamic EKG, cardiac lottery, chest CT, etc., and the results were good.
The doctor then gave the metorol tablet (a drug that slows down the heart rate) and at first it felt good for a few days, but then there was another heart attack and sweat, but it lasted a short time and never came to the hospital.
I didn’t know this was a big night, and I felt like I was going to faint, and my wife was scared, and I drove to the hospital.
I looked at all his reports and did not find any major problems.
But he’s got an attack that’s really in line with the hysteria on the sonar room.
The disease was caused by a problem with the wiring system of the heart, which caused the heart to suddenly beat quickly and then soon to recover.
In return, patients are often afraid and become anxious and insomnia, which seriously affects the quality of life and work.
It’s really like a thief. It’s a sneaky disease.
I told him that, if it didn’t work out well, he might have to go back to the clinic, get the doctor to do more or adjust the drug.
And may require further electrocardiology.
An electrocardiological examination is the extension of an electrode into the oesophagus, which is closest to the heart, and then discharges the heart to see if it can induce a heart disorder.
If that’s possible, it’s a problem, so let’s do a radio-frequency digestion and burn the diseased tissue.
He told me that he had been examined by the cardiologist, but that he did not want to be hospitalized or operate for the time being, so he refused.
That’s impossible. It’s difficult to treat without a clear examination.
And he can’t be helped with an emergency every time he has an attack. The only thing that can help him is psychological consolation.
He told me that fear of sudden death would give him a better chance of survival if he reached the emergency.
He said that the disease had been bothering him for months, and that it had to go crazy.
I told him about the stakes. I can’t do it without further examination.
The hospital is to be hospitalized and the operation is to be operated unless it does not wish to survive.
He was later moved by me and promised to go to the hospital in two days’ time to organize his head.
I’m actually curious about his illness, and I’ve thought about all the possibilities, and I told him that the next time I see a doctor, I can get my stomach glasses together, I can’t get a general stomach lens for emergency care and I can do it during the day.
Some may be heartbreaks, sweats and feelings of near-death caused by retrenchment of the stomach, and it is reassuring to check the stomach mirror if it is all right.
Besides, I think he’s a little anxious, he’s not stable, he’s afraid he’s got a heiform, and he’ll check his thyroid.
Then he went back, and I didn’t give him blood this time.
Before leaving, he also asked me if I had a drug that would save my life at a critical time, something like a life-saving pill.
No, modern medicine isn’t.
Quick-acting heart-saving pills are used to deal with coronary heart disease and are not always effective. Patients have arrhythmia and use of those drugs is ineffective.
It’s not about working, it’s about valsalva, it’s about throat, it’s about throat.
He said that suffering was secondary and that the worst fear was sudden death, for which the recent rest was not good.
I urge him to do all the tests as soon as possible, lest he be afraid.
That was the second time I saw this patient.
Three weeks later, I saw him again.
I wonder why he always has night sickness and no day sickness.
He said he didn’t know. He walked in the park after dinner with his wife, and suddenly his chest got sick and his heart beat fast, just like the previous one.
And sweaty, it’s like driving a crane.
They’re close to our hospital, so they’re here for our emergency.
Just like the two previous ones, it would have been good to have an emergency, and he had no other abnormalities than a wet shirt (so sweaty).
He told me that he had been hospitalized before and that it was normal for him to undergo an electrocardiological examination a few days after his release.
The cardiologist says he’s not the cause of the heart.
Then he listened to me and made his stomach mirrors, and it was normal, without me talking about gastrophagus.
All blood tests are normal and thyroid functions are normal.
I can’t believe it. How can it be normal?
But the secondary test results he showed me were normal.
It doesn’t make sense to have spent so much money, done so many tests and found nothing.
There was another attack while in hospital, and the doctor was unable to do so and went to a psychiatrist.
After the chief of psychiatry assessed, he gave a diagnosis, a panic attack!
A panic attack? I’m surprised.
A panic attack, also known as an acute anxiety attack, is a mental illness.
Typically, when patients are carrying out their daily activities, they suddenly have a strong sense of fear, accompanied by a heart attack, as if the heart was about to pop out; there is a feeling of oppression on the chest, and some people are suffering from breathing difficulties and dying, as if they were about to die.
Some of them also suffer from dizziness, red skin, sweat and numbness.
I realized that it was no wonder that the patient’s electrocardiology, thyroid function, gastroscope, etc. were not abnormal. They were psychosomatic diseases, all symptoms were mental and not really organic.
The more I look at it, the more anxious the patient really is, the more scared I am every time I come to an emergency.
I can only blame myself for not having been involved in the mental and psychological field, and for not being able to think of the possibility at an early stage.
But I’m still wondering, since it’s a panic attack, do patients take psycho-related drugs?
He told me that he’s been eating fluoride ever since he left the hospital.
Flustine is an anti-psychotic drug that treats depression, and of course it helps with this shock.
The patient was still reluctant to take the drug, because it was used to justify his mental abnormality.
He had not believed that he was mentally handicapped, but the doctors had explained to him repeatedly that the results of the various examinations were in front of him.
The wife also guided him, comforted him and said that in recent years, the family had been under stress and had given birth to two more children, that economic and work stress had multiplied and that anxiety was understandable, and that it was crucial to be actively treated.
The question is, why is there a panic attack tonight after the fluctine?
That’s what he asked me, and I couldn’t answer it.
I tried to get a psychiatrist to explain to him, but no one was on duty at night psychiatry, so he could go back the next day and see if he needed to adjust the medication.
“Probably the drug hasn’t worked out, or the drug’s in short doses, or you’re insensitive to the drug. I’m sorry.
I basically told him all the reasons I could think of.
But I also told him that I’m not good at mental disorders, and I can’t give him much.
He said he was still tired and wanted to take a break in the emergency section.
I understand his fears, and he does not believe that he is mentally handicapped, or that he feels sick and afraid of dying, so he wants to stay.
I say the heart can’t see any pathologies at the moment, no cardiacitis, myocardia, coronary heart disease, heart disorders, etc., and it’s unlikely that it will die suddenly and can go home to rest.
I also made it clear to him that anxiety is not a major disease, that the body disease is a disease, that the mental disease is a disease, that it is a disease, that it must be treated.
At the same time, he was reassured that there was no need for any psychological burden, to relax himself and to be treated with medication, and that it might soon be possible to get out of the valley.
But he still felt it would be better to stay one night, after all, because the feeling of panic was really hard, and he was better off in the emergency section.
I’m just giving him a look.
It is not surprising that this mischievous arrangement has finally resolved the difficulties that have plagued us for months.
I’m going to take care of the other patients after I’ve given them a look.
At about 4:00 a.m., Dr. Phoe was in a hurry to find me and said that XXX was in a panic. Let me see.
I dropped my job and I followed it.
The first time I saw him, I finally understood why he was so afraid of the shock.
Because he’s really hard.
He was lying on a sick bed, with his hands covered in his chest, his face sad, his head sweaty and his body soft.
When he saw me, he pointed to his chest and said his heart beats fast.
His wife was very worried too.
I’m gonna get Dr. Phoe on the EKG and get him a EKG right away.
I’m a little excited, and this time I finally caught a live one, to see if there’s anything special about the EKG.
And I think it’s all right to see him this time. He’s had three emergencies, and this is the first time we’ve caught him.
I think he’s sweaty, he’s weak, he’s afraid of low blood sugar, and I want the nurse to come and measure it.
First, the EKG results came out, and it was a cardiac hypervelocity, with a heart rate of about 140 times, not as much as we thought.
I thought he was going to be a hysteria, but it wasn’t.
I’m a little disappointed, but it’s consistent with the patient’s previous test results, and I can only admit it.
But then the blood sugar turned me on my back.
Patient blood sugar is 1.9 mmol/L. The nurse looked up and showed me.
Is there a mistake?
I don’t believe it. Let her remeasure one.
The result was almost, 1.8mmol/L.
This time I’m really going to scold my mother.
Give him glucose, and I’ll give him 40ml of glucose, and we’ll have to get the blood sugar up as soon as possible, or it’ll be a problem.
The normal human abdominal sugar is 3.9-61mmol/L, it’s more than 4:00 in the morning, and the patient is almost empty, and there should be no such low blood sugar.
If there’s so low blood sugar, there must be something wrong.
I first wondered if the nurse was mistaken and gave insulin to the patient because I gave insulin to another diabetic patient.
But we cross-check, the drugs aren’t working, the patients’ low blood sugar is none of our business.
Nurse’s hands and feet are weak, glucose is ready.
I asked the patient, “Have you ever had low blood sugar before? I’m sorry.
He was confused, “never too low blood sugar.” I’m sorry.
Indeed, every time he came to an emergency, I measured his blood sugar, including this time, I gave him regular blood sugar, but it was normal.
I also looked at his last hospital report, and the blood sugar was normal on several occasions.
I told him that such low blood sugar could cause panic, hand shaking, chest suffocation and sweat.
Ask him again if this panic attack is the same as before.
He nodded and told me that it was almost the same, that it was near-death, that he was sweating and that his heart was beating fast.
After the glucose was pushed up, he quickly recovered his normality, his heart rate started to slow, and he became comfortable.
I now understand why patients still have panic attacks when they eat fluctine.
Because he’s probably not a panic attack, not an anxiety attack, or a heart disease, acupuncture, gastrophatosis, etc.
The real cause of all the symptoms is probably low blood sugar.
Low blood sugar? Patients can’t believe it.
Because he never had low blood sugar and no diabetes.
“You had low blood sugar, but you didn’t know. I told him.
The patient was at home every time he had an attack, which was supposed to be low blood sugar, but he did not measure blood sugar at home.
But by then he had recovered, and the blood sugar had risen, so we never noticed that low blood sugar had happened.
Blood sugar was also checked several times during hospitalization, but it was taken without fear, so no low blood sugar was detected.
And tonight, the blood sugar was measured at the time of his attack, and by chance, we caught the low sugar.
1.9mmol/L is already very low, below 3.9mmol/L, even if it is low, the patient is very serious and has a series of painful symptoms.
This is also confirmed by the fact that timely glucose supplementation can quickly relieve symptoms.
He is also aware.
It’s really a coincidence that I wouldn’t have left him if he hadn’t been afraid to die.
‘Cause I always thought he had a heart attack, and then I thought it was anxiety.
And it happened that, while he was watching, he was in yet another panic and we caught the EKG and blood sugar.
The EKG didn’t find much, but the blood sugar surprised us.
Then why is there low blood sugar? He’s confused again.
How can a good end be low blood sugar, and usually eat a lot and not feel hungry?
I wonder too.
The only disease I can think of is insulin in his body.
There’s a lot of hormones in the body that can increase blood sugar, but only one hormone that can reduce blood sugar is insulin.
Insulin, which is a hormone of insulin tissue in pancreas, can deliver glucose from the blood to tissue cells, so tissue cells can use it, so insulin can reduce blood sugar.
If the insulin tissue of the patient increases or the tumor increases, which leads to an increase in insulin inoculation, it may well lead to low blood sugar.
Insulin may have increased intermittently, leading to low blood sugar in patients, leading to a series of post-incidents that we mistakenly thought were heart attacks or panic attacks.
If the patient’s pancreatic tissue is really bad, how much of that abdominal gravitation should be indicative.
However, the patient did two abdominal extravagances before and after, and no abnormalities in pancreas were observed.
I can only explain to him that this insulin growth or the tumor is not too obvious, that the color is too hard to see, that it can be a CT, or that it can be directly a pancreatic angiography, which may be found.
But it’s not possible to do it tonight, but it’ll have to be transferred to the endocrinology so that the endocrinologist can follow up and see if it’s a disease.
“Will this disease be terminal?” the patient asked me.
No, if it’s really insulin cytomas, it can be cured by surgery.
“It’s a benign tumour. It’s not terminal. I told him.
“That’s good, at least better than anxiety. He was relieved.
The next morning, I called the Endocrinology and turned him around.
After looking at his condition, the Endocrinology Unit also suspected that it was an insulin cell problem and arranged a series of examinations.
A few days later, I got a call from them saying that the patient had checked the insulin level and had abdominal CT and photocopying, clearly insulin cell tumor.
I was so excited about that moment.
I’m happy for my patients and I’m happy for myself.
The patient, who appeared in my class three times in a row, spent so much time, performed so many tests, which were ultimately considered anxiety attacks and panic attacks.
If it had not been for his own intent to watch, it would have been impossible for us to discover his true cause and to know when.
Worse still, he might have been eating fluctine, which was a good drug, but what would it do him? Not helping.
Because his condition is insulin cytotum, and because of the increase in insulin in his body, he causes low blood sugar. The cure is to cut off the tumor, to pull it out, to solve the problem.
He was later transferred to the liver pancreas surgery and performed the surgery successfully.
I’ve seen a couple of insulin cytomas in my career, and that’s a very hard case, and it’s a good ending. Subsequently, there was no further panic for six months.
Of course there won’t be any more, because the larceny is down.
Cope classroom: What is the disease of repeated heart attack, chest stifling and sweating?
What’s it like to have a heart attack, a chest attack, a sweat?
As stated in the text, the most common is the heart disease, which is the most common sexual hyperactivity on the crotomic chamber, usually with a clear diagnosis of the highest 24-hour electrocardiogram, cytophysiology and so forth, and with the use of drugs and radiofrequency digestion.
In addition, there are similar manifestations of acetylene and gastrophagus reverses. When a patient ‘ s heart examination fails to detect a problem, a thyroid examination is performed, while a perfect gastroscope examination is performed. The gastro-circle invertebrates are often, but not always, signs of heartburning, chest stifling, sweating and need to be identified.
While panic attacks are an anxiety disorder, they can also be described as such, but they are mental disorders, and the body disease is excluded before it can be diagnosed, although the body disease is so many that it is sometimes difficult to completely exclude it. This requires a comprehensive medical assessment.
Low blood sugar, of course, also shows heart attack, chest boredom and sweat. It is only that the measurement of blood sugar is not low, since the author’s patients end up having an outbreak every time they come to an emergency. If it had not been for the last time that the blood sugar had been measured, it would have been a long time since the real cause of the disease.
What’s a panic attack?
The panic attacks are also called panic disorder and are characterized by acute anxiety, characterized by recurrent panic attacks and marked respiratory difficulties, heart attacks and tremors associated with an imminent death.
The causes of panic attacks are also inaccurate and may be related to genetic factors and to the brain itself.
The study found that many neurotransmitters were involved in the process of panic attacks, such as 5-Oxylene, gonaline, etc.
There are also studies that suggest that panic attacks are related to psychological factors, that people who panic may have experienced real fear before, or that there is a loss of vital human relationships.
That is why the treatment of panic disorder involves, first, psychotherapy, and, secondly, tectonic exposure to fear through imagination and behavioural training.
What is insulin tumor?
Insulin tumours in insulin cells are, by definition, insulin tumours, also known as insulin cytomas. Insulin is an irregular group of cells in pancreas with endocrine functions.
Insulin tumour patients are clinically characterized by low blood sugar symptoms, slow onset, repeated onset and sexual intensification.
Low blood sugar usually occurs before an empty stomach breakfast or before Chinese dinners, rarely after meals.
Sports, hunger, heat, alcohol, menstruation, etc. can induce low blood sugar, most of which is light and heavy, and from occasional to frequent outbreaks. The duration of the outbreak varies, with the shortest possibility being only a few minutes and the most common possibility being a few hours or even days.
It’s just a few minutes of an attack.
Insulin tumours are usually small, and color superpowers are not necessarily visible, and data show a 30 per cent positive rate.
To be able to detect insulin tumors, the CT is required, and the CT is the standard pre-operative method, with a 70% positive rate.
The treatment is based on surgery, which is the most fundamental and effective method, and is generally well prepared provided that early surgery is detected at an early stage.
However, if it has been misdiagnosed over a long period of time and repeated cases of low blood sugar, especially when it causes a low blood sugar coma, the neurological damage may be more severe and worse than expected. Case number: YX11lvWD0pr
I don’t know.
Keep your eyes on the road.
