When the Doctor Uses A Hack

Chapter 363: Chapter 364: Advice from an Expert!

The elderly man entered the consultation room with Wu Yushu.

Wu Yushu sat down across from Chen Cang, “Doctor, hello.”

Chen Cang nodded and got straight to the point, “Hmm, hello, what’s making you uncomfortable?”

Wu Yushu told the truth, “This morning when I got up, I felt unbearable tightness in my chest, and I had some difficulty breathing. It got much better after I sat up. I’ve had this situation before, it happens every year, but it always gets better after a while.”

As he spoke, Wu Yushu continued, “I smoke quite a bit, at least a pack a day, occasionally two, and I’ve been smoking for over a decade.”

Just as Chen Cang was about to ask more, Wu Yushu suddenly added, “Oh right, I’ve been feeling bloated recently, and my appetite is really poor. Could it be that my stomach motility is not good too?”

“Occasionally, I also have chest pain, and this area is also uncomfortable!”

Wu Yushu touched the right side of his rib area, near the liver.

The patient’s conditions were numerous, and symptoms varied.

However, the main symptom was still mainly difficulty in breathing.

Upon hearing this, Chen Cang felt that it resembled chronic bronchitis and chronic obstructive pulmonary disease.

But…

Respiratory distress and orthopnea are not solely diseases of the respiratory system.

They could also be greatly related to the heart.

Heart failure could also cause the above symptoms.

After pondering for a moment, Chen Cang picked up his stethoscope and decided to first rule out a cardiac condition. He then said to Wu Yushu, “Lie down on the bed, and I will listen.”

Wu Yushu nodded.

Chen Cang picked up the stethoscope and started listening in several cardiac auscultation areas.

The first heart sound seemed to be weakened, and there was some murmur in the aortic valve’s second auscultation area… an early diastolic extra sound at the left sternal border between the third and fourth intercostal spaces.

What did this represent?

Chen Cang was somewhat perplexed.

Cardiac auscultation was indeed a profound field.

Chen Cang could only understand a fraction of it.

There was definitely a problem, and with this in mind, Chen Cang felt the point of maximal impulse, which seemed… a bit elusive to touch.

What could this mean?

Chen Cang then began percussing the heart, and the cardiac dullness area seemed a bit enlarged.

What to do?

At that moment, Chen Cang had a stroke of insight.

If the patient had a heart condition, that was an easy matter to address.

After all, he was the man with a hidden profession represented by the “Cardiology,” “Cardiac Surgery,” and “Scientific Research” skill trees.

He opened the cardiology Skill Book, and Chen Cang immediately noticed that among the level one operations, or basic skills, there were marks for many skills like “Cardiac Auscultation,” “Cardiac Percussion,” and so on.

Chen Cang was instantly elated.

He immediately chose to exchange for “Cardiac Auscultation”!

In just an instant, Chen Cang’s mind was flooded with a stream of information, a wealth of knowledge about cardiac auscultation and diagnosis imprinted in his memory.

Chen Cang felt as though he had undergone a baptism and teaching session in cardiac auscultation.

“Ding! Cardiac Auscultation: Master level; Diagnostic Passive Skill.”

Now, when Chen Cang conducted the auscultation again, various pieces of information suddenly appeared in his mind.

He matched them against the patient’s condition continuously.

After listening, Chen Cang frowned slightly, “I suggest we do an electrocardiogram first, and then have a chest X-ray.”

“Your condition is quite complicated, and it might not be a simple case of difficulty breathing.”

Upon hearing this, Wu Yushu was momentarily startled.

“Really? Doctor? I understand my own condition quite well. I am very clear about my constitution; it gets much better after a couple of days.”

“I’ve had this condition before.”

As he said this, Wu Yushu went on, “I’m actually planning to go to work now. Oh right, I also have some stomach bloating and poor appetite, could it be insufficient gastric motility?”

“How about you grab me some medicine? The kind that strengthens stomach motility.”

As he spoke, the man attempted to rise to his feet.

At that moment, the elder placed his hand on Wu Yushu’s wrist and said, “Young man, there’s no need to rush.”

Suddenly, the elder frowned and said, “Maybe we should take his blood pressure!”

The man was immediately perplexed—his blood pressure had always been normal, hadn’t it?

However, taking blood pressure was no big deal.

Chen Cang, looking at the elder, was briefly stunned but thought it better to check the blood pressure.

When he fastened the cuff and measured, Chen Cang was shocked!

The blood pressure was rather low!

And more importantly…

It wasn’t a problem with the blood pressure!

It was something else.

At this thought, Chen Cang’s expression changed!

He noticed that the systolic pressures were different, prompting him to be extra cautious. While observing the man’s breathing, he carefully measured the blood pressure again.

As he heard the first Korotkoff sound, he quickly took note of the current systolic pressure, then meticulously watched Wu Yushu’s breathing pattern before measuring again!

He suddenly discovered a severe problem!

That was, during Wu Yushu’s inhalation, the Korotkoff sounds would disappear, only to reappear during exhalation!

A term flashed through Chen Cang’s mind: Pulsus paradoxus!

At that moment, Chen Cang quickly turned his gaze to the elder who had asked him to take the blood pressure.

His eyes were filled with reverence!

This was an extraordinary person!

Absolute master!

But now was not the time to ponder on that—the situation called for a thorough examination.

The appearance of pulsus paradoxus made it imperative for Chen Cang to examine Wu Yushu once more.

What is pulsus paradoxus?

It is a special pulse condition!

It refers to the phenomenon where the pulse weakens significantly or even disappears during inhalation and reappears or returns to normal during exhalation.

Detecting such a pulse is no simple task.

Why did Chen Cang think the elder was impressive?

Because of what the elder had just said: “Go measure his blood pressure.”

That phrase was pregnant with meaning!

It contained a deep understanding of life and practice!

First off, using a sphygmomanometer to observe pulsus paradoxus is often more obvious than manual palpation.

Any experienced doctor can detect abnormalities when measuring blood pressure attentively.

Don’t underestimate blood pressure measurement—a simple check can reveal many unique diseases and phenomena.

Pulsus paradoxus is not one of the pulses of the extraordinary meridians, but a peculiar pulse condition, also known as “respiratory pause pulse.”

That is, it pauses during inhalation.

This represents a rather dangerous condition, with several possible causes. One could be a large amount of pericardial effusion accompanied by cardiac tamponade, constrictive pericarditis, or a range of cardiac diseases. Of course, conditions like emphysema and significant pleural effusion can also manifest similarly, necessitating further diagnosis.

However, regardless of the underlying disease, the presence of pulsus paradoxus is seldom a good sign!

The elder had just asked Chen Cang to measure blood pressure, and this led to a significant discovery; Chen Cang couldn’t help but feel grateful.

This was a formidable individual!

Most certainly—they not only detected pulsus paradoxus in an instant but also did so without causing any fuss by having Chen Cang measure the blood pressure.

A simple phrase directed Chen Cang to the core element for diagnosis.