21st Century Necromancer

Hearing the nurse's words, Yu Chen and Hiromi Jounouchi hurried to the ward together, only to see Mr. Hamada lying on the bed clutching his chest. Hiromi Jounouchi quickly picked up a stethoscope and placed it on his chest to examine him, while Yu Chen asked a nearby nurse, "Have you checked his blood oxygen level?"

"I'm getting the oximeter now!" the nurse replied to Yu Chen, while also trying to calm Mr. Hamada's nerves, hoping to ease his tension and alleviate his pain.

"There's wheezing in the lungs with vascular murmurs, it must be pulmonary embolism!" Hiromi Jounouchi made a rapid judgment after listening to Mr. Hamada's chest with a stethoscope, "We need to proceed with treatment immediately!"

"Don't rush! Wait for the oximeter to come so we can confirm the diagnosis with the oxygen saturation results before making a decision." However, Yu Chen stopped her, "Physical signs aren't absolute, a blood oxygen level test is a bit safer."

Stopped by Yu Chen like this, although Hiromi Jounouchi still felt anxious, she had no choice but to suppress her eagerness and wait for the oximeter to arrive.

Fortunately, nowadays medical oximeters are very compact, just a small device similar to a clothespin. It's clipped on the finger to measure the oxygen saturation, so even if the nurse had to fetch it from the nurse's station, it wouldn't take much time.

It didn't take long for the nurse to bring over the oximeter, and she immediately clipped it onto Mr. Hamada's finger.

Find your next read at My Virtual Library Empire

Yu Chen glanced at the reading and then confirmed, "Blood oxygen saturation is below 90%, it's likely pulmonary embolism. Send him for a pulmonary artery CT and pulmonary angiography to confirm the diagnosis! Prepare oxygen!"

"Yes!" The nurse, upon hearing Yu Chen's words, immediately complied and hurriedly prepared to take Mr. Hamada for the examination.

————————————————————

For a hospital of the caliber of Tokyo University Medical School Hospital, a pulmonary artery CT scan can naturally be done at any time; there wouldn't be any need to wait.

Even though Mr. Hamada's physical signs were almost enough to diagnose acute pulmonary embolism, pulmonary artery CT and angiography could help the doctors better identify where the problem was and determine the appropriate treatment method. So, conducting such tests was still necessary.

"Pulmonary embolism in the right upper pulmonary artery, this is troublesome," said Hiromi Jounouchi, her tension increasing rather than decreasing after the pulmonary angiography confirmed the location of the embolism.

Acute pulmonary embolism is a clinical and pathophysiological syndrome caused by endogenous or exogenous emboli obstructing the main trunk or branches of the pulmonary arteries, leading to pulmonary circulation disorders. Its incidence is only surpassed by coronary heart disease and hypertension, and it ranks third in mortality, just behind tumors and myocardial infarction.

If not treated promptly, acute pulmonary embolism can affect lung function, leading to numerous complications such as lung infections, palpitations, myocardial infarction, cerebral infarction, shock, heart failure, respiratory failure, arrhythmia, as well as potential cerebral hemorrhage or gastrointestinal bleeding following thrombolytic therapy.

And even with timely treatment, the sequelae of pulmonary embolism are still quite troublesome, because the pulmonary infarction caused by the embolism can affect the patient's ventilation and gas exchange functions, leading to decreased lung function and symptoms such as chest tightness and shortness of breath after activity.

More severe cases may even lead to recurrent pulmonary embolism, resulting in the formation of chronic pulmonary hypertension and chronic thromboembolic pulmonary heart disease. Cardio-pulmonary function can be affected to varying degrees, greatly impacting the patient's post-recovery life.

That's why when Hiromi Jounouchi saw that Mr. Hamada had been diagnosed with pulmonary embolism, she became even more tense and serious about treatment.@@novelbin@@

"Mr. Hamada was admitted to the hospital a week ago for a head injury from slipping in the bathroom. In his current condition, thrombolytic therapy is not suitable," said Hiromi Jounouchi, Mr. Hamada's primary physician. She was very familiar with his situation and knew that thrombolytic therapy was not appropriate for patients with cranial trauma or active bleeding within the past month.

"Should we consider interventional treatment then?" Looking at Mr. Hamada's pulmonary angiography, Yu Chen shook his head slightly and said, "In this case, I would recommend surgical removal of the thrombus. The embolism is not in the main artery; interventional treatment might not be very effective, and there's a risk that the thrombus could break up. Without thrombolysis, it could block even smaller vessels. Surgery to remove the thrombus is the most prudent treatment option in such circumstances."

Hiromi Jounouchi nodded in agreement with Yu Chen's suggestion. In cases where thrombolytic therapy is not feasible, surgery is indeed a more reliable treatment option.

"Prepare for the surgery," said Hiromi Jounouchi, looking at Mr. Hamada's pulmonary angiogram once more, instructing a nearby nurse.

"Understood!" The nurse nodded and hurried off to prepare for the surgery.

Seeing the nurse off to make surgical preparations, Yu Chen and Hiromi Jounouchi were not in too much of a hurry. Although acute pulmonary embolism is very dangerous and does require prompt treatment, there was no need to rush for these few seconds.

"Hiromi, what do you think caused the pulmonary embolism?" Yu Chen, looking at Mr. Hamada's pulmonary angiography, suddenly took an interest in the formation of the clot.

Hearing Yu Chen's concern about this, Hiromi Jounouchi glanced at him before explaining, "It's most likely due to a dislodged venous thrombus from the lower extremities, carried by the circulatory system back to the heart, and then into the pulmonary artery. This is common in the elderly and those who sit for long periods."

"Hmm, the thrombus isn't large, and there are no signs of thrombosis in the surrounding vessels. It is probably what you mentioned," Yu Chen carefully examined Mr. Hamada's pulmonary angiogram and nodded in understanding.

For people who sit for long periods or are elderly, blood clots are more likely to form due to slow blood flow resulting from a lack of movement in the lower limbs. However, venous thrombi in the lower extremities have a characteristic: they can dislodge with bodily movement. Sudden, forceful movements or quickly standing up can cause these thrombi to detach.

And the detachment of a thrombus is not necessarily a good thing because, if these thrombi do not dissolve promptly but are instead carried back to the heart and enter the lungs via the pulmonary artery, they are very likely to cause pulmonary embolism.

Clearly, this was indeed the cause of Mr. Hamada's pulmonary embolism this time.

"Do you need my assistance with the surgery?" Yu Chen proactively offered to help Hiromi Jounouchi now that the diagnosis was confirmed.

However, Hiromi Jounouchi shook her head and said, "No need, I can handle this minor surgery myself. We don't need the assistance of a big professor like you. Instead, you should hurry up and think about how to treat that young girl. Treating her quickly so she can be discharged is how you'll soon escape the crisis of being entangled by her."