Chapter 1382 549: The Body’s Second Heart—Secretly Registering for a Medical Visit

The more tests he read, the more tightly Zhou Can's brows knit.

From this patient's X‑ray, it was clear that the chest film showed no obvious cardiomegaly or pulmonary edema. Color Doppler echocardiography showed cardiac size within the normal range, normal valvular function, but a left ventricular ejection fraction below normal.

After carefully going through all of the patient's tests one by one, he realized that the cause of illness in this 17‑year‑old boy was far more complicated than imagined.

Generally speaking, heart failure will at least be accompanied by some kind of lesion in the heart.

Yet whether it was the size of the heart, the myocardium, or the tricuspid valve, mitral valve and so on, everything was normal. You could say that apart from an ejection fraction that failed to meet the standard, everything else about the patient's heart was normal.

Of course, because of insufficient pumping capacity, his heart rate was already much higher than normal.

This does not count as a lesion, but rather belongs to the heart's compensatory mechanism.

What exactly was causing the ventricular ejection fraction to fall below normal?

You cannot just open up a living person's chest for a look when nothing obvious shows up. You can only rely on various test results and then, based on the doctor's diagnostic experience and medical knowledge, make a comprehensive assessment.

At Zhou Can's level, the assessment results would not differ much from what you'd see if you actually opened the chest.

Unless it was some subtle lesion that the instruments had difficulty detecting.

For example, a tumor with a diameter less than 1 cm is hard to detect through imaging, ultrasound, and other methods. MRI counts as a major advance in medical diagnostics; tumors smaller than 1 cm still have a chance of being detected.

But if the tumor diameter is too small or it is relatively hidden, MRI is still powerless.

In short, at Zhou Can's level, by reading the images and integrating the biochemical and ancillary test results, he was fully capable of making an assessment that matched the findings of opening the chest.

The invention and application of all kinds of diagnostic equipment exist in order to identify the real cause of disease without harming the patient.

Otherwise, to identify a very small lesion you might have to cut the patient open five or six times, even seven or eight times.

You open the abdomen and see it's not the problem there, then suspect it might be a lesion in some organ within the chest and open the chest again… that's simply unimaginable.

After reading all the patient's tests, Zhou Can evaluated that there was no obvious cardiac lesion.

But there was one thing to be wary of: if the patient's heart rate stayed high over the long term, it could lead to very serious consequences, such as an enlarged heart, myocardial ischemia and necrosis, and so on. So the potential harm was significant.

This young man had long‑standing heart failure, but with the help of drug control, plus his very young age, strong physical vitality, and high tolerance.

For the time being, no particularly obvious changes had been found in his heart.

There were already signs of cardiac enlargement, but the degree of enlargement remained within an acceptable range.

As for myocardial ischemia and necrosis, these had not yet occurred.

Frowning, Zhou Can pondered hard: where exactly did the cause of the patient's disease lie?

He finally understood now why so many top Cardiac Surgery experts in the imperial capital were at their wits' end.

Because the cause of this young man's illness was indeed extremely difficult to identify.

Given the poor cardiac ejection capacity, heart transplantation was not the best option, but it was worth a try.

It was like repairing an electrical appliance: after the engineer has checked for a long time and really cannot find which component is broken, it may be a problem with the integrated circuit board; in any case, the appliance cannot function normally. Based on experience and common sense, you can determine that the problem lies somewhere in the main board as a whole.

What if you really cannot find where the problem is?

You replace the main board; that is the simplest and most convenient solution.

The experts in the imperial capital had truly run out of options, which was why they proposed a heart transplant for the young man.

"Your condition is extremely complex. First stay hospitalized here for two days of observation. I will work together with other doctors in the hospital to do our utmost to identify the cause. But there is no way I can guarantee success. If during hospitalization you develop other previously overlooked symptoms, or new symptoms, or recall any key information about the onset of your illness, you can tell the attending doctor and nurses at any time."

Since he could not find the cause of the patient's disease for the time being, this was the only arrangement Zhou Can could make.

Clinically, there are plenty of patients whose etiology cannot be identified.

Sometimes, even when the doctor has cured the disease, the cause still remains unknown.

"Alright, thank you! Please do your best for me!"

The patient expressed his gratitude to Zhou Can.

After Zhou Can and Director Xue Yan walked a few meters away, he heard a family member of that patient say in a very disdainful tone, "I knew none of these so‑called internet‑celebrity doctors are reliable, it's all hype. So young—how good can his skills really be?"

"Just from my impression, this Dr. Zhou seems very down‑to‑earth. At least he seriously tried to diagnose me just now. Since we're already here, we might as well settle down and wait a couple of days to see how it goes."

The patient's words to his family made Zhou Can feel a little better.

...

The day passed in the blink of an eye.

Whenever he had time, Zhou Can would try his best to search for the cause of that 17‑year‑old boy's illness.

There was no new information coming from Cardiothoracic Surgery.

This indicated that the patient was the same as before and had not provided any additional useful clues.

After work, even while eating, Zhou Can kept his brows furrowed.

The family had come all the way from the imperial capital to seek treatment; he had to live up to that trust.

What exactly was causing that young man surnamed Lan to go into heart failure?

Experts in the imperial capital had even examined the patient's cardiac electrical signals, and the results were normal.

To be honest, if you cannot identify the cause of heart failure, even replacing the heart may not necessarily help.