Chapter 1798: 1736 Myocardial Contraction Band—Necrosis

1736 Myocardial Contraction Band—Necrosis! (Alliance Leader Albinism Hacker Extra Chapter 5)

What kind of patients are usually sent over for you to autopsy?" Zheng Ren asked.

Most are people who died in the hospital sent over here, and besides that, a small number are those who died in fights. Real major cases, important cases, I don't get to see." Li Zhaosen said: "Even if technical assistance is needed, I go to the municipal bureau myself." Li Zhaosen said.

As for yourself, are you scared?" Zheng Ren glanced at the corpse; the chest and abdomen had already been dissected, he had basically seen it all.

Su Yun put on his clothes, put on gloves, and began the dissection.

They're just corpses, what's there to fear? It's the living that are scary." Li Zhaosen said.

Matching the gloomy atmosphere here, his remark was quite spot-on. And that corpse was like a commentary, silently agreeing with Li Zhaosen's words.

Su Yun walked straight to the corpse, the knife was placed aside, he picked it up, lifted the heart out, and began dissecting.

The heart's gross structure is fine." Su Yun said, "There is no organic lesion other than congenital heart disease and myocardial infarction."

Zheng Ren didn't chat idly either; he stood behind Su Yun and watched him dissect.

He knew where Su Yun was torn.

If the deceased died of a myocardial infarction, it would mean that Da Liu, who had an argument with the deceased at the time, bears some joint responsibility—at least part of it, which cannot be shirked.

But if it wasn't myocardial infarction death but rather myocardial rupture, then the medical staff who performed chest compressions at the time would bear some responsibility.

It's a dilemma.

The room was filled with a foul internal-organ smell, and the exhaust fan wasn't on. Zheng Ren frowned, really not used to this smell, and said: "Teacher Li, don't you usually turn on the exhaust?"

What's the point of turning that on? If it weren't for waiting for Boss Zheng to come, I could finish an autopsy in twenty minutes." Li Zhaosen said: "The smell hasn't even cleared yet."

Zheng Ren really didn't know how to describe Li Zhaosen.

Besides, the corpses for autopsy smell far better than those for gross anatomy. Especially the fresh ones just fished out of the pool—the formaldehyde stench makes you feel like you've just gone through a breakup after the dissection.

Do you have a girlfriend?" Zheng Ren asked offhand while staring at Su Yun dissecting the heart.

No one, with this job, who'd want to marry me?" Li Zhaosen didn't mind, answering casually.

The heart rupture occurred near the apex of the posterior wall of the left ventricle; the rupture area shows an acute large-area myocardial infarction. The rupture opening is irregular, about 1.2 by 0.8 cm." Su Yun continued observing.

The infarct area is fairly large, myocardial necrosis...

Speaking, he hesitated a moment.

Boss, do you feel anything weird?" Su Yun asked.

Open up the three coronary arteries to have a look—are you confident? Don't cut yourself." Zheng Ren said.

Tch!" Su Yun said: "I've done 122 coronary artery bypass graft surgeries."

Just be careful." Zheng Ren said: "The necrotic area is too big; the whole heart seems ruined, like a rotten peach."

This situation is rare; even when I dissect, I find it strange." Li Zhaosen said: "I've done autopsies on myocardial infarction patients, and even seventy- or eighty-year-olds aren't as severe as this.

Su Yun didn't follow Zheng Ren's advice to directly dissect the coronary arteries; instead he began to examine the heart closely.

What are you thinking about?" Zheng Ren asked.

The smell is awful." Su Yun said: "Like iron rust or something—could it be caused by some chemical poisoning?"

The liver's been dissected; there's no major issue, at most a bit of alcoholic liver, not serious." Li Zhaosen said.

Weird." Su Yun turned the heart to another angle.

Don't touch the coronary arteries first, dissect the left heart. The heart overall is enlarged, the ventricles are hypertrophied, especially the left ventricle." Zheng Ren suddenly said loudly.

An adult's heart is about the size of a person's fist. A sandbag‑sized fist is just a metaphor; generally the heart isn't that big.

Especially since a large part is in Su Yun's hand, Zheng Ren finds it hard to see the size clearly.

I told you something was off!" Su Yun said: "On my first autopsy, I actually forgot something this big.

Speaking, he began to dissect the heart.

Su Yun uses the scalpel differently from Zheng Ren; his technique is more flamboyant, or rather, showy.

The whole heart is enlarged, volume about 10% greater than normal. Taking the left ventricle as reference, it's dilated and hypertrophied; considering the time of death, there was left‑heart failure. The myocardium shows bleeding and extensive fibrosis!" Su Yun stated while dissecting.

Myocardial contraction band..." Soon his words trailed off.

Necrosis?" Zheng Ren's eyes narrowed.

I was just about to look here when I got your call, Boss Zheng." Li Zhaosen also noticed this at the same time and immediately explained.

Myocardial contraction band necrosis signifies something major—basically only methamphetamine abusers show this physiological change.

Not occasional use, but abuse, long‑term and heavy!

Damn it!" Su Yun swore excitedly: "Boss, I know what this weird smell is!

Zheng Ren also wanted to figure out what that smell was.

People who use methamphetamine all have that smell on them.

Zheng Ren and Su Yun's social circles are worlds apart from such people; they hardly ever see them normally, so they didn't react right away.

Li Zhaosen is in the same situation.

What's written in books is just dull text; it can't replace smelling the odor with your nose. Li Zhaosen hurriedly ran to turn on the exhaust fan, and only when he heard the humming did he seem to feel a bit better.

The mechanism of myocardial pathology is multifactorial, including catecholamine excess, coronary artery spasm and ischemia, increased reactive oxygen species, mitochondrial damage, myocardial metabolic changes, and direct toxic effects, etc.

Su Yun chattered on while dissecting. Zheng Ren knew he was thinking.

The situation has taken a turn, even a reversal.

Chronic poisoning can cause myocardial inflammatory cell infiltration, hypertrophy, fibrosis, dilated cardiomyopathy, accelerated arterial atherosclerosis, aortic dissection, even myocardial rupture, etc." Su Yun said: "Now we can pretty much determine that the heart rupture was caused by methamphetamine poisoning, not trauma.

You're too subjective." Zheng Ren said calmly: "The court won't believe your subjective opinion.

Then let's find objective evidence." Su Yun turned back, smiled, his forehead black hair fluttering wildly.

Take subepicardial tissue and send it for pathological biopsy." Zheng Ren said: "Focal lymphocytic infiltration of the subepicardium, coronary arteries, and aorta; myocardial coagulative necrosis, inflammatory cell infiltration, and fibrous tissue proliferation—this is the most objective and strongest evidence.

The room was cold and quiet; Zheng Ren's words were like stones striking the four walls, buzzing.

Good!" Su Yun replied firmly.