Chapter 2178: 2102 Heartbreak (Part 2)

Zheng Ren held the ultrasound cardiography probe, carefully observing the heart's motion pattern.

The morphology of the left ventricle during systole was somewhat abnormal; Zheng Ren gave it a general look, then focused on observing the left ventricular systolic morphology.

After 3′22″, Zheng Ren finished the examination.

He walked out of the ward, Zhou Litao asked: "Zheng Lao Ban, what medicine should we give?"

"No need, excessive grief caused broken heart syndrome." Zheng Ren said.

Director Zhang hesitated a moment; she did know broken heart syndrome, but seeing changes on the ECG, she always wanted to give some medication for prevention and treatment.

Broken heart syndrome needs no medication, but time to heal the wound. Director Zhang understood, yet dared not be careless.

"Zheng Lao Ban, what is broken heart syndrome?" Zhou Litao asked.

"Broken heart syndrome is also called takotsubo cardiomyopathy, a heart disease first discovered by doctors in an island nation, without deeper study." Zheng Ren said, "It is most common in female patients aged 30-50; ultrasound cardiography reveals transient apical ballooning of the left ventricle, named because the patients' systolic morphology resembles Takotsubo."

"Takotsubo?"

"In Japanese, takotsubo means the pot used to catch octopus; I've never seen one, but I have seen related imaging images in case reports in journals." Zheng Ren said.

"Boss, you look at all kinds of things." Su Yun's black hair fluttered in front of her forehead, not knowing what she was thinking.

"I just remember odd diagnoses." Zheng Ren said casually.

He wandered aimlessly down the hallway; Zhou Litao glanced at Zheng Lao Ban and Director Zhang of the cardiology department behind him, quickly opening his duty room to let the group in for a rest.

His duty room was almost becoming Zheng Lao Ban's office, yet Zhou Litao had no complaints, rather feeling somewhat happy.

One could learn many things from Zheng Lao Ban, things that one usually couldn't learn even if they wanted to. For example, the patient before us—if normally diagnosed as myocardial infarction, we would start related drug therapy.

The patient's condition just now, if usually seen, a suspected myocardial infarction diagnosis would not cause life‑danger from misdiagnosis, but correct diagnosis is still important.

Moreover, mentioning broken heart syndrome makes one seem more professional.

Zhou Litao continued asking: "Zheng Lao Ban, please explain."

"The medical community hasn't fully figured out takotsubo cardiomyopathy. Older women tend to have higher risk, and the exact causes remain unclear." Zheng Ren said indifferently, distracted.

"One theory holds that menopause alters the heart's response to hormones; what do you think?" Director Zhang asked.

"It's possible, but no special handling is needed. This disease is usually not fatal, and most people recover even without specific treatment."

"Not necessarily." Su Yun said, "The data for ages 30‑50 is not rigorous."

"Huh?" Director Zhang sounded surprised.

"The latest research shows the most common scenario is a breakup, mainly in women, occasionally in men." Su Yun said, "Actually I think calling it lovesickness syndrome would be more accurate."

"Is that the legendary heartbreak?" Lin Yuan thought; love really is a troublesome thing, and breakup can cause organic lesions.

Although Zheng Lao Ban said no treatment is needed, it still sounds rather frightening.

"Pretty much like that." Zheng Ren said while thinking.

"Broken heart syndrome was first discovered in 1990 in an island nation. After analysis, we found the cause of this disease is encountering fright or severe emotional shock, with excessive emotional fluctuation, over‑excited sympathetic nervous system, and a rapid rise in adrenaline levels."

"Adrenaline levels are 30 times higher than normal, and even 4‑5 times higher than during myocardial infarction."

"Adrenaline and other chemicals affect normal myocardial muscle activity, or cause capillary constriction, leading to sudden contraction of the upper heart, i. e., apical spherical change."

"Because the heart's pumping ability suddenly weakens, it produces symptoms similar to a heart attack—severe chest pain or breathing difficulty."

"Can adrenaline really spike that high? No wonder during emergency resuscitation you can smell adrenaline and dopamine on your body." Su Yun took a breath and began to rebut Zheng Ren.

Zheng Ren's thoughts were pulled back; he recalled that when he was the inpatient chief, hearing a phone ring would make his heart palpitate, and occasionally he would feel short of breath.

"Probably due to adrenaline surge, which is somewhat like broken heart syndrome. If we studied it carefully, would there be an inpatient chief syndrome?"

"In the future, as one gets older, one really should do fewer emergency rescues; otherwise the body can't take it, and one will also end up heartbroken."

Zheng Ren lowered his head in thought, no longer pondering broken heart syndrome, but turning again to consider the young patient named Chen Li.

"This is excessive grief." Director Zhang sighed.

"The ancient Chinese medical texts mention the seven emotions—joy, anger, worry, thought, sorrow, fear, shock—as seven normal emotional responses. When sudden, intense, or prolonged mental stimulation causes emotional reactions that are overly strong or lasting, the seven emotions become excessive, affecting organ function, disrupting qi and blood regulation, and causing disease." Su Yun said, "Chinese medicine can also explain it."

"Zheng Lao Ban, I still don't feel at ease." Director Zhang spoke bluntly: "I suggest we still check cardiac enzymes."

"Should be." Zheng Ren said calmly: "In broken heart syndrome, cardiac enzyme changes are not obvious; checking will tell us."

Zhou Litao immediately stood up, recorded the several tests Director Zhang wanted to perform, then went to issue medical orders, drew blood and sent it for testing.

"This is just a minor matter; even if Director Zhang doubts my diagnosis, Zheng Ren doesn't mind. In clinical practice, if a decision is made unilaterally with no opposition, that's when big trouble looms."

"If the patient dies, she wouldn't know..." Lin Yuan also felt a bit depressed, uttered half a sentence, then immediately realized he had misspoken.

"If this were the Middle Ages, making such a prediction would get one burned as a witch."

"Zheng Lao Ban, for that patient with liver failure, do you have any good options?" Director Zhang turned and asked.

"Well, unless there is a liver source for transplantation."

"Domestic liver sources are scarce; usually one has to wait at least several months."

"Or should I contact my advisor?" Lin Yuan asked quietly.

"She is merely a doctoral student; contacting liver sources… is just a thought."

"But it's still better than doing nothing."

Seeing Chen Li's mother grief‑stricken, like a walking corpse, Lin Yuan also felt his chest tighten.

But that sentence struck Zheng Lao Ban's heart like lightning. Lin Yuan, advisor, Harvard.

He slapped his thigh hard, saying: "MD! I got it wrong from the start!"

Su Yun was surprised; it was rare to hear his own boss swear. He thought… a flash of insight, and Su Yun also understood what Zheng Ren had realized.