Healing Doctor

Chapter 715 A Frustrating Lecture

"There's such a disease?" Lu Gang murmured.

Because Lin Jiu's words were very formal, and the medical records he presented showed people with names and identities, he didn't seem to be lying, so Lu Gang believed him immediately.

"Dr. Chen Pengsheng is the editor-in-chief of the journal *International Journal of Cardiac Arrhythmia*. His article is published in the journal. If Director Lu is interested, he can look it up."

"There are many diseases characterized by 'orthostatic intolerance,' including postural tachycardia syndrome, vasovagal syncope, and orthostatic hypotension."

"What is the impact factor of the International Journal of Cardiac Arrhythmia?" Xu Leyu suddenly asked.

"Around 5, a small magazine," Lin Jiuze said.

"..."

"..."

Xu Leyu and Lu Gang were both rendered speechless by Lin Jiuze's Versailles.

Are all SCI journals with an impact factor of 5 or higher considered small journals?!

According to a 2019 review in the American Journal of Cardiology, postural tachycardia syndrome is the most common form of "orthostatic intolerance" in young people, and is more common in women aged 15-50.

Typical symptoms include dizziness, fainting, problems with thinking, memory and attention, palpitations, tremors and sweating, feeling weak and tired, headache, poor sleep, chest pain, nausea, and shortness of breath.

"It's what you just called 'laziness,' Director Lu."

For some reason, Lin Jiu suddenly changed his usual gentle and refined manner, and as he spoke, he couldn't help but make a sarcastic remark about Lu Gang.

Lu Gang seemed not to hear; he was deep in thought.

"Data shows that one in 500 people in the UK suffers from some degree of orthostatic tachycardia syndrome. It is even more common in the US, affecting one in 100 people. I feel that the ability to make a correct diagnosis depends on the skill level of the local doctors."

"The medical standards in the United States are very high, so one in a hundred people is diagnosed."

Lin Jiu was different today; he was sharp and aggressive, as if Lu Gang had possessed him, and every word he uttered was barbed.

"This disease really exists?!" Zhao Zhe muttered to himself.

"This condition has a long history, with records dating back to 1871. Initially, it was called 'restless heart' or 'soldier's heart.' Later, in 1944, it was officially named postural tachycardia syndrome."

"But why? Gravity allergy. I feel uncomfortable all over when I stand up. This..." Zhao Zhe completely ignored Lin Jiuze's sarcasm. He asked without hesitation, "Dr. Lin, I know at least several thousand people, and so far I haven't found a single patient with a similar condition."

"The patients' conditions vary in severity," Lin Jiu said with a slight smile. "Many patients feel unwell after waking up, but they don't realize there's anything wrong with their bodies. They feel better after moving around a bit."

"What about the pathogenic mechanism?" Lu Gang asked.

The UK's National Health Service (NHS) explains that the disease is the result of multiple mechanisms working together.

When lying on your back, about one-quarter of the body's blood is concentrated in the chest.

If you quickly return to an upright position, gravity will cause blood to shift downwards, with approximately 500-1000 mL of blood flowing to the abdomen, pelvis, and lower limbs a few seconds after you stand upright.

Such instantaneous changes may lead to a decrease in venous return, a decrease in stroke volume, and a reflexive increase in sympathetic nerve activity.

The autonomic nervous system begins to function, compensating by slightly increasing the heart rate to maintain normal blood flow.

For normal people, the above process is unconscious and usually the body handles it on its own within 1 minute.

However, this response is not properly triggered in patients with orthostatic tachycardia syndrome. The heart may even "race" to compensate for the changes in blood flow.

In clinical practice, all patients with postural tachycardia syndrome...

Lin Jiu then began to talk about postural tachycardia syndrome. He naturally walked to the blackboard and began to write on the blackboard with a marker, as if he were giving a lecture.

Zhao Zhe glanced at it a few times and could only see the marker moving around "himself" like a ghost.

Damn it!

Zhao Zhe was also helpless.

However, Lin Jiu's explanation was perhaps a bit difficult, as it was all purely theoretical. But the "gravity allergy" was so strange that Zhao Zhe, Xu Leyu, and Lu Gang listened with great interest.

The article "New Advances in the Treatment of Orthostatic Tachycardia Syndrome" contains a similar description: exercise can activate skeletal muscle pumps, increase blood pressure, and has a good therapeutic effect on severe cases.

Three times a week, 20-30 minutes of aerobic exercise plus lower limb and abdominal resistance training, semi-reclining exercises such as swimming and rowing are recommended.

For teenagers, standing against a wall for 30 minutes each day, twice a day, morning and evening, is also effective. If symptoms of fainting occur during training, such as dizziness, blurred vision, paleness, nausea, vomiting, or sweating, immediately lie down or sit up, or elevate the thighs to relieve the symptoms.

"The symptoms will subside after a period of exercise."

"It'll just be a beating with a belt," Zhao Zhe said softly.

Lin Jiu suddenly swung the marker in his hand at Zhao Zhe, and Ji Xiang caught it.

"Dr. Lin, stop fooling around."

"..." Lin Jiu was in a daze for a moment, and finally sighed.

This isn't MIT, and I'm not facing students from Harvard Medical School, plus a prodigy like Ji Xiang.

Facing Ji Xiang, Lin Jiu knew he was at a disadvantage.

"That's roughly it. A spanking might solve the problem, forcing the child to get up and move around to fight off the illness. But there are still some risks. I suggest a more systematic and theoretical approach..."

Lin Jiu then launched into another long speech.

He speaks like the dean giving a report, briefly mentioning one or two sentences at a time, but eventually he can talk for one or two hours.

His talkativeness is completely different from Zhao Zhe's.

Lu was initially somewhat reluctant, but as Lin Jiu continued speaking, he began taking notes.

After half an hour.

Lin Jiu then capped the marker.

That's all for today.

Zhao Zhe stared quietly at the blackboard, at the long string of words written on it, and felt as if he had returned to school.

Lin Jiu glanced at Ji Xiang, who nodded slightly, and Lin Jiu was relieved.

He was genuinely worried that Ji Xiang would voice his objections.

Lin Jiu has a very thorough understanding of postural tachycardia syndrome, after all, he is at Massachusetts General Hospital and has been conducting related theoretical research for many years.

Facing a hospital of the Second Affiliated Hospital's caliber, he was practically dominating it.

However, when facing Ji Xiang, the target of the "dimensional reduction attack" is reversed.

Lin Jiu was always uneasy, afraid that Ji Xiang would smile, then stand up and talk about some cutting-edge knowledge, directly overturning all the theories he had mastered.

After finishing his notes, Lu Gang suddenly slapped his thigh, "Oh my god, I forgot, I forgot! I have to hurry to the patient! They're waiting for my consultation!"

(End of this chapter)