Chapter 548: The Heart’s Sneaky Mechanisms, Better Check Your Liver

Tuyu Hospital stands apart from those small clinics that survive on test fees.

If a patient has already undergone tests at another top-tier hospital, Tuyu generally won’t ask them to repeat the same exams. Only if a doctor suspects an issue with the accuracy of the results will they request a retest.

Every test serves a purpose—to pinpoint the cause of illness and pave the way for a cure.

If the goal shifts to merely racking up test fees, it betrays medical ethics and strips the process of its true meaning.

However, this issue isn’t black and white.

Some small hospitals, with limited patient volume, burden their doctors with quotas. Each month, they must admit a certain number of inpatients or order a specific number of ultrasounds. Under such pressure, doctors, fighting to keep their jobs, often target the few patients who come seeking help.

Zhou Can followed Director Xueyan down the corridor.

They had already arranged a temporary bed for this patient—a rare privilege.

After all, beds in the Cardiothoracic Surgery Department were in high demand. Many patients seeking treatment ended up sleeping on the floors of waiting rooms or corridors. Those without beds, still in the queue, couldn’t access medication or surgical planning.

Only after being officially admitted and completing the necessary paperwork could patients receive nursing care, medication, surgical consultations, and monitoring.

“Mr. Lan, this is Dr. Zhou Can. He’s made time to come and consult on your case,” Director Xueyan introduced Zhou Can to the patient.

The patient was a young man, barely seventeen or eighteen. His face was unnaturally pale, his breathing rapid and shallow—classic signs of heart failure.

In mild cases, heart failure often shows no obvious symptoms.

Early on, when heart function begins to decline, the heart’s reserve capacity compensates for the damage.

Think of it this way: the heart works tirelessly twenty-four hours a day, but it’s often slacking off. It holds back roughly forty percent of its strength.

It has to play it smart and conserve energy.

If the body’s owner disregards its limits—say, by eating overly salty food or something else that strains the heart—the organ’s reserved strength keeps it from collapsing under the load.

Even during intense physical exertion, when the body demands a burst of effort, the heart can push itself to keep up.

But this young man displayed clear symptoms of heart failure, signaling a severe condition.

“Hello, Dr. Zhou. I came all the way from the Imperial Capital just to see you. I’ve been to several hospitals, but none could pinpoint the exact cause of my illness.”

Despite his young age, the boy spoke with an impressive presence. His gaze was open and honest, yet carried an indescribable detachment. His tone was steady and measured, revealing an extraordinary demeanor.

Most kids from ordinary families, even at twenty-seven, wouldn’t carry themselves with such poise.

It’s often said that it takes three generations of wealth to master the art of dining and dressing with grace.

Cultivating a child’s demeanor is a complex, lengthy process, reflecting a family’s overall strength. It’s not as simple as handing a kid a hefty monthly allowance to mold them into someone with commanding presence.

Families without deep roots, even if they give a teenager thousands in pocket money each month, often see the opposite effect. The kid might think money comes too easily, fall in with the wrong crowd, and squander it on reckless indulgence.

Some fifteen or sixteen-year-olds, not even fully grown, know more about vice than seasoned gamblers.

They’re well-versed in every kind of debauchery.

Isn’t this often the result of parents spoiling a child before their mind matures, showering them with cash and turning them into reckless spendthrifts?

Families with true heritage place immense value on a child’s upbringing.

From a young age, they instill proper values, broaden their horizons, and teach philosophies of life and social conduct.

Such children, even at a tender age, have seen the world. Their maturity outshines their peers.

They often shine in multiple ways—self-discipline, calmness under pressure, the ability to discern right from wrong, and a natural ease in social settings.

The young patient before Zhou Can was one of these exceptional teens.

Even though Zhou Can stood out among his own peers, comparing himself at seventeen or eighteen to this boy, he knew he fell far short.

“Thank you for trusting me. Let me check your condition first.”

Zhou Can spoke to him with a reassuring tone.

“I appreciate it.”

The young man was fully cooperative.

A middle-aged man, around thirty, stood by the hospital bed. His eyes were cold, and he remained silent. Clearly a family member, though his exact relation to the patient wasn’t obvious.

Zhou Can couldn’t help but muse to himself that patients from the Imperial Capital often seemed to carry an air of distinction.

“How long have you been feeling unwell?”

“It started when I was about twelve. Back then, I was aiming to get into a top class. I studied day and night, solving problems, memorizing facts, often spending entire days in the youth library. At first, I didn’t notice much, but about a month before my primary school graduation exams, I started feeling off.”

He paused to think, then answered with clarity.

“What kind of discomfort did you feel?”

Zhou Can pressed for details.

The patient, now seventeen and nearing eighteen, had been ill for five or six years if symptoms began at twelve.

His condition had progressed for a long time.

“It’s hard to describe. My chest felt tight, like a heavy stone was pressing down on my heart, making me feel weighed down. Whenever I exerted myself even a little, I’d struggle to breathe, and my face would flush red. At its worst, my hands and feet would tremble uncontrollably.”

His response was clear, logical, and precise, providing Zhou Can with valuable insight for further diagnosis.

“I’m really impressed by you. At just twelve, you were already working so hard toward a goal. When you first felt unwell back then, did you see a doctor?”

Zhou Can genuinely admired the young man’s dedication.

“I didn’t. For one, it was a critical time before my graduation exams. I wanted to earn my spot in a top class through my own effort, not rely on family connections. Besides, I thought if I could just push through the exams and relax a bit afterward, I’d recover. After the exams, I got into the class I wanted. With some rest, I did feel better for a while. But as my studies grew heavier, the symptoms came back stronger.”

Zhou Can’s heart ached for this determined child, striving so hard at such a young age.

Shame washed over him. At twelve or thirteen, he’d been at his most mischievous and rebellious.

Back in middle school, he’d flirt with pretty classmates just for fun.

For a time, he was like the campus troublemaker.

His homeroom teacher had called his parents in for talks more times than he could count.

Some kids just seem born to lead. From the start, they know how to work hard for what they want and plan their lives with purpose.

“Did you know? I actually tried exercising to improve my health back then. But even a little activity made me feel awful. Once, during a school event, we had to run a thousand meters. I fainted after just four hundred. From then on, my teachers wouldn’t let me join intense sports activities in PE class.”

Almost every kid faces the thousand-meter run in PE, or eight hundred for girls.

Kids with health issues or those who rarely exercise often faint during such events.

But most collapse after finishing the full distance.

This young man passing out at four hundred meters showed just how poor his condition was.

“Did you get checked at a hospital after that?”

“Yes. When my parents heard I fainted during PE, they rushed me to the hospital for tests. At first, the doctors suspected congenital heart disease, but after thorough checks, they found nothing. They advised me to exercise more, gradually building up. For a while, I trained over two hours daily, and I did feel much better. My parents and relatives kept buying me supplements, though they didn’t seem to help much.”

“Later, in eighth grade, my studies got incredibly intense. I represented my class in math Olympiads and art competitions, determined to bring honor to my class and school. I had to cut back on exercise. By ninth grade, aiming for a top high school, I was even busier, barely squeezing in thirty minutes of exercise a day. My health started declining again. After getting into a top high school, the workload stayed crushing. I was supposed to be in eleventh grade this year, but my condition worsened so much I had to take a leave to focus on treatment.”

Hearing the young man’s story, Zhou Can couldn’t help but admire him completely.

If he could cure this boy, Zhou Can believed that in a few years, he might become a pillar of the nation.

“Multiple major hospitals ruled out congenital heart disease, correct?”

Zhou Can asked for confirmation.

“Yes, they all said my heart showed no signs of congenital defects, but they did diagnose heart failure. It started as left-sided failure, then progressed to right-sided, eventually becoming total heart failure. After a joint consultation at Imperial Capital Renhe Hospital, the experts suggested considering a heart transplant or an artificial heart. My parents thought the risks were too high and haven’t agreed to it. A top cardiac surgeon from Renhe, a close friend of my father, told him to bring me to Tuyu Hospital and specifically mentioned your name.”

Those words filled Zhou Can with a quiet sense of pride.

He hadn’t expected his reputation to reach even the top cardiac experts at Imperial Capital Renhe Hospital.

Sure, he’d performed a challenging surgery broadcast live, but in the eyes of Renhe’s elite surgeons, it shouldn’t have been anything extraordinary, right?

Still, earning recognition from such a figure made Zhou Can genuinely pleased.

“I’m just an ordinary surgeon here at Tuyu Hospital.”

Humble as he was, the case still needed his attention.

After checking the patient’s heart rate and pulse, Zhou Can carefully listened to the sounds in the pericardial area. Skilled cardiologists or cardiac surgeons can diagnose many conditions just by auscultation.

For instance, a murmur often betrays aortic valve insufficiency.

Also, while pulse and heart rate might seem similar, they hold distinct significance in clinical diagnosis.

Irregularities in heart rate can be detected through listening.

Pulse, on the other hand, offers insight into the heart’s working state, especially its pumping strength, reflected directly in the rhythm and force.

Take this patient—his pulse was thin and rapid.

In heart failure, as cardiac function declines, a compensatory mechanism kicks in.

It mainly shows as reduced blood output per contraction. To make up for it, the heart rate increases. Even if each beat pumps less blood, the faster rate ensures adequate output over time.

This compensation explains why heart failure patients often experience tachycardia.

The heart’s operation has a certain elasticity.

When the volume per beat drops, it compensates by beating more often.

“You’re not thin, but you lack muscle. Studies matter, but so does your health. Going forward, you’ll need to find a balance between the two. Otherwise, no matter how stellar your grades are, if your body gives out, it’ll all be for nothing.”

After finishing the exam, Zhou Can shared his thoughts with the patient.

“Sometimes, I have no choice but to push myself. Everyone else is striving too. Maybe it’s because I never liked sports growing up, plus my mom had a difficult labor with me, leaving me weaker than my peers.”

A bitter smile flickered across the patient’s face.

Adults often don’t grasp the struggles of youth. If he doesn’t fight for it, how can he get into a top class or a prestigious high school?

“Did you bring the test results from other hospitals?”

“They’re all here.”

The middle-aged man by the bed finally spoke, handing Zhou Can several large folders of materials.

As he took the folders, Zhou Can instinctively glanced at the man’s hands.

The knuckles on the back of his hands were covered in calluses, as were his palms.

A skilled fighter, no doubt.

This man was definitely a trained expert.

His attitude toward Zhou Can was notably cold. Perhaps seeing Zhou Can’s youth, he doubted his capability and didn’t take him seriously.

After inspecting the man’s hands, Zhou Can studied his face for a moment.

The middle-aged man’s expression darkened slightly as he glared back.

“I suggest you get a liver check.”

Zhou Can said calmly.

The man’s face froze for a split second before he gave a noncommittal grunt.

Judging by his reaction, he clearly didn’t take Zhou Can’s advice to heart.

Zhou Can didn’t press further. Instead, he pulled out the patient’s records and began reviewing them sheet by sheet with meticulous care.

Director Xueyan stayed by his side, quietly observing.