Chapter 567: A Unique Heart Attack Patient with Severe Arterial Deformities

“Alright.”

The waiter quickly brought over two takeout boxes.

When it comes to service attitude, these ordinary shops and diners always shine with warmth and attentiveness. Banks and luxury stores, on the other hand, often have a double standard—lavish VIP treatment for the wealthy, while the less fortunate get nothing but cold glares.

“Du Leng and I are planning to tie the knot this year. You all better come to my wedding and raise a glass with us!”

Ma Xiaolan scooped some crayfish, lamb skewers, and leeks into the boxes.

At the same time, she dropped a bombshell that left everyone stunned.

Back when she started dating Du Leng, hardly anyone thought they’d last.

Zhou Can even figured Du Leng was just messing around and that they’d split up soon enough. Never in his wildest dreams did he expect them to reach the point of discussing marriage.

“If Xiaolan’s getting married, I’ll definitely be there. I’m just worried I won’t be able to get time off.”

Qiao Yu was the first to chime in.

“Boss, a wedding is a huge deal, a once-in-a-lifetime event! You’ve got to let us take the day off.”

Ma Xiaolan immediately turned her gaze to Zhou Can.

“I won’t stand in your way, but doctors and nurses have a unique job. The chances of everyone getting leave at the same time are pretty slim. If the wedding’s in the city, I can manage a couple of hours off for you, no problem.”

Zhou Can wasn’t about to make reckless promises.

Medical staff have one of the hardest jobs to take leave from. Patients can’t wait—they need treatment the moment they arrive at the hospital.

Nurses in hospitals are often stretched thin, with many handling the workload of two. Not only are they rarely allowed time off, but the hospital would love nothing more than to have them pulling all-nighters and overtime shifts.

This is especially true in major hospitals, where the issue is rampant.

During a flu outbreak, the treatment room’s medicine cabinets can be stocked from one end to the other. Every patient’s medication needs to be double-checked, prepared in advance, and administered on a strict schedule.

Even if preparing meds for one patient takes just a minute, injecting or administering IVs can take anywhere from two to ten minutes. Then there’s collecting empty vials, removing needles, or handling indwelling catheters, which takes another minute or so.

All in all, fully tending to a single patient takes at least five to ten minutes, sometimes even longer.

Even if nurses extend their shifts to twelve hours a day, when patient numbers spike, it’s still nowhere near enough time.

And when patient numbers surge, another terrifying issue arises—critical cases and unexpected emergencies become more likely.

This can severely drain nursing resources, with multiple staff tied up at once.

So getting leave as a nurse is incredibly tough.

Doctors have it even harder. Each specializes in a unique field, and the higher their rank, the less replaceable they are in their department.

If a chief physician takes a day off, their department might not be able to treat certain types of patients at all.

Ordinary doctors are more interchangeable, but their workload is massive!

The lower on the totem pole—like interns or trainees—the heavier the grunt work. Thinking interns can just stand by with folded arms, watching senior doctors operate and learning at a leisurely pace? That’s a pipe dream.

Take Zhou Can’s Emergency Department as an example. If a critical patient comes in and senior doctors aren’t around, even interns have to step up.

For Ma Xiaolan’s wedding, getting the entire surgical team a full day off is nearly impossible.

Requesting a temporary leave of two or three hours from the department, though, is much more likely to be approved.

Everyone was happily digging into their food when Zhou Can’s phone buzzed.

He pulled it out and saw it was a call from the hospital’s Emergency Department.

He answered.

“Dr. Zhou, please hurry back to the Emergency Department. We’ve got a heart attack patient in critical condition.”

“Got it! I’m on my way!”

Zhou Can stood up and hurriedly addressed the group. “Sorry, I can’t stick around. There’s an emergency patient in critical condition, and I’ve got to rush over. Order whatever food or drinks you want—go wild. I’ll cover the bill tomorrow.”

With that, Zhou Can dashed off.

Luckily, the small alley where they were having late-night snacks was close to Tuyu Hospital. He broke into a brisk jog back to the Emergency Department.

By the time he arrived, the patient had already been wheeled into the resuscitation room.

Heart attack patients need immediate intervention, or they won’t survive long.

“Zhou Can, come take a look at this patient’s condition!”

Director Lou was drenched in sweat, a clear sign he’d already led the Emergency Department’s nurses and doctors in an initial round of resuscitation efforts.

So far, no doctors from Cardiothoracic Surgery or Cardiovascular Medicine had arrived for a consultation.

Both departments are equipped to handle heart attack cases.

The Emergency Department currently lacks the capability for full treatment, though they can manage basic thrombolysis and cardiopulmonary resuscitation.

Zhou Can hurried to the resuscitation bed. When he saw the patient’s face, he froze for a moment.

How could it be him?

Lying on the bed was none other than Director Zhang Qilian, the head of Third Hospital, whom Zhou Can had met twice before.

His face was deathly pale, his eyes dull and indifferent, his breathing shallow and rapid, and his heart rate wildly unstable.

“Has an angiography been done yet?”

“Not yet. The patient was transferred from Third Hospital. Biochemical tests show severely elevated cardiac enzymes, and an ECG strongly suggests a myocardial infarction.”

Director Lou handed over the patient’s medical records for Zhou Can to review.

“Looking at his blood pressure, heart rate, complexion, and the dynamic ST-T changes on the ECG, the infarction area must be significant. If only he’d been brought in sooner. Now, I’m afraid he needs to be rushed to the cath lab for interventional treatment immediately.”

After assessing the patient, Zhou Can swiftly offered his rescue plan.

This was the difference between high skill and mediocrity.

Even though Director Lou and the others knew it was a heart attack, they could only perform routine stabilization measures to keep the patient alive for the time being.

After Zhou Can’s evaluation, he was able to propose a precise rescue strategy right away.

“Contact the cath lab immediately and get the patient transferred. I’ll go speak with the family.”

Director Lou didn’t hesitate, acting with decisive speed.

…

After nearly two hours of intense effort, Zhang Qilian’s life was saved. However, due to prolonged ischemia, he was certain to face serious long-term complications.

Heart failure, arrhythmias, and ventricular aneurysms were likely.

The primary issue would be heart failure.

From now on, even walking a few steps would leave him breathless. His quality of life would plummet drastically.

The only solutions would be an artificial heart or a transplant.

Both myocardial and cerebral infarctions cause irreversible damage.

In fact, prolonged ischemia in any part of the body can lead to irreversible harm.

Some areas are unique, though. Even if a major blood vessel is blocked, other arterial pathways might still supply blood. In such cases, while severe symptoms appear, timely treatment often prevents lasting damage.

Zhang Qilian’s thrombectomy procedure was incredibly challenging.

His blood vessels were highly unusual.

The intervention team struggled, failing to access the coronary arteries through the femoral, radial, or percutaneous coronary approaches.

In the end, it was Zhou Can who stepped in. Using his Level 6 Injection Technique and Level 6 Placement Technique, he finally identified the issue.

It turned out that in the pathway from Zhang Qilian’s femoral artery to his coronary arteries, there were two severe arterial plaques causing significant narrowing. One spot, at a sharp bend, was particularly blocked.

This drastically increased the difficulty of threading a guidewire through the vessel.

If it had just been the femoral access route that was obstructed, the intervention doctors wouldn’t have been fazed. They could still try the radial artery approach.

In clinical emergencies, the radial artery route is often used more frequently.

Sadly, Zhang Qilian’s radial-to-coronary artery pathway was even more severely blocked, with significant vascular deformities. Such a case was extremely rare in clinical practice.

At least for Zhou Can, it was the first time he’d encountered a patient with such extreme vascular abnormalities.

Even during coronary angiography, he discovered that the patient’s coronary arteries were also severely malformed.

This led him to wonder if Zhang Qilian’s entire arterial system was affected by this condition. Was it a congenital defect or some other unique physiology?

The exact cause would have to be investigated later.

With Zhang Qilian’s vascular condition being so extraordinary, it was no wonder the Japanese heart surgeon at Third Hospital was at a loss.

Through this treatment, Zhou Can gained even greater confidence in his interventional skills.

Unbeknownst to him, his expertise in interventions had already surpassed many so-called ‘experts.’

As he stepped out of the cath lab, his mind had already pieced together a rough outline of Zhang Qilian’s illness and treatment journey.

It was likely that during a courtroom clash, Zhou Can had staged a stunning comeback, dealing a blow Zhang Qilian couldn’t stomach.

Already advanced in age, coupled with severe arterial deformities throughout his body, the intense emotional stress probably spiked his blood pressure. This worsened the vascular blockages, ultimately triggering the heart attack.

Some might wonder, when blood pressure rises, shouldn’t blood flow faster and circulation improve? How could that lead to a heart attack?

The mechanism behind it requires analysis from multiple angles.

Firstly, hypertension accelerates atherosclerosis, directly narrowing the arteries.

Zhang Qilian’s widespread arterial deformities were likely the result of long-term uncontrolled high blood pressure.

Secondly, prolonged poor blood pressure control can damage target organs, leading to left ventricular enlargement.

When the left ventricle enlarges, its ability to pump blood weakens.

Think of it like a house. Originally, a family of three lived comfortably in it. One day, the house is expanded massively, but it’s still just three people. The space feels empty and hollow.

The heart ventricle works the same way.

When it enlarges but the blood volume remains the same, its pumping strength naturally diminishes.

Additionally, an enlarged ventricle causes the heart muscle to weaken, another key reason for reduced pumping capacity.

If left unchecked, an enlarged left ventricle will eventually impair blood supply to the heart muscle. At that point, the risk of coronary spasms skyrockets.

With these conditions in place, even a minor trigger can cause a sudden spike in blood pressure. Unstable atherosclerotic plaques can rupture and dislodge, forming a clot that ultimately blocks the coronary artery.

So when communicating with patients who have heart conditions, one must be extremely cautious with their words.

Harsh or provoking language can spike their blood pressure, which is incredibly dangerous.

If you anger someone to the point of death, you’re likely to end up in a lawsuit.

After losing a court battle, Zhang Qilian’s blood pressure soared, tragically resulting in a heart attack.

His own hospital specialized in cardiac surgery, so naturally, he opted for treatment there first. What he never expected was that the highly-paid Japanese heart surgeon would prove so incompetent.

At a critical moment, they dropped the ball yet again.

Despite numerous attempts, they couldn’t remove the clot or clear the blocked coronary artery.

At that point, there was no other choice.

After discussions, the family and Vice Director Zhang decided to trust Tuyu Hospital’s medical expertise and transferred him there for emergency treatment.

Their decision proved to be the right one.

After over two hours of grueling effort, Zhou Can placed two stents in the pathway from the femoral artery to the coronary artery. By propping open the severely narrowed vessels, he allowed the guidewire to pass through successfully.

In the end, the thrombectomy was completed.

By Zhou Can’s estimation, the patient’s body likely needed at least a hundred vascular stents.

Even then, it might not fully resolve the issue.

Zhang Qilian would still face a risk of arterial blockages.

Regardless, Zhou Can had successfully saved his life, and this would undoubtedly boost his reputation even further.

As he exited the intervention room, the family crowded around him.

“Doctor, how’s my husband doing?”

Zhang Qilian’s wife looked remarkably young, her appearance meticulously maintained with delicate makeup.

If it weren’t for the faint nasolabial folds, subtle crow’s feet at the corners of her eyes, and a gaze that didn’t match her youthful exterior, Zhou Can might have pegged her for someone in her twenties.

Her skin was not only fair but also glowed with vitality.

Her figure was impressively well-kept too.

She exuded a gentle elegance, the kind that radiated both outer beauty and inner wisdom.

Zhang Qilian, with his ruthless and cunning nature, wasn’t exactly a looker, yet he’d married such a stunning woman. It reminded Zhou Can of an old saying—flowers often bloom on dung heaps.

“The patient is out of immediate danger for now. However, his arterial deformities are severe, so he’ll need to be extremely cautious moving forward. He must avoid getting agitated at all costs. Also, since he was brought in too late and missed the golden window for treatment, he may experience heart failure after recovery. He won’t be able to do heavy work or engage in intense exercise.”

Zhou Can and Zhang Qilian might be adversaries.

But whether during the rescue or now, he embodied the sacred duty and nobility of a doctor.

His focus remained solely on the patient’s well-being.

“Wonderful!”

After hearing the news, she clasped her hands together, a relieved smile spreading across her face.

It was clear she cared deeply for Zhang Qilian.

Their love seemed genuinely sweet.

The word she’d just spoken was in Japanese, a instinctive reaction. It tipped Zhou Can off that she was likely from Japan.

His gaze inadvertently dropped to her legs.

Sure enough, they had the classic bow-legged shape.

“Thank you, thank you so much!”

She repeatedly expressed her gratitude to Zhou Can.

“You’re welcome! You’ll be able to see the patient soon. He may need to be hospitalized for three to seven days.”

Zhou Can nodded to her and walked away.

…

The next morning, after finishing his rounds in the Emergency Department ward, Zhou Can made a special trip to check on Zhang Qilian’s recovery.

As he reached the inpatient ward of the Cardiovascular Medicine Department, he spotted a familiar figure.

Vice Director Zhang, who had been escorted out by security last time, was standing outside the ward, talking on the phone.

As vice director, with the director now incapacitated, his workload must be overwhelming.

When he saw Zhou Can approaching, a subtle shift flickered across Zhang Mingxing’s face.

It was mostly embarrassment.

“Morning, Director Zhang!”

Zhou Can, on the other hand, was all smiles as he greeted him warmly.