Preliminary Electrocardiogram Round

And so, Lin Wei unexpectedly entered Zhou Cheng's life.

However, it may only last two or three months.

Two months later, Lin Wei was to return to Kyoto.

Three months later, Zhou Cheng will also be dismissed from the hospital.

This period may just be a small episode in their lives.

……

The following day, Zhou Cheng did not go to the hospital emergency department, but instead went to Jinghua Medical University.

Today is the preliminary round of the Jinghua City Electrocardiogram Competition, which will be held at Jinghua Medical University.

The gymnasium of Jinghua Medical University was temporarily converted into a competition venue.

As soon as Zhou Cheng reached the door, he was enveloped by the lively atmosphere.

A red banner hung down from the second floor of the venue, with the words "The 3rd Municipal Electrocardiogram Diagnostic Skills Competition" printed in gold lettering.

A huge list of contestants stood at the entrance, with more than three hundred names arranged by hospital, densely filling the entire board.

The contestants from hospitals across the city wore matching competition vests and chatted in small groups.

Most of them had laptops in their hands, and occasionally you could hear professional discussions such as "how to differentiate between atrial fibrillation with aberrant conduction and ventricular tachycardia" and "the T-wave signs in the hyperacute phase of myocardial infarction".

"Zhou Cheng! Over here!"

Just as Zhou Cheng finished scanning the display board to find his name, he heard a familiar voice.

Turning his head, he saw Su Yi standing on the steps at the entrance of the venue, waving at him.

He was also wearing a blue competition vest and was holding two bottles of mineral water. When he saw him coming, he handed one of the bottles over.

Zhou Cheng took the bottled water and smiled, "You're here so early. How's the preparation? Still number one?"

Previously, Su Yi had been very confident that he would win first place.

Su Yi chuckled, "You know I'm all talk. I only stayed up late last night to look at some electrocardiogram charts, and it's uncertain whether I'll even pass the preliminary round. But I heard the rewards this time are quite generous, even more than the rewards announced at the time. If you pass the preliminary round, you'll get a certificate, and the top ten in the final round will not only receive prize money, but also directly qualify to participate in key municipal research projects. A lot of people are here for that."

The two chatted as they walked into the venue, and were immediately struck by its scale.

The original basketball court was divided into individual testing stations, each with a computer and a table. The screen already displayed the login interface of the competition system.

A temporary stage was set up in front of the venue, with microphones and projection equipment on it. Several leaders in suits were sitting in the audience exchanging ideas.

One of them, Zhou Cheng, looked somewhat familiar; he seemed to be the deputy director of the Municipal Health Commission, who had previously inspected their emergency department.

Not long after, the stage lights came on.

The deputy director of the Municipal Health Commission walked onto the stage, picked up the microphone, and began to speak.

His voice carried throughout the entire venue through the speakers.

"An electrocardiogram (ECG) is a crucial tool for clinical diagnosis, especially in emergency and cardiology departments. An accurate ECG can buy patients valuable time for treatment."

"More than 300 medical staff from our city have signed up for this competition. They include not only key personnel from top-tier hospitals but also young doctors from county-level hospitals. This is a great opportunity for us to learn from and exchange ideas with each other."

"I hope everyone can demonstrate their true abilities, not only in terms of skill but also in terms of attitude. Treat this competition as an opportunity to improve yourselves and better serve patients in the future!"

After the leader finished speaking, enthusiastic applause erupted from the audience.

Afterwards, the teachers from the competition organizing committee went on stage to announce the competition rules and prizes.

This competition is divided into three stages: preliminary round, semi-final, and final.

The preliminary round is a computer-based test with 50 questions, including 30 multiple-choice questions and 20 electrocardiogram interpretation questions. The full score is 100 points, and 60 points is the passing score. The top 100 people will advance to the semi-finals.

In terms of rewards, those who pass the preliminary round will be awarded the title of "Municipal-level Medical Skills Backbone".

The rewards for the semi-finals and finals will be even more generous. The champion of the finals will receive a prize of 5 yuan and the qualification to participate in key projects. The runner-up and third place will also receive corresponding prizes and certificates of honor!

As soon as he finished speaking, another commotion broke out in the audience.

Many contestants' eyes lit up. The qualification to participate in key research projects was more attractive to young doctors than the prize money, as it was like having an extra "stepping stone" to scientific research.

……

"Please take your seats as soon as possible, all contestants. The competition will begin in ten minutes!"

A clear announcement came over the loudspeaker, and the contestants quickened their pace to find their seats.

Zhou Cheng found his examination seat, number 32, in the middle area, according to the number on his admission ticket.

Su Yi's exam seat was diagonally in front of him. The two looked at each other and gave each other a thumbs-up.

"The competition now officially begins!"

At the teacher's command, all the contestants immediately looked at their computer screens.

Zhou Cheng clicked "Start Exam," and the questions instantly appeared on the screen.

The first 30 multiple-choice questions were mostly about the basic theory of electrocardiograms, which were not difficult for him, and he finished answering them quickly.

The difficulty level increased significantly in the last 20 ECG interpretation questions.

Different electrocardiogram patterns appear on the screen in sequence, including atrial fibrillation with intraventricular conduction aberration, special types of supraventricular tachycardia, and ventricular tachycardia that is difficult to distinguish. Contestants need to select the correct diagnosis within a specified time.

Zhou Cheng stared at the screen, holding the mouse, and looked at one of the questions.

The question stem consists of only one line: "Male, 78 years old, sudden loss of consciousness, with a history of coronary heart disease."

However, the patient's electrocardiogram waveform was so chaotic that it was alarming.

In the 12-lead pattern in the center of the screen, the P wave has completely disappeared and has been replaced by an irregular f wave. The RR interval is absolutely irregular, which is a typical manifestation of atrial fibrillation.

However, the QRS complex showed two patterns: most of the QRS waves were narrow and regular, but there were three consecutive wide and deformed QRS waves with a duration of more than 0.12 seconds, and they appeared as "RsR" in lead V1.

The options prominently listed were "atrial fibrillation with intraventricular conduction aberration" and "atrial fibrillation with ventricular tachycardia," two easily confused diagnoses.

In the past, Zhou Cheng would have been in a real bind.

But now, after a period of hard work in the emergency department, his electrocardiogram interpretation skills have been upgraded to the master level!

Currently, he hasn't seen many doctors with master-level skills.

Therefore, the value of master-level skills is self-evident.

Zhou Cheng took a deep breath and activated the system's "lead amplification" function.

He focused on lead V1 and lead II.

First, although the rhythm of the wide QRS complex is fast, it is still weakly associated with the f wave of atrial fibrillation, and although the RR interval is short, it is not completely fixed.

Secondly, the RsR pattern in lead V1 has a distinct "rabbit ear sign," and there is a continuous phenomenon between the wide QRS wave and the narrow QRS wave.

This is a key characteristic of differential conduction within an indoor environment!

Because the rapid ventricular rate during atrial fibrillation leads to bundle branch block, while the QRS waves of ventricular tachycardia are usually unrelated to the atrial fibrillation rhythm and can cause atrioventricular dissociation.

Zhou Cheng quickly checked the indications for ventricular tachycardia.

"There was no atrioventricular dissociation, no ventricular capture, and no ventricular fusion beats."

Taking all these details into account, he decisively selected "atrial fibrillation with intraventricular aberrant conduction"!

Time passed slowly, and the venue was quiet except for the sound of mouse clicks.

When Zhou Cheng finished answering the last question, there were still 10 minutes left in the exam. He checked the answers one last time before clicking "Submit Exam".

When the notification popped up that the submission was successful, Zhou Cheng breathed a sigh of relief and stretched while leaning back in his chair.