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ANGINA PECTORIS « СТЕНОКАРДІЯ»

МЕТОДИЧНА РОЗРОБКА ДЛЯ МЕДИЧНОГО ФАКУЛЬТЕТУ II КУРСУ

I. Learn the following words:

Note – отмечать disturbance – расстройство, нарушение

Radiate - распространяться diminish - уменьшаться

Frequently - часто deviate – отклоняться (от нормы)

Incidence – число случаев, частота adequate - соответствующий

Overstrain - перенапряжение rise (rose, risen) – подниматься

Exacerbate – погіршувати obstruction - закупорка

II. Translate the following words:

The pain radiated to the back, considerable disturbance of metabolic rate, a frequent sharp pain in the substernal area, the diminished waves of ECG, marked deviation in the ECG readings, the overstrain may produce nervous system disturbances, to administer an adequate dose of this drug, these medications exacerbated the condition of the patient, pain was due to the obstruction of the coronary arteries.

III. Read and translate the following sentences paying attention to Complex Object:

1. The nurse on duty didn’t hear the patient leave the room.

2. Mother wanted me to become a doctor.

3. The newspapers report a vaccine against flu to be used successfully.

4. Scientists believe the treatment for cancer to be found out soon.

5. I haven’t seen the surgeons close wounds.

6. Everybody knows the rupture of spleen to be dangerous for life.

IV. Answer the questions:

1. What is Angina Pectoris?

2. What organs are affected in Angina Pectoris?

3. Is it a contagious disease?

4. What is the cause of the disease?

5. How can a person get ill with Angina Pectoris?

6. What should physical examination include?

7. What other examinations are necessary to make a diagnosis?

8. What should be prescribed?

9. Should a patient be treated at home or in the in-patient department?

V. Read and translate the text:

Angina pectoris, commonly known as angina, is chest pain due to ischemia (a lack of blood, thus a lack of oxygen supply and waste removal) of the heart muscle, generally due to obstruction or spasm of the coronary arteries (the heart's blood vessels). Coronary artery disease, the main cause of angina, is due to atherosclerosis of the coronary arteries.

Most patients with angina complain of chest discomfort rather than actual pain: the discomfort is usually described as a pressure, heaviness, squeezing, or burning sensation. Apart from chest discomfort, anginal pains may also be experienced in the epigastrium (upper central abdomen), back, neck area, jaw, or shoulders.

Major risk factors are: Age (≥ 55 years for men, ≥ 65 for women), Cigarette smoking, Diabetes mellitus, Hypertension, Kidney disease, Obesity.

Conditions that exacerbate or provoke angina are: Medications, vasodilators, excessive thyroid replacement, vasoconstrictors.

Angina results when there is an imbalance between the heart's oxygen demand and supply. This imbalance can result from an increase in demand (e.g. during exercise) without a proportional increase in supply (e.g. due to obstruction or atherosclerosis of the coronary arteries).

Case history

Patient Maslov (age 47, white male) was admitted to the in-patient department at 18.35 on the 4^th July. The patient complained of pain in the chest. He had been suffering from pain of various intensity in the chest and behind the breastbone for several weeks. The patient noted the pain to radiate to the left shoulder and down the arm. The patient also observed the pain have been growing worse on moving and on physical exertion. He stated that it frequently began suddenly at night during sleep.

During the attacks of pain he was covered with cold perspiration and his face was pale. The incidence of attacks was frequently associated with the physical and mental overstrain. On physical examination the doctor revealed areas of very sensitive skin from the 7^th cervical vertebra to the 5^th upper thoracic one. On percussion, palpation and auscultation of the heart no significant abnormality was revealed.

The electrocardiogram taken during the attacks showed a disturbance in the blood flow. The most important readings of the electrocardiogram were either diminished or deviated. By having repeated the electrocardiogram after the end of the attack the cardiologist found the adequate readings of the electrocardiogram to return to normal ones.

During the attacks of moderate pain no changes in the peripheral blood or elevation of body temperature were noted. However the temperature rose significantly and there was an accompanying slight leukocytosis when the attacks of pain were particularly severe. The doctor made the diagnosis of angina pectoris with a severe course. Its main cause was atherosclerosis of the coronary arteries.

V. Translate the words into English using lexics from the text:

Фізичне навантаження, стенокардія, судино-звужуючі препарати, поставити діагноз, закупорка судин, потіння, спровокувати захворювання, супроводжуватися біллю, судино-розширюючі препарати, психічне навантаження, відчувати дискомфорт, частота приступів, визначити (4 синоніма), постачання кисню, порушення кровообігу, погіршити стан здоров’я, зменшуватися (3 синоніма), видалення продуктів розпаду, підвищуватися (3 синоніма), причина хвороби, тиснучий біль, викликати захворювання, приводити до захворювання, погіршуватися.

VI. Continue the sentences according to the text:

1. Ischemia of the heart muscle is ……..

2. Coronary artery disease is due to ……..

3. Most patients with angina complain of …….

4. The patient admitted to the in-patient department complained of …….

5. The patient had pains in ……..

6. The pain radiates to …….

7. The pain becomes worse ……..

8. The pain could also begin suddenly ……

9. During the attacks he ……..

10. The following examinations were made ……

11. Physical examination revealed…….

12. During the attacks the body temperature was …..

13. The cause of angina pectoris was ……

VII. Answer the questions to the text:

1. What disease is angina pectoris?

2. What are the causes of angina?

3. What do most patients with angina complain of?

4. What is the character of pain in angina?

5. What are major risk factors?

6. What are the conditions that exacerbate or provoke angina?

7. What conditions of patient’s health result in angina?

VIII. Fill in the table with appropriate translation of the words and terms:

IX. Fill in the patient’s case history with all necessary information from the text:

X. Choose the appropriate continuation of the sentence:

1. For several days patient had been suffering from …. A) pains behind the breastbone. B) severe attacks of cough.

2. It was revealed that the patient had areas of sensitive skin … a) over the anterior surface of the chest from the 2^nd to the 4^th rib. B) from the 7^th cervical vertebra to the 5^th upper thoracic one.

3. As the condition of the patient had been gradually improving his temperature …… considerably (reduced, rose).

4. Severe attacks of angina pectoris are accompanied by …. A) pain radiating down the back. B) pain radiating down the arm.

5. If the patient is suffering from rheumatic endocarditis, his pulse becomes …. on physical exertion. (accelerated, slow)

6. Partial arrest of blood circulation often results in …. to brain cells. (the recovery, the damage)

XI. Translate Russian words in brackets into English:

1. Last year for several weeks the patient had been suffering from constant cardiac pain (яка поширюється вздовж лівого боку).

2. (Порушення кровотоку) was revealed by examination.

3. After a course of (відповідні ин’єкції) the patient stated that the cardiac pain considerably (уменьшилась).

4. (Фізичне та психічне навантаження) increases the incidence of heart attacks in patients with angina pectoris.

5. During the attacks of pain the temperature rose significantly and (супроводжувалася легким лейкоцитозом).

6. The incidence of attacks (було пов’язано з) high blood pressure.

XII. Rewrite sentences using Complex Object and translate them into Russian:

1. The physician considered that the incidence of heart attack is associated with the nervous overstrain.

2. The doctor tells me that I should undergo antibiotic treatment.

3. We noticed that the pain in angina pectoris had been eliminated by the use of nitroglycerin.

4. They have observed that the direct association between infarctions and the nerves occurs only at the age-group of patients over 40.

5. Cardiologists have observed that patients with angina pectoris have no clinical manifestations until the 1^st attack.

6. The professor thinks that the post-operative cause of the patient will be uneventful.

XIII. Combine two sentences into one using Complex Object.

He saw two men. They were looking for something on the floor. – He saw two men looking for something on the floor.

1. The watched the doctor. He was examining their son.

2. The needle fell on the floor. We saw it.

3. The patient was moaning all night long. The nurse heard it.

4. He is a very experienced surgeon. Everybody knows it.

5. He will be well again soon. His friends expect that.

6. We have to do all the exercises in writing. Our teacher insisted on it.

7. We could use our dictionaries at the test. The teacher allowed us to do it.

XIV. Translate into English using Complex Object:

1. Медсестра чула, як пацієнт в палаті № 8 кашляв усю нічь.

2. Ми бачили, як данні ЕКГ повільно змінювалися.

3. Студенти спостерігали, як лікар прослуховував серце хворого.

4. Лікарь очікував, що порушення кровообігу буде усунено після призначення атропіну.

5. Пацієнт сказав, що підвищення температури тіла супроводжувалося потовідділенням.

6. Вони ніколи не чули, щоб цей пацієнт скаржився.

XV. Put verbs in brackets into the correct form.

Last year my father (to be) ill with angina pectoris. He (to admit) to the in-patient department in a very poor condition. He (to experience) acute pain in the substernal area for 5 days. After he (to undergo) all examinations and several ECG (to take), doctor (to make) a diagnosis of angina pectoris which (to cause) by obstruction of coronary arteries. The cardiologist (to administer) him an adequate treatment. To relieve pain my father (to give) the course of injections. My father (to stay) in the hospital for 2 weeks and now he (to follow-up) at the out-patient department. His condition already considerably (to improve) and soon he (to return) to work again.

XVI. Make questions to underlined words:

1. The patient complained of pain in the chest.

2. The patient had been suffering from pain in the substernal area.

3. During the attacks of pain he was covered with cold perspiration.

4. The surgeons have already finished the operation.

5. Attacks of angina pectoris are accompanied by severe pain.

6. The usage of nitroglycerin eliminates the pain in angina pectoris.

XVII. Explain the following words in 5 sentences:

Atherosclerosis, angina pectoris, blood, artery.

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