17. Основные патологические состояния сердечно-сосудистой системы.



 

 - Hi, haven’t seen you for ages. How are you getting on?

- So-so. Thank you. I’ve got some problems in the university. It’s not a secret that the term is going to the      end and there is practically no time to prepare for my final tests. And what is about you?

- I’m OK. Thank you. I have already passed all my exams, including cardiology and as for me it is the most awful exam from our session.

- OK, you are so lucky! Could you please tell me some questions which were used there? I haven’t been sleeping for a week, learning this subject, but unfortunately, it doesn’t come to my mind.

- Willingly! First of all there was question about rheumatic endocarditis, which is characterized by a general malaise, early fatigue on exertion, cardiac discomfort and palpitation. In rheumatic endocarditis the heart is slightly enlarged and a soft systolic murmur is heard at the heart apex. These symptoms are usually accompanied by diastole murmur heard at the apex and base of the heart.

- And should I speak about the treatment of rheumatic endocarditis? For example, that the patients, suffering from this disease are treated at the in-patient department. They are usually administered antibiotic therapy and Adonis preparations to control cardiovascular insufficiency. They are also recommended a diet which is to be nourishing and containing many vitamins. It also should be limited in salt.

- Yes, you can, but don’t forget to say that the patients must undergo aspirin and bicillin treatment in spring and autumn to prevent the recurrence of the disease. I think that will be enough. The second question was about Angina pectoris, because it is one of the most frequent diseases of the cardiovascular system.

- So should I speak about the symptoms, such as pain, radiating to the left shoulder and down the arm. The pain usually grows worse on moving and on physical exertion.

- Surely, you can say everything you want. You can also add that during the attacks of pain a patient is usually covered with cold perspiration and his face is pale. The incidence of attacks are frequently associated with physical and mental overstrain.

- I know that in angina pectoris the patient can stay in the hospital for about two weeks and then he should be followed-up at the out-patient department.

- You are absolutely right. Well, honestly speaking, I’m in a hurry, because our group is going to celebrate the end of the session.

- Oh! I’m so thankful for you! Thank you for your help. I’ll phone you. Bye.

- Bye.

10. История болезни: основные разделы, их содержание



 

-          Good morning Mr. Hudson. I see from your card that you’ve just moved into the area and perhaps you could tell me a little about your previous health as I won’t get your records for another month and then we can deal with your present problem.

-          Well I’ve actually…

-          Have you ever been in hospital?

-          Only when I was a child. I had appendicitis when I was ten.

-          And what’s your job. What do you do for living?

-          Well, I work for the post office. I’m a postmaster.

-          Have you always been with the post office?

-          Yes, well apart from my time in the army you know…

-          I see. And you’re married. Any family?

-          Yes, two girls and a boy,

-          That’s fine. Can you tell me now what seems to be the problem today?

-          It’s this terrible pain. I’ve got this terrible pain in my back. I’ve had it for more than e week now…

-          Can you show me exactly where it is?

-          It’s down here, here.

-          And does it go anywhere else?

-          It goes down my left leg. And I feel pins and needles in my foot.

-          And is it there all the time?

-          Yes, it is. It’s keeping me awake at night. I’ve been taking aspirins but the pain just comes back again.

-          And was there anything that started it off?

-          Well, yes, I think. I’ve been trying to sort out the garden at my new house and I don’t know, I may have been overdoing things a bit.