Методична розробка для медичного факультету II курсу angina pectoris « стенокардія»

1. 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

2. 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.

3. 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.

4. 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.