Myocardial infarction

PARTI

Exercise 1. Practise the pronunciation of the following words. Translate them into Ukrainian:

myocardial [_tmaiou'ka:di9l], attack [a'taek], blockage [bbkidj'], supply [ss'plai], injury ['indjari] restore [ri'sto:], irreversible [_tiri'v3:s3bl], occur [э'кз:], scar [ska:], trigger ['trigs], deprive (of) [di'praiv]

Exercise 2. What disease is described?

VII. high pressure (tension) in the arteries;

VIII. a medical condition when a patient has too much body fat;

IX. an inflammation of one or both lungs which is usually caused by bacteria, viruses, or fungi;

X. a process of progressive thickening and hardening of the artery walls as a result of fat deposits on their inner lining;

XI. chest discomfort that occurs when there is decreased blood oxygen supply to an area of the heart muscle;

XII. a chronic condition associated with abnormally high levels of sugar (glucose) in the blood;

XIII. the death of heart muscle from the sudden blockage of a coronary artery by a blood clot;

XIV. inflammation of the gall bladder due to bacterial infection or the presence of gallstones.

Exercise 3. Find the corresponding equivalents:

V. blood vessels a.гостра інфекція

VI. blood clot b. коронарна артерія

VII. heart muscle c. неминуча смерть

VIII. coronary artery d. надмірне вживання алкоголю

IX. to cause injury e. кров'яний тромб

X. irreversible death f. визивати ушкодження

XI. acute infection g. серцевий м'яз

XII. heavy alcohol consumption h. кров'яні судини

Exercise 4. Read and translate the following word-combinations:

the death of the heart muscle, the sudden blockage of a coronary artery, to supply with, to cause injury to the heart muscle, chest pressure sensation, to be restored, to occur, to die for 6 to 8 hours, to be replaced by, physical exertion and mental overstrain, lack of physical activity.

Exercise 5. Re-write the sentences opening brackets and putting the verbs either in the Active or Passive Voice. Then make them negative and interrogative:

XII. Shortness of breath (to cause) by physical exertion.

XII. An accelerated heartbeat (to describe) as palpitation by patients.

XV. Heart size (to measure) by percussion.

XVI. The murmurs in the heart (not to hear) by the doctor during yesterday's examination.

XVII. Fever (to know) as pyrexia.

XVIII. Patient often (to refer) to microbes as germs or bugs.

XIX. He (to admit) to the hospital with flu-type symptoms.

XX. Tumours (to invade) tissues and then (to spread) to distant parts of the body.

Exercise 6. Read and translate the text:

MYOCARDIAL INFARCTION

A myocardial infarction (MI), also known as a heart attack, is the death of heart muscle from the sudden blockage of a coronary artery by a blood clot. Coronary arteries are blood vessels that supply the heart muscle with blood and oxygen. Blockage of a coronary artery deprives the heart muscle of blood and oxygen, causing injury to the heart muscle. Injury to the heart muscle causes chest pain and chest pressure sensation|/lf blood flow is not restored to the heart muscle within 20 to 40 minutes, irreversible death of the heart muscle will begin to occur. Muscle continues to die for six to eight hours at which time the heart attack is usually "complete". The dead heart muscle is eventually replaced by scar tissue.

Causes of MI

Recently, it has been determined that the high rate of heart attacks is most frequently associated with intense physical exertion and mental overstrain. Nevertheless, such diseases as coronary atherosclerosis, angina pectoris and any acute infection, e.g. pneumonia, can also trigger a myocardial infarction.

Major risk factors are: age (less than 75 years for men and more than 75years for women); high blood pressure; coronary artery diseases; obesity and lack of physical activity; diabetes mellitus; cigarette smoking and heavy alcohol consumption; mental and physical stress; family history of heart diseases, especially of MI.

Exercise 7. Answer the following questions:

V. What is a myocardial infarction?

VI. What is MI caused by?

VII. What does the blockage of the coronary artery cause?

VIII. When does irreversible death of the heart muscle occur?

IX. How much time does it take a heart muscle to die completely?

X. What is MI most frequently associated with?

XI. What diseases may also result in a heart attack?

XII. Enumerate all the risk factors for MI.

Exercise 8. Find synonyms in the text to the following words and word-combinations:

obstruction, myocardial infarction, blood circulation, to happen, psychological overstrain, inflammation of

the lungs, squeezing of the chest, to result in, physical exercise, elevated blood pressure.

Exercise 9. Give the English equivalents to the following word-combinations:

смерть сердечного м'яза, закупорка (3 синоніма), постачати кров та кисень, пошкодження сердечного м'язу, біль в грудній клітині, відчуття тиснення, замінюватися шрамом, висока частотність сердечних нападів, часто пов'язувати з, привести до (3 синоніма), кров'яний тиск, недостатність фізичних вправ.

Exercise 10. Put questions to the underlined words:

XII. Myocardial infarction is also known as a heart attack.

XII. MI means the death of heart muscle.

XII. MI is caused by the sudden blockage of a coronary artery by a blood clot.

XII. Coronary arteries supply the heart muscle with blood and oxygen.

XII. Blockage of a coronary artery deprives the heart muscle of blood and oxygen.

XII. The heart attack is usually "complete" within 6-8 hours.

XII. Coronary atherosclerosis, angina pectoris, pneumonia can trigger a MI.

8. Irreversible death of the heart muscle will begin to occur in 20-40 minutes.

PART II

Exercise 1. Practise the pronunciation of the following words. Find their translation:

victim [Viktim], experience [ik'spisrisns], fullness ['fulnas], heartburn ['ha:tba:n], indigestion [jndi'cfrestfan], vague ['veig], enzyme ['enzaim], prompt ['prompt], percutaneous [ psikju'teiniss]

підшкірний, печія, нетравлення шлунка, відчувати, швидкий, невиразний, ензим, жертва, відчуття наповненості

Exercise 2. Join the words from the columns and translate the gained word-combinations:

chest malaise

shortness of infarction

life complications

long-term failure

squeezing breath

heart threatening

general pain

myocardial sensation

Exercise 3. Read and translate the text:

MYOCARDIAL INFARCTION

Symptoms

Although chest pain or pressure is the most common symptom of a MI, heart attack victims may experience a variety of symptoms including: fullness and squeezing sensation of the chest; shortness of breath; nausea, vomiting; sweating; heartburn and indigestion; arm pain; general malaise.

Even though the symptoms of a MI at times can be vague and mild, it is important to remember that heart attacks producing no symptoms or only mild symptoms can be just as serious and life-threatening as heart attacks that cause severe chest pain. Complications

Complications may occur immediately or may need time to develop. Acute complications may include heart failure if the damaged heart is no longer able to adequately pump blood around the body; aneurysm or rupture of the myocardium; arrhythmias. Long-term complications include heart failure, atrial fibrillation, and the increased risk of a second MI.

Diagnosing

When there is severe chest pain, a heart attack must be suspected in the first turn(A problem arises, when the symptoms do not include chest pain. Then a heart attack may not be suspected, and the appropriate tests may not be performed. ECG will immediately show all the abnormalities in the heart activity during the acute phase.

In patients with vague symptoms of MI, the diagnosis can be made only hours later through blood tests since the latter usually reveal a number of cardiac enzymes (special proteins that are released into the blood by dying heart muscle) that help confirm the diagnosis and show amount of the dead heart muscle.

Treatment

The most important factor in treating a heart attack is prompt medical attention. Such medications as antiplatelet, anticoagulant, cl'ot dissolving drugs, aspirin, nitroglycerin may be administered. Percutaneous coronary intervention is recommended as well.

Exercise 4. Answer the following questions:

XXI. What are all possible symptoms of IM?

XXII. Are the symptoms always clear?

XXIII. May complications appear after the heart attack?

XXIV. What types of complications may MI lead to?

XXV. Is it difficult to make a diagnosis of MI?

XXVI. What must be done when the symptoms of MI are vague?

XXVII. What is the most important thing in diagnosing and treating a heart attack?

XXVIII. What may the medical treatment of a MI include?

Exercise 5. Translate the following words and word-combinations:

Сильний грудний біль, найпоширеніший симптом, відчуття стискання, задишка, нудота та блювання, печія та нетравлення шлунку, загальне нездужання, неясні та загрозливі для життя симптоми, гострі та довго тривалі ускладнення, серцева недостатність, підтверджувати діагноз, швидка медична допомога.

Exercise 6. What symptom is described?

V. difficulty in breathing;

VI. process of eliminating fluid through the pores of the skin;

VII. burning sensation beneath the breastbone caused by irritation of the esophagus;

VIII. feeling of unease or a mild sickness;

IX. difficulty in digesting food, accompanied by abdominal pain, belching, etc.;

X. pressure in the chest;

XI. abnormal sound heard through a stethoscope over the region of the heart;

XII. any variation from the normal rhythm in the heartbeat.

Exercise 7. What do these medical terms mean?

	dyspepsia	a)	gases
	thrombus	b)	vomiting
	flatulence	c)	shortness of breath
	emesis	d)	loss of appetite
	palpitation	e)	nausea
	retching	f)	accelerated heartbeat
	dyspnea	g)	indigestion
	anorexia	h)	clot

Exercise 8. Define the meaning of each type of physical examination, then form the verbs from the given nouns:

XII. inspection a) listening with a stethoscope

XII. palpation b) looking

XII. percussion c) feeling with the hands

XII. auscultation d) tapping with a finger

Now form the verbs from the given above nouns to define the physical activity of the doctor and memorize them:

e.g. examination - to examine

E xercise 9. Fill in the table "Myocardial Infarction"

	Definition
	Causes
	Symptoms
	Complications
	Examinations: - physical - blood tests
	Treatment

Exercise 10. Re-write sentences opening the brackets:

Last year the patient Green, aged 65, (to admit) to the hospital with acute chest pain. He (to experience) shortness of breath and pain that (to radiate) to the left arm. The doctor immediately (to suspect) a heart attack and (to make) the patient (to take) an ECG. The diagnosis (to confirm) by the abnormal reading of the ECG. The blood analyses (to reveal) a number of cardiac enzymes. The cardiologist (to administer) his patient an adequate treatment. To relieve pain he (to give) nitroglycerin. Fortunately, the patient (not to have) any complications, because the doctor's help (to be) prompt and thorough. Very soon patient Green's condition (to improve).

Exercise 11. Explain the following terms:

myocardial infarction

myocardium

chest pain

arrhythmia

TEST

1) What is meant by the term myocardial infarction?

a) a heart failure b) a heart attack c) brain aneurism d) all variants are correct

2) During the myocardial infarction the heart muscle...

a) recovers b) doesn change c) dies d) nothing occurs with it

3) The heart attack is caused by the sudden blockage of a coronary artery by...

a) a blood clot b) an aneurism c) a cholesterol plaque d)

4) Blockage of a coronary artery deprives the heart muscle of... a) carbon dioxide b) water c) oxygen d) oxygen and blood

5) Injury to the heart muscle causes...

a) vomiting b) chest pain c) fever d) headache

6) The dead heart muscle is eventually replaced by... tissue a) new smooth b) striated c) new epithelial d) scar

7) The high rate of heart attacks is most frequently associated with..

a) gastric ulcers b) depression c) physical exertion and stress d) smoking

8) Any acute infection, e.g. pneumonia, can also... a myocardial infarction. a) trigger b) prevent c) avoid d) escape

9) Family history of... diseases are of great importance in myocardial infarction. a) nerve b) venereal c) heart d) endocrine

10) Heavy alcohol consumption and cigarette smoking greatly... to IM. a) contribute b) deprive c) prevent d) serve

11) The symptoms in MI are always...

a) vague b) clear c) unnoticed d) sometimes vague, sometimes clear

12) Heart attacks producing no symptoms can be... a) life-threatening b) safe c) secure d) mild

13) Acute complications may include...

a) atherosclerosis b) heart failure c) angina pectoris d) headache

14) In MI the... is done in the first turn.

a) blood analysis b) X-ray c) ECG d) urine analysis

15) The blood tests usually reveal a number of...

a) leukocytes b) protein c) cardiac enzymes d) pus corpuscles

16) Enzymes are released into the blood by the...

a) dying heart muscle b) lungs c) liver d) endocrine glands

17)... plays the most important role in diagnosing and treating a heart attack. a) medications b) prompt medical attention c) chemotherapy d) surgery

18) Medical treatment for heart attacks may include...

a) vasoconstrictors b) antibiotics c) antiplatelets d) anti-inflammatory drugs

19)... intervention is recommended as well.

a) percutaneous b) intramuscular c) intravenous d) no

20) MI.. leads to death. a) never b) always c) sometimes d) if not treated in time

Diseases of the upper respiratory tract (tonsillitis, pharyngitis, laryngitis)

1. Topic vocabulary:

On swallowing -при ковтанні

Crypt - ямка

Nonconfluent - незливаючи

To be confined to - обмежуватися

To peel away - сходити

To be inflamed - бути запаленим

Excessive use - надмірне використання

Hoarseness - хрипіння

Apparent - видимий

Tickling - першіння

Steam inhalation - парова інгаляція

2. Give the Ukrainian equivalents:

Pain on swallowing, edematous and hyperemic tonsils, purulent exudate, nonconfluent membrane, symptomatic therapy, adequate treatment, severely inflamed mucous membrane, cervical adenopathy, frequent cause, excessive use, irritating substances, prominent symptom, severity of inflammation, apparent dyspnea, laryngeal edema, marked erythema, voice rest, to relieve discomfort

3. Translate into Ukrainian. Pay attention to the translation of the Passive Voice:

1. Tonsillitis is characterized by sore throat and pain, most marked on swallowing.

2. Tonsillectomy should be considered if acute tonsillitis repeatedly develops after adequate treatment.

3.Chronic tonsillitis may be relieved only briefly by antibiotic therapy.

4. Acute pharyngitis is frequently accompanied by acute tonsillitis.

5.Mucous membrane is covered with mucopurulent secretion.

6. The bacteria may be inhaled into the respiratory passages during contact with ill persons.

7. The pharyngeal mucous membrane may be mildly red or severely inflamed.

4. Read and translate the text:

TONSILLITIS

Acute inflammation of the palatine tonsils, usually due to streptococcal or, less commonly, viral infection. Tonsillitis is characterized by sore throat and pain, most marked on swallowing and often referred to the ears. High fever, malaise, headache, and vomiting are common.

Diagnosis

The tonsils are edematous and hyperemic. There may be a purulent exudate from the crypts and a membrane—white, thin, nonconfluent, and confined to the tonsil—that peels away without bleeding.

Treatment

In viral tonsillitis, symptomatic therapy is as for pharyngitis. Tonsillectomy should be considered if, despite these precautions, acute tonsillitis repeatedly develops after adequate treatment, or if chronic tonsillitis and sore throat persist or are relieved only briefly by antibiotic therapy.

PHARYNGITIS

Acute inflammation of the pharynx. Usually viral in origin, it may also be due to a Group A or other bacteria. It is characterized by sore throat and pain on swallowing. Differentiating viral from bacterial pharyngitis on the basis of physical examination alone is difficult. In both, the pharyngeal mucous membrane may be mildly red or severely inflamed and may be covered by a membrane and a purulent exudate. Fever, cervical adenopathy, and leukocytosis are present in both viral and streptococcal pharyngitis but may be more marked in the latter.

Treatment includes aspirin, to relieve discomfort, and rest. Antibiotic therapy is usually

LARYNGITIS

Inflammation of the larynx. The most frequent cause of acute laryngitis is a viral URI. Laryngitis may also occur in the course of bronchitis, pneumonia, influenza, whooping cough, measles, and diphtheria. Excessive use of the voice, allergic reactions, and inhalation of irritating substances such as cigarette smoke can cause acute or chronic laryngitis.

Symptoms and Signs

Unnatural change of voice is usually the most prominent symptom. Hoarseness and even aphonia, together with a sensation of tickling, and a constant wish to clear the throat, may occur. Symptoms vary with the severity of the inflammation. Fever, malaise, dysphagia, and throat pain may occur in the more severe infections; dyspnea may be apparent if laryngeal edema is present. Indirect laryngoscopy discloses a mild to marked erythema of the mucous membrane that may also be edematous.

Treatment

There is no specific treatment for viral laryngitis. Voice rest and steam inhalations give symptomatic relief and promote resolution of acute laryngitis.

5. Answer the questions:

1.What is tonsillitis?

2. What are the symptoms of tonsillitis?

3. What kind of pharyngitis do you know?

4. What are the most frequent causes of laryngitis?

5. What are the symptoms of laryngitis?

6. What are the symptoms of pharyngitis?

7. What does the treatment of pharyngitis include?

6. Put questions to the underlined words:

1.Catarrhal condition of the throat decreases the patient's work capacity.

2. Bad teeth and chronic inflammation of the tonsils should receive timely treatment.

3. Pain is most marked on swallowing.

4. Dyspnea may be apparent if laryngeal edema is present.

5. Chronic tonsillitis is relieved only briefly by antibiotic therapy.

6. Symptoms vary with the severity of the inflammation.

7. Indirect laryngoscopy discloses marked erythema of the mucous membrane.

7. Open the brackets and put the verbs in the correct tense and voice:

1. Tonsillitis (to characterize) by sore throat and pain, often radiated to the ears.

2. If chronic tonsillitis and sore throat persist, the patient (to perform) tonsillectomy.

3. Pharyngitis (to characterize) by sore throat and pain on swallowing.

4.The most frequent cause of acute laryngitis (to be) a viral URI.

5. Symptoms (to vary) with the severity of the inflammation.

6.In tonsillitis a membrane (to peel away) without bleeding.

7. Indirect laryngoscopy (to disclose) a mild to marked erythema of the mucous membrane.

8. Explain the following terms:

Tonsillitis

Pharyngitis

Laryngitis

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