1. Read the text and say whether the following statements are true to the text.

   1. It is very difficult to diagnose hypertension due to the fact that the symptoms are similar to many cardiovascular diseases.

   2. Hypertension has a great variety of manifestations.

2. Choose the sentences in the text to answer the following questions.

1. What are the prodromal symptoms of hypertension?

2. When do angina pectoris and myocardial infarction appear as com­plication of hypertension?

3. What can you tell about the malignant forms of hypertension?

   3. Choose the correct definitions to the following terms.

arterial pressure is markedly increased and vascular CNS, renal and cardiac deterioration occur over weeks or months instead of years, excessive salt intake increased salt and fluid in the arteriolar walls, long stand­ing exposure to stress, various malformations or conditions that decrease the compliance of the aorta or that increase the cardiac output or stroke volume of the left venticle.

Essential hypertension

Systolic hypertension

Malignant hypertension

IV. Say it in one word:

1) a thread used in surgery, especially for tying blood vessels;

2. flow of blood from the heart to the lungs and back again to the heart;

3. insufficient blood flow to a tissue;

4. introducing a catheter for diagnostic purpose;

5. weariness from labor or use.

Key: ligature; pulmonary circulation; ischemia; catheterization; fatigue.

CONTROL ASSIGNMENTS

1. Make a diagnosis of your own.

The pain is intense, generally persists longer than 15-20 min. may not be related to exertion or exercise and is not relieved by nitrates, (m). Mind:

The cardinal sign of coronary artery insufficiency is anginal pain related to either exertion or emotional stress.

2. What is characterized by the following features?

   1. The tunica consists of little more than the endothelial lining.

   2. The tunica media is thin compared with that of arteries.

   3. The tunica adventitia is the thickest layer of the vessel wall and is composed of longitudinally arranged thick collagen fibres which merge with the surrounding connective tissue. (Vein or aorta)

3. What is it?

The innermost layer of the heart, consists of an endothelial lining and its supporting connective tissue. The endothelium is a single layer of flat­tened epithelial cells, which is continuous with the endothelium of the vessels entering and leaving the heart.

The endothelium is supported by a delicate layer of fibro-elastic con­nective tissue which accomodates gross movements of the myocardium without damage to the endothelium the endocardium contains blood ves­sels, nerves and branches, of the conducting system of the heart.

What is it?Free surface of it is covered by a single layer of flattened epithelial cells, the mesothelium; a similar mesothelial layer lines the opposing pari­etal pericardial surface. The mesothelial cells secrete a small amount of serous fluid which lubricates the movement of the epicardium on the pari­etal pericardium. A thin layer of fibro-elastic connective tissure supports the mesothelium; this layer is connected to the myocardium by a broad layer of adipose connective tissue.

DOCTORS and PATIENTS

Patient: Can this operation be performed safely, doctor?

Doctor: That, my dear sir, is just what we are about to discover.

* * *

Young Doctor: Why do you always ask your patients what they have for dinner?

Old Doctor: It's a most important question, for according to their menus I make out my bill.

* * *

• I saw the doctor today about my loss of memory.

• What did he do?

Made me pay him in advance

.,, . TEXTS FOR INDIVIDUAL READING

/

, -r ANGINA PECTORIS

^? • . rff^e*, ACtU^K >

Acute coronary insufficiency and coronary failure Jare terms often

used to describe a syndrome characterized by prolonged substernal pain? due to severe inadequacy of the coronary circulation.

The anginal syndrome is caused by a temporary inability of the coro­nary arteries to supply sufficient oxygenated blood to the heart muscle. The pain is thought to be due to stimulation of afferent nerve endings in the myocardium by accumulation of unoxidized metabolic products result­ing from myocardial anoxia.

Pain in the chest is the outstanding clinical manifestation. Its loca­tion, distribution, type, duration and relation to increased cardiac work are characteristic. The distress usually is localized behind the sternum.,... and only rarely in the apical region or left anterior^ axilla ry line. Occasionally it is located in the neck, shoulder, or epigastrium.! Ц fre- quently radiates to the left shoulder, then down the left arm to the elbow.

or even as far as the finger tips - uncommonly to the right shoulder and arm.

The pain may be^calied more appropriately a feeling of oppression or distres^an3^aTs~trsimlly described as squeexing, crushing, or viselikc, rather than sharp or knifeliKeTThe intensity varies from mild, substernal discomfort to severe and incapacitating distress. The typical seizure lasts -H^j^ia^B^g^ggTJxceptionally, an attack may persist as long as 30 To" 60 minutes, but this is highly suggestive of myocardial infarction^JThe patient usually relates the attack to exertion^ overeating, or an emotion­al upset, and notes thaf iTdisappears with rest. Other symptoms^aTtimes are~palpitation, faintness, dіzz7rtess'i "dyspnea, and digestTve^disturbances.

'Angina pectbris'lacks typical physical "fffldings, objective signs vary­ing with the nature of the underlying disorder. Hypertension, cardiac enlargement, valvular heart disease, cardiac arrhythmias and peripheral arteriosclerosis are not uncommon. T^eJalfiQcLfi^seure^frequently is ele- ^atedjiujriag tbe^fieriod qf^aijb In many .casesj howey_er, .110 cardiovascu­lar abnormalities can be d^tected_on physical examination.

1. Read the text, try to divide it into several independent parts. Define the main subject of each paragraph.

2. Read and translate the paragraph containing the discription of location of the pain in angina pectoris.

3. Read the text and give Ukrainian equivalents of the following words and word combinations. Use them in sentences of your own.

Coronary insufficiency, myocardial anoxia, substernal pain, clinical manifestation, temporary inability, heart muscle, substernal discomfort, emotional upset, digestive disturbances, cardiac arrhythmias, cardiovas­cular abnormality.