1. Choose the sentences from the text to answer the following

questions.

1. What causes aortic insufficiency?

2. Where is the leak formed?

3. Why does blood pressure rise?

4. How many types of aortic insufficiency do you know?

5. What are the patient's complaints?

1. Give English equivalents of the following and use them in the

sentences of your own.

Недостатність клапана, аортальна недостатність, шлуночок, розширювати, периферійні артеріоли, пошкодження, розширення, підозрювати, гіпертрофоване серце, тріпотіння, поверхня мітрального клапана.

3. Point out gerundial constructions in the following sentences.

Translate them.

1. A person's becoming immune to an infectious disease after he had once had it gave rise to the question of artificial immunity.

2. Causative agents having penetrated in the body doesn't necessari­ly cause infectious disease.

3. The onset of rheumatic fever began with the child's sleeping poor­ly, losing his appetite and running a subfebrile fever in evenings.

4. Of considerable importance is the necessity of the medical stu­dent's acquiring knowledge related to infection.

IV. Give the summary of the text according to the following points.

1. Formation of the lesion in the aortic valve.

2. Impaired work of the left ventricle.

3. Three types of aortic insufficiency.

4. Role of arteriosclerosis in formation of valvular lesion and decom­pensation.

5. Patient's complaints.

ENDOCARDITIS

By endocarditis is meant inflammation of the endocardium, the endothelial layer which lines the heart's cavities and covers the flaps of its valves. On each spot of this membrane which becomes inflamed there forms a fibrin clot, called a vegetation, which later becomes a mass of scar tissue invading the surrounding tissues. A clot formed on the wall of one of the heart's cavities is called a mural thrombus.

SIMPLE RHEUMATIC ENDOCARDITIS

Rheumatic endocarditis anatomically manifests itself first by tiny translucent vegetations, which resemble beads about the size of the head of the pin, arranged in a row along the free margins of the valve flaps. These tiny beads look harmless enough and may disappear without injur­ing the valve flaps, but more often their results are serious, for they are the starting point of a process which gradually thickens the flaps, after years rendering them just a little shorter, just a little thicker than nor­mal, just a little shrivelled along their edges - not much, but enough to prevent them from perfectly closing the orifice of the valve. Hence a leak develops. In other cases the inflamed margins of the valve flaps become adherent to each other, thus narrowing the valve orifices.

Clinically in cases of rheumatic fever it is often difficult to tell just when the endocarditis begins, and the seriousness of the faint murmur heard during the fever is not recognized until months after the arthritis has subsided. Possibly in those cases, which seem to develop indepen­dently, a very mild arthritis may have been present but was disregarded. Often the injury is discovered accidentally later in life. In cases of rheumatic endocarditis usually more than one valve is involved, but prac­tically always the mitral.