Text A. Rheumatic Endocarditis

The patient complained of a general malaise, early fatigue on exertion, car­diac discomfort and palpitation.

The physician found him to have been having an increase of body tempera­ture to a subfebrile level for a prolonged period of time. The patient stated that the onset of the disease had been preceded by tonsillitis. The patient's pulse rate had become irregular and accelerated on physical exertion.

The blood analysis revealed moderate leucocytosis and an elevated ESR. The electrocardiogram showed the changes in the most important readings. On

percussion the doctor determined the heart to be slightly enlarged. These find­ings of the physical examination were confirmed by the X-ray examination.

While listening to the patient's heart the doctor found a soft systolic mur­mur to be heard at the heart apex. These symptoms were accompanied by dias­tole murmur heard at the apex and base of the heart. The doctor estimated the murmurs to be varying in their intensity and duration. It was evidence of an inflammatory process in the valves. The doctor determined the organic changes in the mitral, aortic and tricuspid valves to be clearly marked.

The physician considered the patient to be ill with rheumatic endocarditis and insisted on his following a strict bed regimen at the in-patient department.

IX. Ответьте на следующие вопросы:

1. What most characteristic clinical manifestations has rheumatic endocardi­tis? 2. What readings does the electrocardiogram show in case of rheumatic endocarditis? 3. How can a therapeutist determine the enlargement of the heart? 4. How can systolic and diastolic heart murmurs be revealed in patients with rheumatic endocarditis? 5. What regimen must a patient with rheumatic en­docarditis follow?

X. Выучите следующие слова. Предложения переведите:

insufficiency [, ins9'fi/9nsi] n недостаточность. Cardiac insufficiency was diagnosed in this patient.

eliminate [I'limmeit] v устранять; ликвидировать, уничтожать. The pain was eliminated due to the administration of this drug.

nourish ['плпГ] v питать, кормить; to be well nourished быть хорошо упитанным, повышенного питания. The patient was a well nourished male.

tablespoonful ['teibl, spu: nful] n столовая ложка чего-л. You must take a tablespoonful of this medicine.

preparation [, ргерэ'ге1|п] n препарат; приготовление. Adonis preparations are administered in case of rheumatic endocarditis.

follow-up ffblgu 'лр] п отдаленные результаты; последующее наблюдение врача; больной, состоящий на учете; а последующий; v проследить отдаленные результаты; наблюдаться по поводу отдаленных результатов. The patient was followed-up at the out-patient department. The follow-ups did not reveal any patho­logic signs. You must come for the follow-up examination in a month.

undergo [/nda'gau] (underwent, undergone) v подвергаться; испытывать, переносить. The patient underwent the operation last month.

recurrence [n'kArans] n возвращение; повторение; рецидив. The recur­rence of the disease was rather unexpected.