Myocardial infarction

Whenever the diagnosis of recent myocardial infarction is made or even suspected, it is the physician's duty to insist that the patient should be put to bed. He must remain at absolute rest until it can be assumed that a reasonable state of healing of the infarcted area has been achieved. There should hardly be any compromise with this program, particularly during the first two or three weeks, for it is during this period that the damaged muscle is undergoing necrosis and gradual replacement by fibrous tissue.

Overburdening of the heart by unnecessary effort may delay healing or cause rupture of the myocardium and death. Good nursing is a valuable adjunct.

The period of absolute rest is quite variable. In cases in which the symptoms have been minimal, the temperature and leukocyte count have been only slightly elevated and have returned to normal within a few days and there is no tachycardia or dyspnea, gradually increasing ambulation may be permitted after four or five weeks in bed. When the initial shock has been more severe and the abnormal findings have persisted for a longer period, caution should be observed in allowing the patient to get out of bed until there has been a rest period of six or eight weeks.

The persistence of fever, leukocytosis, increased sedimentation rate, tachycardia, dyspnea and chest pain is an indication that the period of bed rest should be considerably extended.

After the patient has become ambulatory, the increase in activity should be very gradual. This may require a further period of convalescence of three to six or nine months. Probably work should be attempted only part time at first and all strenuous exercise countermanded.

POST-TEXT ASSIGNMENTS

Exercise 6. Answer the questions;

1. What time must the patient remain at absolute rest?

2. How long is the damaged cardiac muscle undergoing necrosis and replacement by fibrous tissue?

3. What may delay healing?

4. In what cases should the period of bed rest be considerably extended?

5. In what cases is the rest period prolonged?

6. How long does a period of convalescent last?

Exercise 7. Give English equivalents to the following word combinations:

Первоначальный шок, поврежденная мышца, фиброзная ткань, анормальные данные, постепенное замещение, период покоя, продолжающаяся лихорадка, период выздоровления, слегка повышенное количество лейкоцитов

Exercise 8. Translate into English; pay attention to modal verbs:

1. Все энергичные упражнения должны быть противопоказаны.

2. Больной должен соблюдать постельный режим в течение месяца.

3. Лейкоцитоз, ускоренное СОЭ, тахикардия и боль в груди являются показанием к удлинению постельного режима.

4. Увеличенная нагрузка на сердце может даже вызвать разрыв миокарда и смерть.

5. Если врач подозревает инфаркт миокарда, больной должен быть уложен в постель немедленно.

Вставание с постели можно разрешить после 4-5 недель постельного режима.

Период выздоровления продолжается от 3 до 9 месяцев.

Exercise 9. Find antonyms to the following words in the text:

Bradycardia, intact muscle, restlessness, to prohibit, to stop, to accelerate, mild

Exercise 10. Make the following sentences negative:

The first two or three weeks the damaged muscle is undergoing necrosis and gradual replacement by fibrous tissue.

The patient has become ambulatory after 4 or 5 weeks in bed.

The period of absolute rest is quite variable.

Overburdening of the heart by unnecessary effort may delay healing.

All strenuous exercises should be countermanded.

Exercise 11. Explain the term in English:

a) Tachycardia,

b) leukocytosis,

c) convalescence,

d) necrosis

Exercise 12. BODY.Match the following parts of the body with the jumbled definitions on the right.

1. kidney a. organ in the head which controls thought and feeling

2. lung b. long pipe leading from the stomach which takes waste

matter from the body

3. liver c. two small, fleshy organs in the throat

4. heart d. baglike organ in which food is broken down for use

by the body

5. brain e. one of twenty-four bones protecting the chest

6. intestine f. one of a pair of organs which separate waste liquid

from the blood

7. appendix g. one of two bony parts of the face in which teeth are set

8. tonsils h. large organ which cleans the blood

9. rib i. one of a pair of breathing organs in the chest

10. stomach j. passage from the back of the mouth down inside the neck

11. jaw k. short organ of little use which leads off the large intestine

12. throat l. organ in the chest which controls the flow of blood by

pushing it round the body

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