UNIT 4: CARDIOVASCULAR CARE

TERMS & COLLOCATIONS

Animated structure of the human heart:

https://www.youtube.com/watch?v=_CfTAmgRRO4

Stroke Volume (SV) = the volume of blood in millilitres ejected from each ventricle due to the contraction
of the heart muscle which compresses these ventricles.

artery = a blood vessel that delivers oxygen-rich

(=oxygenated) blood from the heart to the tissues of the
body

arteriole [ a:´tiərioul ] = the smallest arterial vessel with a

diameter of less than 100 μm

aorta [ ei´ɔ:tə ] = the main and largest artery in the human

body, originating (=stemming ) from the left ventricle of the
heart and extending down to the abdomen, where it splits
into two smaller arteries.

venule [ ´venju:l ] = а small vein, especially one that connects capillaries to a larger vein

valve = a one-way opening that allows blood to flow in one direction through the chambers

capillary [ kə´piləri ] = the thinnest blood vessel that connects arterioles to venules

superior and inferior vena cava [ ¸vi:nə´keivə ] = the two largest veins in the body which carry oxygen-
depleted blood from various regions of the body to the right atrium

hemoglobin [ ¸hi:mou´gloubin ]

red blood corpuscle [ ´kɔ:pʌsl ] = red blood cell

blood pressure = a measure of the force that the heart uses to pump blood around the body

Systole ([ ´sistəli ]) is defined by the following characteristics: systolic pressure

- The heart muscle contracts.
 - When the heart contracts, it pushes the blood out of the heart and into the large blood vessels of
the circulatory system. The blood goes to all of the organs and tissues of the body.
- During systole, a person’s blood pressure increases.

Diastole ([ dai´æstəli ]) is defined by the following characteristics: diastolic pressure

- Diastole is when the heart muscle relaxes.
- When the heart relaxes, the chambers of the heart fill with blood, and a person’s blood pressure
decreases.

sinoatrial node (SN) = an oval shaped region of special

cardiac muscle in the upper back wall of the right
atrium made up of cells known as pacemaker cells

atrioventricular node (AV) = an electrical gatekeeper

between the atria and ventricles and introduces a
delay between atrial and ventricular excitation,
allowing for efficient ventricular filling

the bundle of His = a collection of heart muscle cells

specialized for electrical conduction (named after Swiss cardiologist Wilhelm His Jr., who discovered them
in 1893)

Purkinje fibres ([pə ‘kindʒi]) are branched fibres that carry the electrical impulse to the ventricles. It is
branched into both the right and left bundle branches of the heart, and runs through the interventricular
septum (named after Czech anatomist Jan Purkinje)

endocardium [ ¸endou´ka:diəm ] = the innermost layer

of tissue that lines the chambers of the heart

myocardium = the thickest and middle muscular layer

of the heart

epicardium [ ¸epi´ka:diəm ] = innermost layer of the

pericardium

pericardium = pericardial sac

 Plasma

About 55% of our blood is plasma, and the remaining

45% are red blood cells, white blood cells and platelets
that are suspended in the plasma. Plasma is about 92%
water. Plasma performs several functions: transporting
blood cells and nutrients, regulating the body’s water
and mineral salts, irrigating tissues, providing a defense
against infections and coagulating blood. (to irrigate [´iri¸geit] = to moisten, to wet)

Blood types are also important for plasma transfusions, but the rules are different than the rules for red
blood cells transfusions. For instance, people with type AB blood are universal plasma donors, and they can
only receive type AB plasma. Plasma is separated from whole blood through centrifugation. ([¸sentrifju
´geiʃən]) Plasma can be used to create up to 13 different blood products. These blood products help to
treat burn victims, kidney patients, chemotherapy patients, people who’ve lost a lot of blood, or have
recently had major surgery, and especially, boost the immune system of people who cannot make
antibodies.

wound irrigation = the process of washing or flushing a wound (orifice, etc.) with water or medicine before
dressing

blood clotting = coagulation

hemorrhage = bleeding from a damaged blood vessel

The shape of the human red blood cell is known to be a bi-concave disk.

bi-concave disc = discocyte= a geometric shape resembling an oblate spheroid with two concavities on the
top and on the bottom.

An electron micrograph of blood cells. From left to right: human

erythrocyte, activated platelet, leukocyte.

RBCs have no nucleus ([ ´nju:kliəs ] pl. nuclei [´nju:kliai]) so they can carry
more hemoglobin, and thus, more oxygen.
 Shape of platelets (thrombocytes)

Cardiovascular diseases (CVDs)

FUNCTIONS OF THE CIRCULATORY SYSTEM

The Cardiovascular system is a vital organ system that delivers essential substances to all cells for basic
functions to occur. It is a network composed of the heart and bloods vessels that distribute blood
throughout the body for transportation of different substances. The circulatory system is divided into two
separate loops: The shorter pulmonary circuit ([´sə:kit]) exchanges blood between the heart and the lungs
for oxygenation. The longer systemic circuit distributes blood throughout all other systems and tissues of
the body. Both of these circuits begin and end in the heart. The main function of the circulatory (or
cardiovascular) system is to deliver oxygen to the body tissues, while simultaneously removing carbon
dioxide produced by metabolism. Oxygen is bound to molecules called haemoglobin that are on the
surface of the red blood cells in the blood. The Cardiovascular systems also nourishes, removes metabolic
wastes and keeps temperature at a normal level.

Symptom vs. Sign

A symptom is a manifestation of disease apparent to the patient himself, while a sign is a manifestation of
disease that the physician perceives. The sign is objective evidence of disease; a symptom is subjective.

Shaking chills (rigors) are the body's reaction to a severe infection or to the release of viruses or bacteria
into the bloodstream.

strenuous physical activity [ ´strenjuəs ] = intense

tachycardia [ ¸tæki´ka:diə ] = a heart rate over 100 beats a minute. It can be secondary to many types of
irregular heart rhythms (arrhythmias).

Ischemia [ is´ki:miə ] = a vascular disease involving an interruption in the arterial blood supply to a tissue,
organ, or extremity that, if untreated, can lead to tissue death. It also means local hypoxia in a given part
of a body sometimes resulting from constriction (such as vasoconstriction, thrombosis or embolism).

Types of Ischemia: cardiac, brain, cutaneous, kidney, limb ischemia

Plaques made up mostly of cholesterol build up on your artery walls and restrict blood flow.
Atherosclerosis is the most common cause of myocardial ischemia. Ischemia can be partial (poor
perfusion) or total blockage.

Crackles or crepitations are short, explosive sounds heard on auscultation of the chest. They may be fine or
coarse in character, and may be cleared by coughing (if due to secretions).

dysphagia [dis ‘feidʒə] = a difficulty in swallowing

eye manifestations = ocular symptoms that result from a primarily non-ocular disorder or injury
e.g. The most common ocular manifestations of COVID-19 were dry eye or foreign body sensation,
redness, tearing, itching, eye pain and discharge.

Laboratory Values

mmol = millimole is the amount of a substance equal to a thousandth of a mole (a measure of the amount
of a substance)

High-density lipoprotein (HDL) cholesterol is known as the "good" cholesterol.

Low-density lipoprotein (LDL) cholesterol is sometimes called “bad” cholesterol.

TSH stands for thyroid stimulating hormone.

Free thyroxin (FT4) can assist in determining whether the thyroid is performing properly. It aids in the
diagnosis of hypothyroidism or hyperthyroidism.

Free Triiodothyronine (FT3) is one of the main hormones produced by the thyroid gland.

The thyroid gland is an endocrine gland ([´endou¸krain]) in your neck. The two main hormones your thyroid
releases — thyroxine (T4) and triiodothyronine (T3) — collectively make up thyroid hormone. The Thyroid
hormone is the hormone that controls your body's metabolism, the process in which your body transforms
the food into energy.

Anti-thyroid peroxidase (anti-TPO) antibodies - their presence in the blood suggests that the cause of
thyroid disease is an autoimmune disorder, such as Hashimoto's disease or Graves' disease. In autoimmune
disorders, your immune system makes antibodies that mistakenly attack normal tissue.

Anti TG (TAT) = antithyroglobulin antibodies are associated with Hashimoto's disease

C-Reactive Protein (CRP) = a protein that your liver makes. High levels of CRP may mean you have a
serious health condition that causes inflammation.

to be susceptible to [sə´septibl] = to be prone to = to be disposed to = to be liable to = to be subject to =

vulnerable to [´vʌlnərəbl]
e.g. to be prone to varicose veins ([ ´væri¸kous ])
e.g. to increase the susceptibility to congenital heart disease in the fetus

a natural inclination to = = disposition to = predilection to

e.g. The disease shows a recognized male predilection.

THE EPIDEMIOLOGIST’S BATHTUB

Incidence refers to only new cases of a disease = new occurrences

Prevalence refers to all (new + old) cases of a disease.
Recurrence refers to cases developing a secondary occurrence of a disease.
Remission refers to cured cases.
Mortality refers to fatalities/ casualties. [´kæʒjuəlti]
 DESCRIBING TRENDS AND DEVELOPMENT

Examples:

slight fall in the prevalence of obesity among children and

The graph shows that
steep rise adolescents aged 2 - 19 years since 2018 (up to
there has been a
sharp drop now).
steady decline
Figure 2 reveals that
gradual increase (Use the Past Simple Tense if you talk about
there has been a
marked decrease tendencies in the past, e.g. between 2002 - 2014)

roughly [´rʌfli] = approximately (approx.) = around = about

Fig 1. Out-of-hospital cardiac arrest during the COVID-19 pandemic

Fig 2. Trends in obesity among children and adolescents ages 2–19 years, by age: United States

to dismantle a myth/a belief = to debunk = to discredit = to disempower = to expose the falsehood of a

common misconception

to curb the obesity epidemic = to restrain = to check (=to stop)

e.g. China's Guangzhou on Wednesday imposed COVID-19 curbs in parts of the city, joining
Shenzhen in battling local flare-ups.

to resort to [ ri´zɔ:t ] = to do something as a final available option or resource

e.g. in the last resort = as a last resort / She resorted to several traditional medicines and
herbal concoctions to treat her cough.

to deter [ di´tə: ] (-rr-) = to prevent, to discourage, to restrain

e.g. Risk factors deterred the patients from participating in the test.
to conduct a study = to carry out research

in exchange for = instead of

e.g. a handful of nuts in exchange of a bag of crisps
chubby = plump e.g. chubby face

compulsion [ kəm´pʌlʃən ] = (in Psychology) an irresistible urge to behave in a certain way

Obsessive compulsive disorder (OCD) features a pattern of unwanted thoughts and fears (obsessions) that
lead you to do repetitive behaviors (compulsions). These obsessions and compulsions interfere with daily
activities and cause significant distress. You may try to ignore or stop your obsessions, but that only
increases your distress and anxiety. Ultimately, you feel driven to perform compulsive acts to try to ease
your stress. Despite efforts to ignore or get rid of bothersome thoughts or urges, they keep coming back.
This leads to more ritualistic behavior — the vicious cycle of OCD.

Examples of obsession signs and symptoms include:

  Fear of being contaminated by touching objects others have touched
 Doubts that you've locked the door or turned off the stove
 Intense stress when objects aren't orderly or facing a certain way
 Images of driving your car into a crowd of people
 Thoughts about shouting obscenities (= use offensive language) or acting inappropriately in public
 Unpleasant sexual images
 Avoidance of situations that can trigger obsessions, such as shaking hands

Symptoms usually begin gradually and tend to vary in severity throughout life.

respondent to a poll/ in a survey = participants

The findings are alarming. (= disturbing = worrying)

waist circumference [sə:´kʌmfərəns] = perimeter

to crave comfort food/ chocolates = to long for = to desire strongly

Comfort foods not only taste good, they actually lessen the impact of stress hormones. Eating sweet and
starchy food helps our bodies make serotonin which makes us feel calmer, and decrease the stress
hormone cortisol.

a paroxysm of coughing = a fit of / a bout of coughing

paroxysmal [ ¸pærək´sizməl ] = occurring periodically, especially with brief episodes = recurrent

Infarction = tissue death (or necrosis) due to inadequate blood supply to the affected area. It may be
caused by artery blockage, rupture, mechanical compression, or vasoconstriction. Infarction care is divided
based on histopathology (white infarction and red infarction) and location (heart, brain, lung, spleen,
intestines)

varicosity = the state of having varicose veins which become enlarged, dilated and overfilled with blood

Heart murmurs = sounds, such as whooshing or swishing — made by rapid, choppy (turbulent) blood flow
through the heart. They are audible on auscultation. A typical heartbeat makes two sounds, sometimes
described as "lub-DUP" when the heart valves are closing.

Venous drainage refers to the perfusion of blood to different regions of the body. The veins of the lower
limb drain deoxygenated blood and return it to the heart.

Surgical drains are tubes

placed near surgical incisions in
the post-operative patient, to
remove pus, blood, urine, bile,
etc. preventing it from
accumulating in the body.

catheter [´kæθitə ] = a flexible

or rigid hollow tube, employed
to drain fluids from body
cavities or to distend body
passages, especially one for
passing into the bladder through the urethra to draw off urine or into the heart through a leg vein or arm
vein for diagnostic examination.

Coronary angiography [¸ændʒi´ɔgrəfi] = x-ray examination of blood vessels or lymphatics following

injection of a radiopaque substance (a contrast dye).

COMMON TESTS TO CHECK CARDIOVASCULAR HEALTH

Magnetic resonance imaging (MRI) = a medical imaging technique that uses a magnetic field and
computer-generated radio waves to create detailed images of the organs and tissues in your body

Electrocardiogram (ECG or EKG) = a medical test that detects heart problems by measuring the electrical
activity generated by the heart as it contracts

Cardiac ultrasound, or echocardiography (ECHO) = a type of ultrasound scan using a small probe to send
out high-frequency sound waves that create echoes when they bounce off different parts of the body

Exercise Stress Test (EST) = an ECG performed under conditions of gradually increasing physical exercise.
“Stress” is exerted (=placed, put, exercised) on the heart and cardiovascular system by running on a
treadmill or pedalling an exercise bike.

Positron Emission Tomography (PET) scan = an imaging test that produces detailed 3-dimensional images
of the inside of the body. It can help reveal the metabolic or biochemical function of your tissues and
organs. The PET scan uses a radioactive drug (tracer) to show both normal and abnormal metabolic
activity.

Lipid Profile/ Panel = a blood test that measures: total cholesterol, LDL cholesterol, HDL cholesterol,
Triglycerides (a lipid that causes hardening of the arteries).

Cardiac Catheterisation (Cardio Cath)= an invasive diagnostic procedure that provides important
information about the structure and function of the heart. It usually involves taking X-rays of the heart's
arteries (coronary arteries) using a technique called Coronary angiography or arteriography.

a placebo [pləˈsiːbou] = a sham substance or treatment which is designed to have no known therapeutic
value. Common placebos include inert tablets (like sugar pills), inert injections (like saline), etc.
placebo effect = a beneficial health outcome resulting from a person's anticipation (=expectation) that an
intervention will help

concussion [ kən´kʌʃən ] = a type of traumatic brain injury (TBI), caused by a bump, blow, or jolt to the
head or by a hit to the body that causes the head and brain to move rapidly back and forth

a heroin addict
addiction to (drugs, alcohol, , marijuana [ˌmær.əˈwɑːnə], sedatives, stimulants, hallucinogens, caffeine,
cocaine, sex, gambling, etc.)

coronary heart disease = buildup of plaque

Congenital heart disease (CHD) = birth defects in the heart’s structure

 Coronary bypass surgery creates a new path for
blood flow to the heart. A healthy blood vessel
from another part of the body is used to redirect
blood around a blocked area of an artery. A blood
vessel from the leg (saphenous vein bypass) or
chest (internal mammary artery) may be used.

graft = transplant

grafting procedure

to stitch = to suture [ ´su:tʃə ]

Symptoms of myocardial infarction

During an infarction, a sub febrile fever could also arise (=low-grade fever 37.5° - 38.3°C). Patients often
exhibit (=present with) respiratory issues to the point of passing out. The doctor immediately recommends
an ECG. The ECG clearly exhibits the signs of infarct, which are necrosis, lesions ([´li:ʒən] = tissue damage), and
ischemia. The conversation between doctors and patients is undervalued (=to underestimate = to
overlook) aspects of medical care.

Angina pectoris
Angina pectorus [ æn´dʒainə ´pektəris ] = stenoncardia = a syndrome characterized by paroxysmal,
constricting pain below the sternum, most easily precipitated (= to precede [ pri´si:d ] ) by exertion (= effort,
strain) or excitement and caused by ischemia of the heart muscle, usually due to a coronary artery disease,
as arteriosclerosis (=atherosclerosis)

Patients who experience angina pain, are usually very agitated ([´ædʒi¸teitid]= excited, disturbed) and anxious, at
times pale, perspiration (=sweating) visible on the forehead, scared of potential imminent (=pending)
death. During the examination of the patient, tachycardia or extrasystoles (irregular) can be detected. They
could be suffering from high arterial blood pressure, but not very high values. Temperature is normal, no
fever is usually observed. Blood examinations such as leukocyte tests, glycemic tests ([glai’si:mik]) show no
change in normal values, as opposed to ([ ə´pouzd ] =in contrast to = compared to) a case of myocardic
infarction.

The doctor can run a differential diagnosis between a myocardic infarction, where pain is more severe and
prolonged, and could occur regardless of (=irrespective of) physical exertion (=strain). Pain in angina
pectoris is shooting and could last from 5 minutes to entire days.

Angioplasty [‘ædʒioplasti:] = a procedure that uses a balloon-tipped catheter to open a blocked blood
vessel and improve blood flow. The doctor uses medical imaging, typically live x-rays, to thread and guide
the catheter across the blockage. Once the balloon spans the blockage, it is inflated to open the blocked
vessel and improve blood flow. It may be done with or without a metal mesh tube called a stent. If a stent
is used, it will be left inside the blood vessel to help keep it open.

The patient’s heart is skipping a beat. / The hearts pounds. = beats

somnolence [ ´sɔmnələns ] = the feeling of drowsiness/sleepiness

vertigo [ ´və:tigou ] = dizziness = light-headedness

vitiligo [ ¸viti´laigou ] = a long-term condition where pale white patches develop on the skin, caused by the
lack of melanin (skin pigment)

Ventricular fibrillation (VF) = a type of arrhythmia, or irregular heartbeat, that affects your heart's
ventricles. The only effective treatment for VF is an electrical shock called defibrillation. Defibrillation is an
electrical current applied to the chest. The electrical current passes through the heart with the goal of
stopping the VF and providing an opportunity for the heart's normal (=spontaneous) electrical system to
take control.

to be bed-ridden = to be confined to bed due to illness, injury, etc.

insect-ridden carpet/ bedding = full of insects

Bipolar disorder = it causes extreme mood swings that include emotional highs (mania [´meiniə] or
hypomania) and lows (depression). = manic disorder

Schizoaffective disorder = a mental health disorder marked by a combination of schizophrenia ([¸skitsou

´fri:niə]) symptoms, such as hallucinations or delusions, and mood disorder symptoms, such as depression
or mania.

The patient has a past medical history notable for (= significant for) a myocardial infarction (MI).

afebrile [ æ´fi:brail / æ´febrəl ] = not feverish

bradycardia [ ¸brædi´ka:diə ] = a slow heartbeat rate, usually less than 60 beats per minute. ≠ tachycardia

OPEN QUESTIONS:

1. What is blood plasma? What are its functions in the human body? How can plasma be obtained? What is
plasma used for?

2. What are the functions of the circulatory system?

3. What is systole and diastole?

4. What is Ischemia: cause, types?

5. What are Obsessive Compulsive Disorders (OCD)? What are examples of obsession signs and symptoms?

6. What does “infarction” refer to?

7. What does the procedure of Cardiac catheterization involve? [ ¸kæθitərai´zeiʃən ] What is stenting and
the risks involved?

8. What are the most common tests to check cardiovascular health? Explain each one briefly.

Homework Assignments:

1. Complete Tasks 3B, 5 (Watch the video in the link at the beginning of the file).
2. Examine Figure 1 and Figure 2 and write one sentence for each graph, using the expressions for
describing trends and development.

3. Complete Task 10A, 16.

4. Watch the following YouTube video and report on the procedure. What are the risks involved in
stenting? https://www.youtube.com/watch?v=pWfGjNeUyo8

5. Make sure you are able to answer the above questions (in green).

 This is illegible handwriting!