Card 1 Read and translate the text

Card 20
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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 sub febrile level for a prolonged period of time. The patient slated 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 leukocytosis 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.

Revmatik endokardit

Bemor umumiy bezovtalikdan, kuch sarflashda erta charchoqdan, yurak bezovtaligidan va yurak urishidan shikoyat qildi.

Shifokor uni uzoq vaqt davomida tana harorati pastki febril darajaga ko'targanligini aniqladi. Bemor kasallikning boshlanishidan oldin tonzillit bilan kasallanganligini aytdi. Bemorning yurak urishi tezligi tartibsiz bo'lib, jismoniy kuch bilan tezlashdi.

Qonni tahlil qilishda o'rtacha darajadagi leykotsitoz va yuqori ESR aniqlandi. Elektrokardiyogram eng muhim ko'rsatkichlardagi o'zgarishlarni ko'rsatdi. Perkussiyada shifokor yurakning biroz kattalashganligini aniqladi. Ushbu fizik tekshiruv natijalari rentgen tekshiruvi bilan tasdiqlangan.

Shifokor bemorning yuragini tinglar ekan, yurak tepasida yumshoq sistolik shovqinni eshitdi. Ushbu alomatlar yurak cho'qqisi va pastki qismida eshitilgan diastol shovqini bilan kechdi. Shifokor shovqinlarni intensivligi va davomiyligi bo'yicha har xil deb taxmin qildi. Bu klapanlardagi yallig'lanish jarayonining dalili edi. Shifokor mitral, aorta va trikuspid qopqog'idagi organik o'zgarishlarni aniq belgilashni aniqladi.

Shifokor bemorni revmatik endokardit bilan kasal deb hisobladi va statsionar bo'limida qattiq yotish rejimiga rioya qilishni talab qildi.