Shadowing-Übung: Hypertrophic Cardiomyopathy Made Easy | (Includes Hypertrophic Obstructive Cardiomyopathy & SAM) - Englisch Sprechen Lernen mit Video
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Hypertrophic cardiomyopathy is a genetic disorder of the cardiac muscle tissue,
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characterised by abnormal thickening of the cardiac muscle without any clear cause.
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It is the second most common cardiomyopathy with a prevalence of around 1 in 500,
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and it is the most frequent cause of sudden cardiac death in young patients.
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Overall, males and females are equally affected.
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However, females are more likely to present at an older age with more significant heart failure.
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All ethnicities can be affected.
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However, a form of hypertrophic cardiomyopathy affecting the apex is significantly more prevalent in Asian people.
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It is inherited in an autosomal dominant fashion and the genetic abnormalities occur primarily in genes that code for sarcomere proteins.
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40 % are in the gene coding for beta myosin heavy chains on chromosome 14
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and 40 % in the cardiac myosin binding protein C gene.
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In total over 150 mutations have been identified to be involved with this condition.
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These mutations lead to altered translation efficiency,
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followed by changes in the signaling pathways and ultimately leading to changes in the histology,
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including myocyte hypertrophy and fibrosis.
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This leads to parts of the heart becoming thicker than usual.
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The most commonly affected areas are the interventricular septum and the left ventricle, although any part can be affected.
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The left ventricular outflow tract is particularly susceptible to encroachment from the thickening of the septum,
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leading to obstruction of the left ventricular outflow tract.
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This is known as hypertrophic obstructive cardiomyopathy and is seen in around 25 % of those with hypertrophic cardiomyopathy.
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A unique feature of this obstruction is that it is dynamic, meaning it is not fixed.
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The left ventricular outflow tract is encroached in these patients due to the increased size of the interventricular septum,
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particularly evident during systole.
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Another feature that contributes to the obstruction is systolic anterior motion,
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or SAM, which is the anterior movement of the mitral valve during systole leading to worsening of the outflow tract obstruction.
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This is best seen on a parasternal view on echocardiography.
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Although it is not specific for hypertrophic cardiomyopathy it is more commonly seen.
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Several other factors can also contribute to the dynamic nature of the obstruction such as contractility for example during exercise
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which causes a more forceful contraction and a greater degree of obstruction.
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A reduction in preload can also worsen the left ventricular outflow tract obstruction,
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where preload is the volume in the ventricle at the end of diastole.
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Examples that reduce preload include hypovolemia, vasodilation, such as after administration of nitrates,
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and tachycardia that reduces preload due to shorter diastolic filling time.
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The smaller left ventricular volume facilitates the systolic anterior motion of the mitral valve.
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Over time, as the fibrosis increases, the ventricle becomes stiffer and less compliant, leading to diastolic heart failure,
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also known as heart failure with a preserved ejection fraction.
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A marker of this is increased pressure in the left atrium, which increases the risk of arrhythmias like atrial fibrillation.
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In long -standing cases, the interstitial fibrosis and the left ventricular outflow tract obstruction lead to thinning of the left ventricle,
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eventually producing a systolic failure.
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Often, patients are asymptomatic.
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When symptoms are present, they are usually the result of four main mechanisms.
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First is diastolic dysfunction, leading to increased left atrial pressure and pulmonary vein pressure.
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This is exacerbated in exertion, giving exertional dyspnea.
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It can also manifest as orthopnea, which is breathlessness when lying flat,
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and paroxysmal nocturnal dyspnea, which is sudden onset shorness of breath during sleeping.
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Peripheral edema is another possible or finding.
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Secondly, we have obstruction of the left ventricular outflow tract which can also cause dyspnea but can cause syncope,
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especially during exercise.
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Next we have arrhythmias which can include atrial fibrillation which is seen in around 25 % of patients,
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ventricular tachycardia and ventricular fibrillation.
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These can lead to palpitations, lightheadedness or syncope, shortness of breath and chest pain.
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We also mentioned earlier
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that hypertrophic cardiomyopathy is the most common cause of sudden cardiac death in young patients and this is largely due to arrhythmias.
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This brings us to the fourth mechanism, an imbalance between the myocardial oxygen supply and the demand.
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Oxygen supply is reduced because the flow of blood through the hypertrophy tissue is lower,
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while there is an increase in the demand due to the thicker myocardial tissue.
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This can cause chest pain that may have typical features of angina.
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For the diagnosis, a physical exam will often reveal a mid -systolic murmur best heard at the left sternal border.
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An ECG may show left ventricular hypertrophy voltages shown by large amplitude QRS complexes
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and possibly Q waves that are distinguished from previous infarctions by having a width of less than 40 milliseconds.
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The diagnosis of hypertrophic cardiomyopathy is based on abnormal thickening.
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This is defined as a thickness of the interventricular septum of 15 millimeters or greater,
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or 13 millimeters with a family history or genetic background.
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It can be difficult to distinguish between hypertrophic cardiomyopathy and physiological hypertrophy seen in athletes.
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A possible distinguishing feature is that the volume of the cavity in physiological hypertrophy is not reduced,
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whereas the volume is reduced in hypertrophic cardiomyopathy.
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An asymmetrical distribution of the hypertrophy also favours hypertrophic cardiomyopathy.
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The primary therapy is the use of beta blockers as they serve to reduce contractility and to increase diastolic filling time.
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Calcium channel blockers are options in patients not responsive to beta blockers or in patients in whom beta blockers are contraindicated.
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In patients who have developed heart failure, diuretics may be useful, however, must be used with care in order to avoid hypovolemia,
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which as we said, can precipitate the left ventricular outflow tract obstruction.
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Higher risk patients, such as athletes, patients with previous ventricular fibrillation or tachycardia,
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symptomatic patients, patients with significant thickening of the septum or ventricular wall, typically defined above 30 mm,
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or a family history of sudden cardiac death should be considered for an implantable cardioverter defibrillator, known as an ICD.
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Septal myomectomy or ablation can be considered in patients with severe obstruction that despite pharmacotherapy are still symptomatic.
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Thank you.
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Wortschatz und Sprechhinweise zu dieser Lektion
Diese Sprechübung basiert auf dem Video „Hypertrophic Cardiomyopathy Made Easy“. Diese Wörter kommen am häufigsten vor: ventricular, patients, cardiomyopathy, obstruction, hypertrophic. Dieses Video enthält 76 Sätze und 1004 Wörter zum Nachsprechen. Der gesprochene Teil dauert 8:40. Der Sprecher spricht gleichmäßig mit etwa 116 Wörtern pro Minute – ein angenehmes Tempo fürs Shadowing. Nur 67 % der Wörter gehören zu den 3.000 häufigsten im Englischen, der Wortschatz ist also anspruchsvoll.
Wichtiger Wortschatz in diesem Video
15 lernenswerte Wörter aus dem Video, mit Aussprache und Bedeutung:
| Wort | Aussprache | Bedeutung |
|---|---|---|
| obstruction Substantiv | /əbˈstɹʌk.ʃən/ | Obstruktion, Verhinderung |
| tract Substantiv | /tɹækt/ | Gebiet |
| cardiac Adjektiv | /ˈkɑɹdiˌæk/ | Herz- |
| sudden Adjektiv | /ˈsʌd.ən/ | plötzlich, jäh |
| gene Substantiv | /d͡ʒiːn/ | Gen |
| genetic Adjektiv | /d͡ʒəˈnɛt.ɪk/ | genetisch |
| tissue Substantiv | /ˈtɪʃ.(j)u/ | Gewebe |
| distinguish Verb | /dɪˈstɪŋ.ɡwɪʃ/ | unterscheiden |
| anterior Adjektiv | /ænˈtɪɹ.i.ɚ/ | frontal, vorder |
| thick Adjektiv | /θɪk/ | dick |
| muscle Substantiv | /ˈmʌs.əl/ | Muskel |
| commonly Adverb | /ˈkɑmənli/ | gewöhnlich |
| contribute Verb | /kənˈtɹɪb.jut/ | beisteuern, beitragen |
| define Verb | /dɪˈfaɪn/ | bestimmen |
| dynamic Adjektiv | /daɪˈnæm.ɪk/ | dynamisch |
Grammatik in diesem Video
Die Strukturen, die der Sprecher am häufigsten verwendet, mit den genauen Worten aus dem Video:
| Struktur | Im Video |
|---|---|
| Passiv be + Partizip Perfekt – wichtig ist, was geschieht, nicht wer es tut | are equally affected · can be affected · is inherited |
| Relativsätze who / which + Satz – eine Zusatzinformation über eine Person oder Sache | SAM, which is · orthopnea, which is · dyspnea, which is |
| Present Perfect have/has + Partizip Perfekt – eine vergangene Handlung, die jetzt noch wichtig ist | have been identified · have developed |
Aussprache, auf die du achten solltest
- Die „th“-Laute: thick /θɪk/, athlete /ˈæθ.liːt/, thin /ˈθɪn/, width /ˈwɪtθ/, pathway /ˈpæθˌweɪ/
- Die Laute „sh“ und „zh“: obstruction /əbˈstɹʌk.ʃən/, tissue /ˈtɪʃ.(j)u/, distinguish /dɪˈstɪŋ.ɡwɪʃ/, mutation /mjuˈteɪʃən/, reduction /ɹɪˈdʌk.ʃən/
- Lange Wörter – auf die Betonung achten: anterior /ænˈtɪɹ.i.ɚ/, mechanism /ˈmɛk.ə.nɪ.zəm/, physiological /ˌfɪz.i.əˈlɑ.d͡ʒɪ.kəl/, primarily /ˈpɹaɪ.mə.ɹə.li/, efficiency /ɪˈfɪʃ.ən.si/
Laute, die Deutschsprachigen schwerfallen:
- /w/ — mit runden Lippen, nicht wie das deutsche „w“ (/v/): distinguish /dɪˈstɪŋ.ɡwɪʃ/, whereas /(h)wɛɹˈæz/, equally /ˈiːkwəli/, frequent /ˈfɹiː.kwənt/, width /ˈwɪtθ/
- Stimmhafter Auslaut — /b/, /d/, /g/, /z/, /v/ am Wortende nicht verhärten: valve /ˈvælv/, whereas /(h)wɛɹˈæz/, preserve /pɹəˈzɝv/, voltage /ˈvəʊltɪd͡ʒ/, bind /ˈbaɪ̯nd/
- /æ/ — offener als „ä“: tract /tɹækt/, cardiac /ˈkɑɹdiˌæk/, anterior /ænˈtɪɹ.i.ɚ/, dynamic /daɪˈnæm.ɪk/, valve /ˈvælv/
So übst du mit diesem Video
- Höre dir das ganze Video einmal an, ohne zu sprechen, und notiere die Wörter, die du nicht kennst.
- Sprich Satz für Satz in normaler Geschwindigkeit nach und wiederhole jeden, bis dein Rhythmus zum Sprecher passt.
- Nimm dich auf und vergleiche mit dem Original; achte dabei auf Wörter wie obstruction, tract, cardiac.
Was ist die Shadowing-Technik?
Shadowing ist eine wissenschaftlich fundierte Sprachlerntechnik, die ursprünglich für die professionelle Dolmetscherausbildung entwickelt und durch den Polyglotten Dr. Alexander Arguelles populär gemacht wurde. Die Methode ist einfach aber wirkungsvoll: Du hörst englisches Audio von Muttersprachlern und wiederholst es sofort laut — wie ein Schatten, der dem Sprecher mit nur 1–2 Sekunden Verzögerung folgt. Anders als passives Hören oder Grammatikübungen zwingt Shadowing dein Gehirn und deine Mundmuskulatur, gleichzeitig echte Sprachmuster zu verarbeiten und zu reproduzieren. Studien zeigen, dass es Aussprachegenauigkeit, Intonation, Rhythmus, verbundene Sprache, Hörverständnis und Sprechflüssigkeit signifikant verbessert — was es zu einer der effektivsten Methoden für die IELTS Speaking-Vorbereitung und reale englische Kommunikation macht.