Shadowing Practice: ST Elevation and Depression on an EKG Rhythm Strip - Learn English Speaking with Video

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In this video, we'll take a look at ST segment changes.

How do we identify and measure ST elevation and depression?

And what does it mean for our patient?

The ST segment is the space between the QRS and the T wave.

It should be resting comfortably on the baseline, but in some strips you may see it above or below the baseline.

When you're checking location of the ST segment, sometimes it seems a little variable.

But what we're basing this measurement on is where the J -point is.

That's the junction between the QRS and the ST segment.

It's where we stopped measuring the QRS complex.

So start by identifying where the baseline is.

Where does your PR segment rest?

And where does your diastolic phase between the T -wave and the P -wave come to rest?

That's your baseline.

Now, is the J -point on, below, or above the baseline.

The threshold for this is one millimeter or more elevated or depressed,

so one small box above or below the baseline is considered significant and warrants noting on the interpretation.

Take your calipers.

Place one point on the baseline and one point on the J -point.

You're measuring vertically for this, so take that measurement to a nice clear area where you can count the small boxes.

Vertically, each box represents one millimeter, so count the boxes and note ST elevation or depression

if you have at least one full small box or one millimeter of change from the baseline.

For this strip we have elevation.

The J point is three small boxes above the baseline.

So it's a three millimeter ST elevation.

For this strip we have depression.

The J point is two small boxes below the baseline.

So it's a two millimeter ST depression.

A lot of elevation and depression is chronic, and is indicative of some level of ischemic damage.

You can get a lot more specific with that

if you do a 12 -lead and look at how the ST changes appear on a number of different leads,

but on a 3 and 5 -lead monitor, we'll just say they indicate ischemia.

There are a couple of findings that are a bit more concerning, though.

If you see acute elevation, meaning it wasn't there before, and after the J -point you see a convex curve,

meaning after the j -point the tracing goes back up before returning to the baseline.

It ends up taking on a shape known commonly as a tombstone.

When you see tombstones, think heart attack.

The tombstone shape won't always show in every lead.

Depending on where the infarct is, the tombstone will show itself in the associated leads, and others may show nothing.

Here's an example of a 12 -lead EKG.

If we were looking at lead 2, we would have seen a tombstone shape appear for our patient.

But if we were looking at lead 1, it's only showing a minor depression.

Some other leads, like 3 or AVF, are showing the tombstone, but the rest are showing depression or sometimes no change at all.

This EKG may be indicative of an inferior wall MI,

which can be figured out based on which leads are showing the elevation changes and which are not.

That being Having said, we'll only be viewing leads 1, 2, 3, AVR, AVL, AVF and V1 on our 5 -lead setup.

And primarily, we'll be looking at lead 2.

So we can't see every infarct with a 5 -lead setup.

But when you do see it, check your patient for symptoms and activate the emergency response.

If the patient is showing symptoms, even if the 5 -lead isn't showing any elevation, activate the emergency response.

The 12 -lead may reveal what we couldn't see with the 5.

Another acute change you may see is when after the J -point, the ST segment curves down into a concave curve.

It can be indicative of pericarditis.

This ST change is usually widespread across many leads.

Pericarditis is inflammation of the pericardial sac surrounding the heart.

Symptoms include sharp chest pains, much like infarction.

So again, if you see this ST change on your strip, check your patient for symptoms and activate the emergency response.

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Vocabulario y notas de pronunciación para esta lección

Esta lección de conversación se basa en el vídeo “ST Elevation and Depression on an EKG Rhythm Strip”. Las palabras que más se repiten: lead, baseline, elevation, depression, tombstone. Este vídeo tiene 56 frases y 693 palabras para practicar shadowing. La parte hablada dura 4:15. El hablante habla a un ritmo natural de unas 163 palabras por minuto, cercano a una conversación cotidiana. Solo el 77 % de las palabras está entre las 3.000 más comunes del inglés, por lo que el vocabulario es exigente.

Vocabulario clave de este vídeo

15 palabras del vídeo que vale la pena aprender, con su pronunciación y significado:

Palabra	Pronunciación	Significado
baseline sustantivo	/ˈbeɪslaɪn/	línea basal
elevation sustantivo	/ˌɛlɪˈveɪʃn̩/	elevación
segment sustantivo	/ˈsɛɡmɛnt/	segmento
strip verbo	/ˈstɹɪp/	remover
symptom sustantivo	/ˈsɪm(p)təm/	síntoma
curve sustantivo	/kɚv/	curva
activate verbo	/ˈæktɪˌveɪt/	activar
measurement sustantivo	/ˈmɛʒ.ə.mənt/	medida, medición
acute adjetivo	/əˈkjut/	agudo, perspicaz
primarily adverbio	/ˈpɹaɪ.mə.ɹə.li/	primariamente
sharp adjetivo	/ʃɑɹp/	agudo, afilado
reveal verbo	/ɹɪˈviːl/	revelar, propalar
associate sustantivo	/əˈsoʊʃi.ət/	asociado
commonly adverbio	/ˈkɑmənli/	comúnmente
monitor sustantivo	/ˈmɑ.nɪ.tɚ/	monitor

Phrasal verbs que vas a escuchar

Palabra	Significado
end up verbo	terminar, ir a parar
figure out verbo	averiguar, captar

Pronunciación a tener en cuenta

El hablante usa 12 contracciones y formas reducidas, como we'll, you're, can't. Dilas en su forma corta, tal como las oyes.

Los sonidos de “sh” y “zh”: elevation /ˌɛlɪˈveɪʃn̩/, measurement /ˈmɛʒ.ə.mənt/, sharp /ʃɑɹp/, associate /əˈsoʊʃi.ət/, interpretation /ɪnˌtɜːpɹəˈteɪʃən/
Palabras largas — cuida el acento: indicative /ɪnˈdɪk.ə.tɪv/, primarily /ˈpɹaɪ.mə.ɹə.li/, associate /əˈsoʊʃi.ət/, interpretation /ɪnˌtɜːpɹəˈteɪʃən/, inferior /ɪnˈfɪɹ.i.ɚ/

Sonidos difíciles para hispanohablantes:

/v/ — no es /b/: los dientes tocan el labio inferior: elevation /ˌɛlɪˈveɪʃn̩/, curve /kɚv/, activate /ˈæktɪˌveɪt/, indicative /ɪnˈdɪk.ə.tɪv/, reveal /ɹɪˈviːl/

Cómo practicar con este vídeo

Escucha el vídeo entero una vez sin hablar y anota las palabras que no conoces.
Empieza a velocidad 0,75×, haz shadowing frase por frase y vuelve a la velocidad normal cuando te resulte fácil.
Grábate y compara con el original, prestando atención a palabras como baseline, elevation, segment.

¿Qué es la Técnica de Shadowing?

Shadowing es una técnica de aprendizaje de idiomas respaldada por la ciencia, desarrollada originalmente para la formación de intérpretes profesionales y popularizada por el políglota Dr. Alexander Arguelles. El método es simple pero poderoso: escuchas audio en inglés nativo y lo repites en voz alta de inmediato, como una sombra que sigue al hablante con solo 1-2 segundos de retraso. A diferencia de la escucha pasiva o los ejercicios de gramática, el shadowing obliga a tu cerebro y músculos de la boca a procesar y reproducir simultáneamente patrones de habla reales. Las investigaciones muestran que mejora significativamente la precisión de la pronunciación, la entonación, el ritmo, el habla conectada, la comprensión auditiva y la fluidez al hablar, convirtiéndola en una de las metodologías más efectivas para la preparación del IELTS Speaking y la comunicación en inglés en el mundo real.

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Shadowing Practice: ST Elevation and Depression on an EKG Rhythm Strip - Learn English Speaking with Video

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