Pratique du Shadowing: Hypertrophic Cardiomyopathy - Patient’s Guide for Better Understanding - Apprendre l'anglais à l'oral avec la vidéo
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Hi, I'm Dr. Kenneth Taylor, Director of the Hypertrophic Cardiomyopathy Center at Piedmont, and I want to talk to you today about hypertrophic cardiomyopathy.
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Hypertrophic cardiomyopathy is a genetic disorder, and it results in a thickening of the heart muscle.
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There are a number of different forms of this disorder, and so we'll talk a little bit about that.
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The classic form of hypertrophic cardiomyopathy involves thickening of what we call the interventricular septum.
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So the heart has four chambers, diagrammed here.
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The left ventricular chamber and the right ventricular chamber are the two pumping chambers of the heart.
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They're separated by this wall that we call the septum.
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Normally that septum is about a centimeter thick.
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In people who have particularly the obstructive form of hypertrophic cardiomyopathy,
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There is a thickening of the septum right here underneath the
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aortic valve where the blood is trying to get out of the heart.
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And so when blood is trying to get out of the heart,
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this thickened muscle gets in the way and obstructs the blood trying to get out.
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It's kind of like if you took a hose
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and put your finger on the end of the hose and blocked it off partially, the water would squirt out of the end of the hose.
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And the reason it squirts out is that there's a pressure gradient
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or a difference in pressure from on one side of where you've put your finger to the other side.
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And that obstruction creates a gradient or a pressure gradient.
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And we can actually measure that gradient with our echo technology.
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So, for example, if you have a blood pressure that's about, let's say, 120 over 70, and you have obstruction here from the septum,
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if you measure the pressure in the chamber of the heart, the top number will be higher than that.
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So, for example, if you have a 50 millimeter gradient, for example, then the pressure inside the heart will be 170,
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whereas the blood pressure is 120.
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And that pressure gradient plays a role in the symptoms of this disease, and it's something we follow with echoes.
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The other thing that happens in people who have this thickening of the septum is
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that right next to the septum is the mitral valve.
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And the mitral valve has these cords, kind of like parachute cords.
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And when blood is accelerated through this outflow tract, it, for lack of a better word,
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sucks these cords into the outflow tract, resulting in more narrowing and more obstruction.
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And it also opens this valve and causes the valve to leak.
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or something we call mitral regurgitation.
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So we also see that in an echo, and depending on how much obstruction there is,
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if there's more obstruction, there may be more leakiness of the mitral valve.
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That also may contribute to symptoms in this disease.
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We typically treat this disease first with medicines to try to reduce how much this heart muscle thickens
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and how much it obstructs blood flow coming out of the heart.
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And we can follow that with echoes
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and with stress echoes to look at the gradient across the
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outflow tract as well as the degree of leakiness of the mitral valve.
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There are several issues that we need to talk about in patients with hypertrophic cardiomyopathy.
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The first one relates to the diagnosis, where in the heart muscle is thickened,
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and whether there's obstruction or not.
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And we typically look at that with an echo and often times we use MRI for better clarification of the pathology.
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So we will typically do an echo if you haven't already had one
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and we will often times do an MRI to look at what the heart muscle actually looks like
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and what the valve structure looks like.
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The next thing we like to assess is what your symptoms are like.
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and typically we will try to assess that with a stress test, either a regular treadmill or more than likely something called a stress echo.
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And with a stress echo what we do is we put you on a treadmill
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or on a bike and we look at that gradient we talked about
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and then we exercise you and see if that gradient changes with exercise.
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We also monitor your blood pressure and see how well you can do to see what kind of symptoms you might have.
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The third issue is that patients with hypertrophic cardiomyopathy are at risk for certain arrhythmias.
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And those arrhythmias can be potentially dangerous.
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And in fact, there is a small population of patients with hypertrophic cardiomyopathy who are at risk for something we call sudden cardiac death,
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where they basically can have an arrhythmia and die suddenly.
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So we look for arrhythmias in a couple of different ways, one of which is with monitoring, something like a Holter monitor.
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And the other is that we have a group of colleagues called electrophysiologists who specialize in the electrical system of the heart.
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And we will typically make sure that our electrophysiologist goes through all of the information
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and has a discussion with you about your particular risks for having an arrhythmia and your risks for having sudden cardiac death.
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And the reason that's important is if your risk is found to be elevated,
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then in some population of patients with this disorder, we recommend defibrillators.
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So as far as therapy,
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we will talk about first medical therapy and then potentially the role for something we call an ICD or defibrillator.
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Lastly, if patients don't do well with medical therapy,
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occasionally we're in a position of talking about more definitive therapy to relieve obstruction.
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And there are kind of two different pathways, one of which is called septal myomectomy where a surgeon goes in
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and opens your chest and cuts out the thickened heart muscle and potentially repairs any abnormalities with the mitral valve.
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And that's been shown to significantly improve symptoms and significantly improve outcomes in patients with this disorder.
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There is an alternative called an alcohol septal ablation where we actually go in with a cath
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and find the blood vessel that feeds this particular area of the heart and inject a little alcohol and cause, for lack of a better word,
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a little heart attack, which can reduce the obstruction.
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We typically think of that as a second choice to the myomectomy
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and used mostly in patients who are felt to be not surgical candidates.
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So we call that whole category what we call septal reduction therapy.
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The vast majority of patients don't need that and can be managed medically.
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Lastly, as I mentioned, this is a genetic disease.
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And so first -degree family members need to be screened.
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And we can talk about the best way to screen them.
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Typically, family members should be screened first -degree relatives, so siblings, children, parents, with an echo and an EKG.
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And we can have a conversation about the role of genetic testing as well.
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Thank you very much for your time.
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I hope this has been helpful for your understanding of hypertrophic cardiomyopathy, and I look forward to addressing any of your questions.
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Vocabulaire et conseils d’expression pour cette leçon
Cette leçon d’expression orale s’appuie sur la vidéo « Hypertrophic Cardiomyopathy - Patient’s Guide for Better Understanding ». Les mots qui reviennent le plus souvent : cardiomyopathy, gradient, hypertrophic, valve, pressure. Cette vidéo contient 83 phrases et 1192 mots à répéter en shadowing. La partie parlée dure 7:40. Le locuteur parle à un rythme naturel d’environ 155 mots par minute, proche d’une conversation courante. Seuls 78 % des mots font partie des 3 000 mots les plus courants en anglais, le vocabulaire est donc exigeant.
Vocabulaire clé de cette vidéo
15 mots de la vidéo à retenir, avec leur prononciation et leur sens :
| Mot | Prononciation | Sens |
|---|---|---|
| echo nom | /ˈɛk.oʊ/ | écho |
| valve nom | /ˈvælv/ | clapet, soupape |
| obstruction nom | /əbˈstɹʌk.ʃən/ | obstruction |
| muscle nom | /ˈmʌs.əl/ | muscle |
| chamber nom | /ˈt͡ʃeɪ̯mbɚ/ | chambre, pièce |
| symptom nom | /ˈsɪm(p)təm/ | symptôme |
| disorder nom | /dɪsˈɔɹdɚ/ | désordre |
| distress nom | /dɪˈstɹɛs/ | détresse |
| potentially adverbe | /pəˈtɛnʃ(ə)li/ | potentiellement |
| monitor nom | /ˈmɑ.nɪ.tɚ/ | moniteur, monitrice |
| genetic adjectif | /d͡ʒəˈnɛt.ɪk/ | génétique |
| cord nom | /ˈkoɹd/ | corde |
| hose nom | /hoʊz/ | tuyau |
| tract nom | /tɹækt/ | appareil |
| finger nom | /ˈfɪŋɡɚ/ | doigt |
Les verbes à particule que vous entendrez
| Mot | Sens |
|---|---|
| cut out verbe | arrêter de |
| get out verbe | sortir |
| go through verbe | traverser |
| look forward to verbe | avoir hâte de, attendre avec impatience |
La grammaire de cette vidéo
Les structures que le locuteur utilise le plus, avec les mots exacts de la vidéo :
| Structure | Dans la vidéo |
|---|---|
| Voix passive be + participe passé — l’accent est mis sur ce qui arrive, pas sur qui le fait | is accelerated · is thickened · is found |
| Present perfect have/has + participe passé — une action passée qui compte encore maintenant | you've put · haven't already had · that's been shown |
| Propositions relatives who / which + proposition — une précision sur une personne ou une chose | people who have · attack, which can |
Prononciation à surveiller
Le locuteur utilise 8 contractions et formes réduites, comme don't, haven't, I'm. Prononcez-les sous leur forme courte, telles que vous les entendez.
- Les sons « th »: thick /θɪk/, underneath /ˌʌndɚˈniθ/, pathway /ˈpæθˌweɪ/, pathology /pəˈθɒləd͡ʒi/, thicken /ˈθɪkən/
- Les sons « sh » et « zh »: obstruction /əbˈstɹʌk.ʃən/, potentially /pəˈtɛnʃ(ə)li/, occasionally /əˈkeɪʒənəli/, reduction /ɹɪˈdʌk.ʃən/, partially /ˈpɑɹʃəli/
- Mots longs — placez bien l’accent: potentially /pəˈtɛnʃ(ə)li/, electrical /ɪˈlɛktɹɪkəl/, occasionally /əˈkeɪʒənəli/, definitive /dɪˈfɪn.ɪ.tɪv/, accelerate /ɪkˈsɛl.əˌɹeɪt/
Les sons difficiles pour les francophones :
- /h/ — il se souffle, il n’est pas muet: hose /hoʊz/, helpful /ˈhɛlp.fl̩/, whereas /(h)wɛɹˈæz/, hypertrophic /hʌɪpəˈtɹɒfɪk/
- /tʃ/ et /dʒ/ — à ne pas adoucir en « ch » et « j »: chamber /ˈt͡ʃeɪ̯mbɚ/, genetic /d͡ʒəˈnɛt.ɪk/, surgeon /ˈsɝd͡ʒən/, surgical /ˈsɝd͡ʒɪkəl/, pathology /pəˈθɒləd͡ʒi/
- /r/ anglais — langue recourbée, sans frotter la gorge: obstruction /əbˈstɹʌk.ʃən/, disorder /dɪsˈɔɹdɚ/, distress /dɪˈstɹɛs/, cord /ˈkoɹd/, tract /tɹækt/
Comment s’entraîner avec cette vidéo
- Écoutez la vidéo en entier une fois sans parler et notez les mots que vous ne connaissez pas.
- Commencez à la vitesse 0,75×, répétez phrase par phrase, puis revenez à la vitesse normale quand cela devient facile.
- Enregistrez-vous et comparez avec l’original, en faisant attention à des mots comme echo, valve, obstruction.
Qu'est-ce que la technique du Shadowing ?
Le Shadowing est une technique d'apprentissage des langues fondée sur la science, développée à l'origine pour la formation des interprètes professionnels. Le principe est simple mais puissant : vous écoutez de l'anglais natif et le répétez immédiatement à voix haute — comme une ombre suivant le locuteur avec un décalage de 1 à 2 secondes. Les recherches montrent une amélioration significative de la précision de la prononciation, de l'intonation, du rythme, des liaisons, de la compréhension orale et de la fluidité.