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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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Vocabolario e note di pronuncia per questa lezione
Questa lezione di conversazione si basa sul video “Hypertrophic Cardiomyopathy - Patient’s Guide for Better Understanding”. Le parole che ritornano più spesso: cardiomyopathy, gradient, hypertrophic, valve, pressure. Questo video contiene 83 frasi e 1192 parole da ripetere con lo shadowing. Il parlato dura 7:40. Chi parla ha un ritmo naturale di circa 155 parole al minuto, vicino a una conversazione quotidiana. Solo il 78% delle parole rientra nelle 3.000 più comuni dell’inglese, quindi il lessico è impegnativo.
Vocaboli chiave di questo video
15 parole del video che vale la pena imparare, con pronuncia e significato:
| Parola | Pronuncia | Significato |
|---|---|---|
| echo sostantivo | /ˈɛk.oʊ/ | eco |
| valve sostantivo | /ˈvælv/ | valvola |
| obstruction sostantivo | /əbˈstɹʌk.ʃən/ | ostruzione |
| muscle sostantivo | /ˈmʌs.əl/ | muscolo |
| chamber sostantivo | /ˈt͡ʃeɪ̯mbɚ/ | camera |
| symptom sostantivo | /ˈsɪm(p)təm/ | sintomo |
| disorder sostantivo | /dɪsˈɔɹdɚ/ | disordine |
| distress sostantivo | /dɪˈstɹɛs/ | angoscia, pena |
| potentially avverbio | /pəˈtɛnʃ(ə)li/ | potenzialmente |
| monitor sostantivo | /ˈmɑ.nɪ.tɚ/ | monitor |
| genetic aggettivo | /d͡ʒəˈnɛt.ɪk/ | genetico |
| cord sostantivo | /ˈkoɹd/ | cordone |
| hose sostantivo | /hoʊz/ | manichetta |
| tract sostantivo | /tɹækt/ | apparato |
| finger sostantivo | /ˈfɪŋɡɚ/ | dito, dita |
I phrasal verb che sentirai
| Parola | Significato |
|---|---|
| cut out verbo | smetterla, finirla |
| go through verbo | attraversare |
| look forward to verbo | non vedere l'ora |
La grammatica di questo video
Le strutture che chi parla usa di più, con le parole esatte del video:
| Struttura | Nel video |
|---|---|
| Forma passiva be + participio passato — conta ciò che accade, non chi lo fa | is accelerated · is thickened · is found |
| Present perfect have/has + participio passato — un’azione passata che conta ancora adesso | you've put · haven't already had · that's been shown |
| Frasi relative who / which + frase — un’informazione in più su una persona o una cosa | people who have · attack, which can |
Pronuncia a cui fare attenzione
Chi parla usa 8 contrazioni e forme ridotte, come don't, haven't, I'm. Pronunciale nella forma breve, così come le senti.
- I suoni “th”: thick /θɪk/, underneath /ˌʌndɚˈniθ/, pathway /ˈpæθˌweɪ/, pathology /pəˈθɒləd͡ʒi/, thicken /ˈθɪkən/
- I suoni “sh” e “zh”: obstruction /əbˈstɹʌk.ʃən/, potentially /pəˈtɛnʃ(ə)li/, occasionally /əˈkeɪʒənəli/, reduction /ɹɪˈdʌk.ʃən/, partially /ˈpɑɹʃəli/
- Parole lunghe — attenzione all’accento: potentially /pəˈtɛnʃ(ə)li/, electrical /ɪˈlɛktɹɪkəl/, occasionally /əˈkeɪʒənəli/, definitive /dɪˈfɪn.ɪ.tɪv/, accelerate /ɪkˈsɛl.əˌɹeɪt/
I suoni difficili per chi parla italiano:
- /h/ — va soffiata, non è muta: hose /hoʊz/, helpful /ˈhɛlp.fl̩/, whereas /(h)wɛɹˈæz/, hypertrophic /hʌɪpəˈtɹɒfɪk/
- Consonante finale — senza aggiungere una vocale dopo: valve /ˈvælv/, distress /dɪˈstɹɛs/, genetic /d͡ʒəˈnɛt.ɪk/, cord /ˈkoɹd/, hose /hoʊz/
- /æ/ — più aperta della “e”: valve /ˈvælv/, tract /tɹækt/, cardiac /ˈkɑɹdiˌæk/, lastly /ˈlæstli/, vast /væst/
Come esercitarsi con questo video
- Ascolta tutto il video una volta senza parlare e annota le parole che non conosci.
- Inizia a velocità 0,75×, fai shadowing frase per frase e torna alla velocità normale quando diventa facile.
- Registrati e confronta con l’originale, facendo attenzione a parole come echo, valve, obstruction.
Cos'è la tecnica dello Shadowing?
Shadowing è una tecnica di apprendimento delle lingue supportata da studi scientifici, originariamente sviluppata per la formazione dei traduttori professionisti e resa popolare dal poliglotta Dr. Alexander Arguelles. Il metodo è semplice ma potente: ascolti un audio in inglese di madrelingua e lo ripeti immediatamente ad alta voce — come un'ombra che segue il parlante con un ritardo di solo 1–2 secondi. A differenza dell'ascolto passivo o degli esercizi di grammatica, lo shadowing costringe il tuo cervello e i muscoli della bocca a elaborare e riprodurre simultaneamente i modelli di discorso reale. La ricerca dimostra che migliora significativamente la precisione della pronuncia, l'intonazione, il ritmo, il discorso connesso, la comprensione dell'ascolto e la fluidità del parlato — rendendolo uno dei metodi più efficaci per la preparazione alla prova di speaking dell'IELTS e per la comunicazione reale in inglese.