シャドーイング練習: ST Elevation and Depression on an EKG Rhythm Strip - 動画で英語スピーキングを学ぶ
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56 文
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In this video, we'll take a look at ST segment changes.
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How do we identify and measure ST elevation and depression?
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And what does it mean for our patient?
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The ST segment is the space between the QRS and the T wave.
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It should be resting comfortably on the baseline, but in some strips you may see it above or below the baseline.
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When you're checking location of the ST segment, sometimes it seems a little variable.
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But what we're basing this measurement on is where the J -point is.
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That's the junction between the QRS and the ST segment.
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It's where we stopped measuring the QRS complex.
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So start by identifying where the baseline is.
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Where does your PR segment rest?
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And where does your diastolic phase between the T -wave and the P -wave come to rest?
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That's your baseline.
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Now, is the J -point on, below, or above the baseline.
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The threshold for this is one millimeter or more elevated or depressed,
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so one small box above or below the baseline is considered significant and warrants noting on the interpretation.
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Take your calipers.
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Place one point on the baseline and one point on the J -point.
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You're measuring vertically for this, so take that measurement to a nice clear area where you can count the small boxes.
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Vertically, each box represents one millimeter, so count the boxes and note ST elevation or depression
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if you have at least one full small box or one millimeter of change from the baseline.
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For this strip we have elevation.
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The J point is three small boxes above the baseline.
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So it's a three millimeter ST elevation.
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For this strip we have depression.
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The J point is two small boxes below the baseline.
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So it's a two millimeter ST depression.
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A lot of elevation and depression is chronic, and is indicative of some level of ischemic damage.
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You can get a lot more specific with that
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if you do a 12 -lead and look at how the ST changes appear on a number of different leads,
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but on a 3 and 5 -lead monitor, we'll just say they indicate ischemia.
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There are a couple of findings that are a bit more concerning, though.
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If you see acute elevation, meaning it wasn't there before, and after the J -point you see a convex curve,
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meaning after the j -point the tracing goes back up before returning to the baseline.
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It ends up taking on a shape known commonly as a tombstone.
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When you see tombstones, think heart attack.
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The tombstone shape won't always show in every lead.
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Depending on where the infarct is, the tombstone will show itself in the associated leads, and others may show nothing.
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Here's an example of a 12 -lead EKG.
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If we were looking at lead 2, we would have seen a tombstone shape appear for our patient.
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But if we were looking at lead 1, it's only showing a minor depression.
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Some other leads, like 3 or AVF, are showing the tombstone, but the rest are showing depression or sometimes no change at all.
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This EKG may be indicative of an inferior wall MI,
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which can be figured out based on which leads are showing the elevation changes and which are not.
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That being Having said, we'll only be viewing leads 1, 2, 3, AVR, AVL, AVF and V1 on our 5 -lead setup.
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And primarily, we'll be looking at lead 2.
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So we can't see every infarct with a 5 -lead setup.
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But when you do see it, check your patient for symptoms and activate the emergency response.
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If the patient is showing symptoms, even if the 5 -lead isn't showing any elevation, activate the emergency response.
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The 12 -lead may reveal what we couldn't see with the 5.
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Another acute change you may see is when after the J -point, the ST segment curves down into a concave curve.
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It can be indicative of pericarditis.
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This ST change is usually widespread across many leads.
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Pericarditis is inflammation of the pericardial sac surrounding the heart.
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Symptoms include sharp chest pains, much like infarction.
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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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このレッスンの語彙とスピーキングのポイント
このスピーキングレッスンは、動画「ST Elevation and Depression on an EKG Rhythm Strip」を教材にしています。 繰り返し出てくる語は次のとおりです：lead, baseline, elevation, depression, tombstone。 この動画には、シャドーイング用の文が56文、単語が693語あります。 音声の長さは4:15です。 話す速さは1分あたり約163語で、日常会話に近い自然なペースです。 英語の頻出3,000語に含まれる単語は77%だけなので、語彙は難しめです。
この動画の重要語彙
動画に出てくる覚えておきたい単語15語を、発音と意味つきで紹介します。
| 単語 | 発音 | 意味 |
|---|---|---|
| segment 名詞 | /ˈsɛɡmɛnt/ | 切片 |
| strip 動詞 | /ˈstɹɪp/ | 剥ぐ, 外す |
| symptom 名詞 | /ˈsɪm(p)təm/ | 症状, 症候 |
| curve 名詞 | /kɚv/ | 曲線 |
| measurement 名詞 | /ˈmɛʒ.ə.mənt/ | 測定 |
| acute 形容詞 | /əˈkjut/ | せつじつ |
| sharp 形容詞 | /ʃɑɹp/ | 鋭い, 鋭利な |
| reveal 動詞 | /ɹɪˈviːl/ | 現す, 表す |
| associate 名詞 | /əˈsoʊʃi.ət/ | 提携者 |
| monitor 名詞 | /ˈmɑ.nɪ.tɚ/ | モニター |
| indicate 動詞 | /ˈɪndɪˌkeɪt/ | 示す, 指す |
| interpretation 名詞 | /ɪnˌtɜːpɹəˈteɪʃən/ | 通訳 |
| chronic 形容詞 | /ˈkɹɑ.nɪk/ | 慢性的 |
| depend 動詞 | /dɪˈpɛnd/ | 依存する |
| trace 名詞 | /tɹeɪs/ | 跡, 痕跡 |
注意したい発音
話し手はwe'll, you're, can'tなど、短縮形や弱形を12回使っています。聞こえたとおりの短い形で発音しましょう。
- 「sh」と「zh」の音: elevation /ˌɛlɪˈveɪʃn̩/, measurement /ˈmɛʒ.ə.mənt/, sharp /ʃɑɹp/, associate /əˈsoʊʃi.ət/, interpretation /ɪnˌtɜːpɹəˈteɪʃən/
- 長い単語（アクセントの位置に注意）: indicative /ɪnˈdɪk.ə.tɪv/, primarily /ˈpɹaɪ.mə.ɹə.li/, associate /əˈsoʊʃi.ət/, interpretation /ɪnˌtɜːpɹəˈteɪʃən/, inferior /ɪnˈfɪɹ.i.ɚ/
日本語話者が苦手な音：
- /r/ と /l/ の区別 — /l/ は舌先を歯茎につけ、/r/ はどこにもつけない: primarily /ˈpɹaɪ.mə.ɹə.li/, reveal /ɹɪˈviːl/, variable [ˈvæɹ.i.ə.bl̩], threshold /ˈθɹɛʃ(h)oʊld/
- /v/ — /b/ にならないように、上の歯を下唇に当てる: elevation /ˌɛlɪˈveɪʃn̩/, curve /kɚv/, activate /ˈæktɪˌveɪt/, indicative /ɪnˈdɪk.ə.tɪv/, reveal /ɹɪˈviːl/
- /f/ — 「フ」ではなく、上の歯と下唇で出す: inferior /ɪnˈfɪɹ.i.ɚ/, comfortably /ˈkʌmftɚbli/, inflammation /ɪnfləˈmeɪ̯ʃən/, infarct /ɪnˈfɑɹkt/, infarction /ɪnˈfɑɹk.ʃən/
この動画での練習方法
- まず声を出さずに動画を最後まで聞き、知らない単語をメモします。
- まず0.75倍速で一文ずつシャドーイングし、慣れてきたら通常の速度に戻します。
- 自分の声を録音して元の音声と比べます。segment, strip, symptomなどの単語に特に注意しましょう。
シャドーイングとは？英語上達に効果的な理由
シャドーイング（Shadowing）は、もともとプロの通訳者養成プログラムで開発された言語学習法で、多言語習得者として知られるDr. Alexander Arguelles によって広く普及されました。方法はシンプルですが非常に効果的：ネイティブスピーカーの英語を聞きながら、1〜2秒の遅延で声に出してすぐに繰り返す——まるで「影（shadow）」のように話者を追いかけます。文法ドリルや受動的なリスニングと異なり、シャドーイングは脳と口の筋肉が同時にリアルタイムで英語を処理・再現することを強制します。研究により、発音精度、抑揚、リズム、連音、リスニング力、そして会話の流暢さが大幅に向上することが確認されています。IELTSスピーキング対策や自然な英語コミュニケーションを目指す方に特におすすめです。