쉐도잉 연습: Left Sided Heart Failure - 영상으로 영어 말하기 배우기

Hi everyone, Dr. Mike here.

In this video, we're taking a look at left side heart failure.

Let's jump straight into it.

Alright, to begin, let's orientate ourselves.

I've separated the left and right hand side of the heart up here

so it makes more functional sense because each side has their own circulation.

So because we're focusing on the left hand side, let's look at this.

The left hand side of the heart, which I've got is the left atrium here and the left ventricle here, it receives blood from the lungs.

So here I've got an alveolus, which is a representation of the lungs.

And here's the post capillary aspect of the pulmonary circulation.

So it receives oxygenated blood from the lungs going into the left atrium through the mitral

or bicuspid valve into the left ventricle.

It contracts with all that muscle.

Remember left hand side of the heart is three to four times thicker than the right hand side

because it has to pump blood to the entire body.

So it contracts forcefully, pushes blood out through what's called the aortic semilunar valve into the aorta

and then sends this blood out through the systemic circulation to all the tissues of the body.

So that is the circulation of the left hand side of the heart, receives blood from the lungs, sends blood to the body

so this is really important to understand heart failure behind the

left -hand side of the heart is the pulmonary circulation in

front of the left -hand side of the heart is the systemic circulation

because when we have heart failure

so let's define it an inability of the heart to effectively

work as a pump its job here to effectively work as a pump is to ensure

that there's no congestion behind so it receives the blood it needs and that the blood that enters

leaves appropriately to meet the metabolic demands of the body that's how it needs to work as a pump

if any of those things don't happen so congestion occurs behind or inadequate outflow in front

that's heart failure now let's look at left side heart failure

and some of the causes so that it makes sense anything

that can affect that is going to cause left side heart failure

so let's focus on our first one first one that we want to focus on here is arterial hypertension arterial

hypertension so hypertension is high blood pressure

but it's referring to chronic right you know high blood pressure over time

so effectively you don't just have one vessel here obviously you've got all of these multitude of arteries

and arterioles and if you've got a degree of occlusion

or blockage so let's say there's something that's narrowing this vessel like an atherosclerotic plaque for example

and this atherosclerotic plaque you know it can start forming clots

and then clots can narrow the hollow lumen of the vessel right

but what happens is if that's narrowed or the blood vessels are constricting

when they shouldn't blood tends to back up now this is

arterial hypertension right the left hand side of the heart it's going to receive blood normally,

it's going to fill normally and then the myocardium of the left ventricular wall will contract to eject that blood out.

But look it's facing resistance, now it's facing a pressure resistance so there's pressure to overcome.

Now in order to overcome this pressure, because think if it contracted as normal it would hit this pressure

and some blood would fall back in so not enough blood would leave, that would be heart failure.

We don't want that.

So the left myocardium, the left ventricular myocardium remodels itself in response to this pressure overload.

This is actually called afterload, increased afterload.

So this is really important, particularly when it comes to understanding heart failure,

is that if you have increased pressure or pressure overload that you need to overcome in the heart.

The heart will compensate by changing structurally.

So what the heart does is it undergoes what's called concentric hypertrophy.

So hypertrophy is when the heart gets, or the tissue gets larger.

Here we're talking about cardiac tissue, so the myocardium, it gets larger.

So we need to add some contractile subunits, sarcomeres, to get larger.

So the concentric is telling you in what way it's getting larger

so again if it's in response to having to overcome a pressure

or pressure overload it gets bigger through concentric hypertrophy

which means this the heart will let's say the hollow inside of the heart looks like this,

and there's the myocardium, its response is it will get bigger like this.

Because what it's done is if that is a sarcomere and that's a sarcomere and that's a sarcomere,

it will add sarcomeres in parallel, making it thicker.

So what you get is a thicker heart muscle but what

that means is the hollow inside of the heart reduces and

so you go okay in the early stages of responding to

this pressure overload this concentric hypertrophy works in some degree

because just like going to the gym you're experiencing a resistance the muscle needs to get bigger

and stronger to overcome that resistance right so you get concentric hypertrophy

but over time it's consistently having to overcome this increased pressure

and it starts to encroach on the hollow inside of the ventricle which means that less blood is entering.

So what we get is decreased filling.

Less blood is entering but because I've also got

so much muscle here it's hard for it to relax and it remains stiff.

So you get decreased filling and increased stiffness and these things together result in decreased output and what we get?

Left -sided heart failure.

So that is due to arterial hypertension.

Now there's another cause, there's a couple more for left -sided heart failure.

Another cause here is what we call ischemic heart disease.

Ischemic heart disease.

Sometimes it's referred to as coronary artery disease.

So what we're saying here is, instead of the narrowing happening here in the systemic vessels,

the systemic arteries, the narrowing happens to the blood vessels that are feeding the heart muscle itself, the coronary supply.

So here's a coronary artery here and the blood will enter

and diffuse across to feed this nice thick myocardium but

if it is blocked due to an atherosclerotic plaque

and then maybe a clot forms and travels through and blocks it

so let's say we've blocked a fair chunk of this

that muscle doesn't get fed

and the muscle dies you've probably heard this before it's called a heart attack right a myocardial infarction So an MI,

a myocardial infarct, right?

An MI.

And so that means the heart muscle begins to die off.

And if that heart muscle begins to die off, it can no longer contract, right?

And if it doesn't contract, it can't eject enough blood.

It doesn't work appropriately as a pump.

It's not meeting the metabolic demands of the body, left side heart failure.

But in addition, what can happen is that over time, the heart tries to remodel and compensate.

Now, we spoke about a form of remodeling in response to overcoming pressure, but is there a pressure here to overcome?

No, there's not, right?

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Because this isn't here.

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We don't have this arterial hypertension.

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All we have is the muscles dying off.

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So what do we do?

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How can we overcome this?

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Think about it.

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If that's dying off and it can't contract properly, right?

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The filling is fine the pressure here is fine, but because it can't contract hard enough, it doesn't eject enough.

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So the filling is normal, but the ejection is low.

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So you get a volume overload issue.

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Remember here, it was a pressure overload issue.

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Now you've got a volume overload issue.

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And the heart remodels in a different way in response to volume overload.

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So in response to volume overload, we get eccentric hypertrophy.

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Eccentric hypertrophy.

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So remember I said here we're adding sarcomeres in series.

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Oh, sorry, in parallel.

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I've given it away.

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We add sarcomeres, however you spell parallel.

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I can tell you all about biology.

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I can't spell.

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We're adding it in series in this instance.

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So again, the heart starts like this, the left ventricle starts like this as a normal size, but then it goes like this.

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It gets bigger because it's hypertrophy, but you get a dilated hypertrophy,

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what we call a dilated cardiomyopathy.

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Because what we've done is it's gotten bigger, but it's added sarcomeres.

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So there's the sarcomeres that existed.

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We've added them in series next to them to make it bigger but not thicker

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right so you get this dilated effect

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so this is what can happen over time in response to volume very important

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and so that what ends up happening is it just keeps filling with blood

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and it can't contract adequately to meet the requirements for output all right

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so that's the second i didn't even finish writing ischemic that's how bad i am at spelling all right

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so another one we've got arterial hypertension we've got ischemic heart disease

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and we need to talk about the next one which is valvular disease.

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All right.

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So what were the valves I spoke about in the left -hand side of the heart, right?

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We've got this valve here, which is called the mitral valve, also known as the bicuspid valve.

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And this valve here, which is called the aortic valve, sometimes called the aortic semilunar valve.

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All right.

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here's what can happen in this instance let's start with aortic valve if you have an aortic

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valve stenosis or a stenotic

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so stenosis means stiffening hardening uh stiffened aortic valve it's not going to open

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and close properly right so it stays stiffly shut

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so it's hard for the blood to get ejected now think about

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that if it's hard for the blood to get ejected And what was a scenario we spoke about where that happened?

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Arterial hypertension, remember?

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In arterial hypertension, it was trying to overcome the systemic blood pressure that was going back,

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but it's no different really to having to overcome a stiffened valve.

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So the same thing happens as here, is that because you're trying to overcome that,

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it's a pressure overload issue and the heart remodels to get thicker.

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So it gets thicker but again this thickness gets so thick

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that it narrows the inside of the ventricle

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and it can't maintain itself over time and so you can then get left side heart failure.

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So that happens as well in the aortic valve stenosis very similar to what's happening here.

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You can have not a mitral valve stenosis but what's called mitral regurgitation

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so that means it's sort of the opposite of the stiffness it's a bit floppy right

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so if it's a floppy valve it's not going to close properly it might sort of flat back

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and that means

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when this ventricle contracts not all the blood gets ejected some jumps back up into the left atrium

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which then means think about this which then That means when it relaxes, that blood falls back down and overfills the heart because you got the normal blood entering,

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not the normal blood leaving.

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Some goes up here, so it's adding to the next filling event.

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What's that?

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It's a volume overload issue.

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So what happens in martial valve regurgitation is you get an eccentric hypertrophy and a dilation of that ventricle.

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See, it's all making sense now, I hope.

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There's another set of causes here, and this is what we call dilated cardiomyopathies.

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Dilated cardiomyopathies.

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So cardio heart myopathies are muscle pathologies, muscle changes, and it's dilated.

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So it's this that's happening.

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But it's due to non -overload issues or non -overload causes.

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What do I mean by that?

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Well, these are the overload causes, right?

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So the fourth set of causes, the dilated cardiomyopathies, that happens,

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but it's not in response to increase pressures that it needs to overcome

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and it's not in response to increased volume effects that it needs to overcome.

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It's due to other strange things that are happening in the body and they all have their own specific mechanisms.

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So what can cause this?

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Well, it can be alcohol abuse.

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It can be cocaine.

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It can be some chemotherapies.

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It can do it.

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Genetics.

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right, so it can be inherited, diabetes, mellitus, obesity, right, so all age,

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so all these things in their own way can actually result in this dilated cardiomyopathy,

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but it's not in response to overcoming pressure changes or increased volume, all right.

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So these are the major causes for left side heart failure.

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Let's talk a bit about the symptoms, all right, So how does it present should be pretty easy because we know what's happening

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backwards and forwards and what you can have is backwards the symptoms due to backwards failure

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so due to congestion and symptoms due to forward failure

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so reduced cardiac output i think that's probably worth writing down what do you think

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so let's say you can have backward failure backward failure and that's due to congestion

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and you can have forward failure and that's due to reduced cardiac output so reduced amount of blood leaving the heart.

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So let's think about this first let's start with backwards failure

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if you've got blood not ejecting

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and it backs up backs up backs up into the pulmonary circulation here think about

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that this is coming from the lungs this blood backs up into the pulmonary And you get pulmonary congestion.

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So what you can get for backwards failure is pulmonary congestion,

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which means the blood is just backing up into the pulmonary circulation.

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But then it gets into the capillary bed and fluid will leak out into the alveoli.

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right and that fluid accumulation is pulmonary edema now if you've got pulmonary edema

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what do you think that means can you exchange gases well no

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because there's a thickened respiratory membrane here so it's harder for oxygen

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and carbon dioxide to get transported mainly the oxygen

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because carbon dioxide diffuses relatively well in fluid better without it but relatively well.

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So what are you going to get as your symptoms here?

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It's going to be dyspnea, right?

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So that's a shortness of breath or an alteration in breathing and orthopnea.

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So this means when you lay down you get this shortness of breath

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and that's because of the way that the fluid sits in the lungs reducing its ability for gas transport to occur.

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So that's the backwards failure effects of left side heart failure.

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What are the forward failure effects?

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So let's have a look at the forward failure effects.

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Well, because you've got a reduction in blood flow going forward, right?

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You've got a reduction in cardiac output.

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You end up getting less oxygen and nutrients to the tissues, including muscle.

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So what you end up getting is what?

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Fatigue, right?

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Exhaustion, weakness.

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So fatigue, weakness.

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And it might be exercise or even non -exercise induced depending on the degree, right?

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Exercise or non -exercise induced.

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Again, can't spell induced.

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So that is a set of symptoms that can happen due to the forward failure.

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So left side heart failure, the respiratory issues, pulmonary congestion, pulmonary edema, shortness of breath, orthopnea.

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When it comes to the reduced ability to give oxygen and nutrients to the body, fatigue and weakness because you're not getting the oxygen and nutrients you need, particularly to the muscle.

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So you might exercise and be even more exhausted and weak, fatigued and so forth.

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So look, this is Left Side Heart Failure.

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I'm Dr. Mike and I hope that helps.

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Thank you.

📺 같은 채널

Epithelial Tissue

Daily ConversationUniversity Students

✨ 추천 영상

271 문장

이 레슨의 어휘와 말하기 포인트

이 말하기 레슨은 영상 “Left Sided Heart Failure”을(를) 바탕으로 합니다. 가장 자주 반복되는 단어는 다음과 같습니다: blood, failure, pressure, valve, overload. 이 영상에는 섀도잉할 문장 230개와 단어 2644개가 있습니다. 말하는 구간의 길이는 18:57입니다. 화자는 분당 약 140단어의 일정한 속도로 말해서 섀도잉하기에 편한 속도입니다. 영어에서 가장 많이 쓰이는 3,000단어에 속하는 단어가 79%뿐이라 어휘가 어려운 편입니다.

이 영상의 핵심 어휘

영상에 나오는 익혀 둘 만한 단어 15개를 발음, 뜻과 함께 정리했습니다.

단어	발음	뜻
valve 명사	/ˈvælv/	밸브
overcome 동사	/ˌəʊ.vəˈkʌm/	극복하다, 이겨내다
muscle 명사	/ˈmʌs.əl/	근육
thick 형용사	/θɪk/	두껍다
narrow 형용사	/ˈnæɹəʊ/	좁은, 좁다
vessel 명사	/ˈvɛsəl/	배, 선박
lung 명사	/ˈlʌŋ/	허파, 폐
output 명사	/ˈaʊtpʊt/	출력
pump 명사	/pʌmp/	펌프
oxygen 명사	/ˈɑksɪd͡ʒən/	산소
symptom 명사	/ˈsɪm(p)təm/	증상, 증후
tissue 명사	/ˈtɪʃ.(j)u/	조직
fluid 명사	/ˈflu.ɪd/	유체, 유동체
fatigue 명사	/fəˈtiːɡ/	피곤, 피로
artery 명사	/ˈɑɹ.təɹ.i/	동맥

영상에 나오는 구동사

단어	뜻
go back 동사	돌아가다
go up 동사	올라가다
lie down 동사	눕다
write down 동사	적다, 적어 두다

따라 말해 볼 만한 문장

영상에 나오는 짧고 완결된 문장으로, 일상 대화에서 그대로 쓸 수 있습니다:

Let's jump straight into it.
Alright, to begin, let's orientate ourselves.
We don't have this arterial hypertension.
How can we overcome this?
What do I mean by that?

이 영상의 문법

화자가 가장 많이 쓰는 문형을 영상 속 실제 표현과 함께 정리했습니다.

문형	영상 속 표현
현재완료 have/has + 과거분사 — 과거의 일이 지금도 관련이 있을 때	I've separated · have increased · we've blocked
수동태 be + 과거분사 — 누가 하는지보다 무슨 일이 일어나는지에 초점	is actually called · is decreased · is blocked
관계절 who / which + 절 — 사람이나 사물에 대한 추가 정보	alveolus, which is · ventricle which means · one which is

주의할 발음

화자는 you've, can't, we're 같은 축약형과 약화된 형태를 47번 사용합니다. 들리는 대로 짧게 발음하세요.

“th” 소리: thick /θɪk/, breathe /bɹiːð/, thickness /ˈθɪknəs/, pathology /pəˈθɒləd͡ʒi/, chemotherapy /ˌkiːməʊˈθɛɹəpi/
“sh”와 “zh” 소리: circulation /ˌsɝkjʊˈleɪʃən/, tissue /ˈtɪʃ.(j)u/, reduction /ɹɪˈdʌk.ʃən/, representation /ˌɹɛp.ɹə.zɛnˈteɪ.ʃən/, martial /ˈmɑɹʃəl/
긴 단어 — 강세 위치에 주의: circulation /ˌsɝkjʊˈleɪʃən/, respiratory /ɹɪˈspɪ.ɹət.ə.ɹi/, metabolic /mɛtəˈbɒlɪk/, representation /ˌɹɛp.ɹə.zɛnˈteɪ.ʃən/, mechanism /ˈmɛk.ə.nɪ.zəm/

한국어 화자가 어려워하는 소리:

/f/ — ㅍ(/p/)으로 바꾸지 말고 윗니를 아랫입술에 대기: fluid /ˈflu.ɪd/, fatigue /fəˈtiːɡ/, refer /ɹɪˈfɜː/, define /dɪˈfaɪn/, functional /ˈfʌŋkt͡ʃənəl/
/v/ — ㅂ(/b/)과 구별하기: valve /ˈvælv/, overcome /ˌəʊ.vəˈkʌm/, vessel /ˈvɛsəl/, overload /ˌəʊvəˈləʊd/, ventricle /ˈvɛn.tɹɪk.əl/
/z/ — ㅈ이 아니라 성대를 울리는 /s/: representation /ˌɹɛp.ɹə.zɛnˈteɪ.ʃən/, mechanism /ˈmɛk.ə.nɪ.zəm/, diabetes /ˌdaɪəˈbiːtiːz/, exhaust /ɪɡˈzɔst/, diffuse /dɪˈfjuz/

이 영상으로 연습하는 방법

먼저 말하지 않고 영상을 끝까지 듣고 모르는 단어를 적어 둡니다.
보통 속도로 한 문장씩 섀도잉하고, 화자의 리듬과 맞을 때까지 반복합니다.
자신의 목소리를 녹음해 원본과 비교하고, valve, overcome, muscle 같은 단어에 특히 주의합니다.

쉐도잉이란? 영어 실력을 빠르게 키우는 과학적 방법

쉐도잉(Shadowing)은 원래 전문 통역사 훈련을 위해 개발된 언어 학습 기법으로, 다언어 학자인 Dr. Alexander Arguelles에 의해 대중화된 방법입니다. 핵심 원리는 간단하지만 매우 강력합니다: 원어민의 영어를 들으면서 1~2초의 짧은 지연으로 즉시 소리 내어 따라 말하는 것——마치 '그림자(shadow)'처럼 화자를 따라가는 것입니다. 문법 공부나 수동적인 청취와 달리, 쉐도잉은 뇌와 입 근육이 동시에 실시간으로 영어를 처리하고 재현하도록 훈련합니다. 연구에 따르면 이 방법은 발음 정확도, 억양, 리듬, 연음, 청취력, 말하기 유창성을 크게 향상시킵니다. IELTS 스피킹 준비와 자연스러운 영어 소통을 원하는 분들에게 특히 효과적입니다.

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쉐도잉 연습: Left Sided Heart Failure - 영상으로 영어 말하기 배우기

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