쉐도잉 연습: ST Elevation and Depression on an EKG Rhythm Strip - 영상으로 영어 말하기 배우기
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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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이 레슨의 어휘와 말하기 포인트
이 말하기 레슨은 영상 “ST Elevation and Depression on an EKG Rhythm Strip”을(를) 바탕으로 합니다. 가장 자주 반복되는 단어는 다음과 같습니다: lead, baseline, elevation, depression, tombstone. 이 영상에는 섀도잉할 문장 56개와 단어 693개가 있습니다. 말하는 구간의 길이는 4:15입니다. 화자는 분당 약 163단어로, 일상 대화에 가까운 자연스러운 속도로 말합니다. 영어에서 가장 많이 쓰이는 3,000단어에 속하는 단어가 77%뿐이라 어휘가 어려운 편입니다.
이 영상의 핵심 어휘
영상에 나오는 익혀 둘 만한 단어 15개를 발음, 뜻과 함께 정리했습니다.
| 단어 | 발음 | 뜻 |
|---|---|---|
| symptom 명사 | /ˈsɪm(p)təm/ | 증상, 증후 |
| curve 명사 | /kɚv/ | 곡선 |
| measurement 명사 | /ˈmɛʒ.ə.mənt/ | 측정 |
| sharp 형용사 | /ʃɑɹp/ | 날카로운 |
| reveal 동사 | /ɹɪˈviːl/ | 나타내다, 드러내다 |
| associate 명사 | /əˈsoʊʃi.ət/ | 제휴자, 조합원 |
| monitor 명사 | /ˈmɑ.nɪ.tɚ/ | 모니터 |
| indicate 동사 | /ˈɪndɪˌkeɪt/ | 가리키다 |
| interpretation 명사 | /ɪnˌtɜːpɹəˈteɪʃən/ | 통역 |
| depend 동사 | /dɪˈpɛnd/ | 의존하다, ...에 달려 있다 |
| trace 명사 | /tɹeɪs/ | 흔적, 자국 |
| threshold 명사 | /ˈθɹɛʃ(h)oʊld/ | 문턱, 문지방 |
| inflammation 명사 | /ɪnfləˈmeɪ̯ʃən/ | 염증 |
| tombstone 명사 | /ˈtuːmstoʊn/ | 묘석 |
| millimetre 명사 | 밀리미터, 밀리 |
주의할 발음
화자는 we'll, you're, can't 같은 축약형과 약화된 형태를 12번 사용합니다. 들리는 대로 짧게 발음하세요.
- “sh”와 “zh” 소리: elevation /ˌɛlɪˈveɪʃn̩/, measurement /ˈmɛʒ.ə.mənt/, sharp /ʃɑɹp/, associate /əˈsoʊʃi.ət/, interpretation /ɪnˌtɜːpɹəˈteɪʃən/
- 긴 단어 — 강세 위치에 주의: indicative /ɪnˈdɪk.ə.tɪv/, primarily /ˈpɹaɪ.mə.ɹə.li/, associate /əˈsoʊʃi.ət/, interpretation /ɪnˌtɜːpɹəˈteɪʃən/, inferior /ɪnˈfɪɹ.i.ɚ/
한국어 화자가 어려워하는 소리:
- /f/ — ㅍ(/p/)으로 바꾸지 말고 윗니를 아랫입술에 대기: inferior /ɪnˈfɪɹ.i.ɚ/, comfortably /ˈkʌmftɚbli/, inflammation /ɪnfləˈmeɪ̯ʃən/, infarct /ɪnˈfɑɹkt/, infarction /ɪnˈfɑɹk.ʃən/
- /v/ — ㅂ(/b/)과 구별하기: elevation /ˌɛlɪˈveɪʃn̩/, curve /kɚv/, activate /ˈæktɪˌveɪt/, indicative /ɪnˈdɪk.ə.tɪv/, reveal /ɹɪˈviːl/
- /r/과 /l/ 구별하기: primarily /ˈpɹaɪ.mə.ɹə.li/, reveal /ɹɪˈviːl/, variable [ˈvæɹ.i.ə.bl̩], threshold /ˈθɹɛʃ(h)oʊld/
이 영상으로 연습하는 방법
- 먼저 말하지 않고 영상을 끝까지 듣고 모르는 단어를 적어 둡니다.
- 0.75배속으로 한 문장씩 섀도잉을 시작하고, 익숙해지면 보통 속도로 돌아갑니다.
- 자신의 목소리를 녹음해 원본과 비교하고, symptom, curve, measurement 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.