Shadowing Practice: Left Sided Heart Failure - Learn English Speaking with Video

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?

100

Because this isn't here.

101

We don't have this arterial hypertension.

102

All we have is the muscles dying off.

103

So what do we do?

104

How can we overcome this?

105

Think about it.

106

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

107

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

108

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

109

So you get a volume overload issue.

110

Remember here, it was a pressure overload issue.

111

Now you've got a volume overload issue.

112

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

113

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

114

Eccentric hypertrophy.

115

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

116

Oh, sorry, in parallel.

117

I've given it away.

118

We add sarcomeres, however you spell parallel.

119

I can tell you all about biology.

120

I can't spell.

121

We're adding it in series in this instance.

122

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

123

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

124

what we call a dilated cardiomyopathy.

125

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

126

So there's the sarcomeres that existed.

127

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

128

right so you get this dilated effect

129

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

130

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

131

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

132

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

133

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

134

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

135

All right.

136

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

137

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

138

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

139

All right.

140

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

141

valve stenosis or a stenotic

142

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

143

and close properly right so it stays stiffly shut

144

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

145

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

146

Arterial hypertension, remember?

147

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

148

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

149

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

150

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

151

So it gets thicker but again this thickness gets so thick

152

that it narrows the inside of the ventricle

153

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

154

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

155

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

156

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

157

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

158

and that means

159

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

160

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,

161

not the normal blood leaving.

162

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

163

What's that?

164

It's a volume overload issue.

165

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

166

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

167

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

168

Dilated cardiomyopathies.

169

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

170

So it's this that's happening.

171

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

172

What do I mean by that?

173

Well, these are the overload causes, right?

174

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

175

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

176

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

177

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

178

So what can cause this?

179

Well, it can be alcohol abuse.

180

It can be cocaine.

181

It can be some chemotherapies.

182

It can do it.

183

Genetics.

184

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

185

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

186

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

187

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

188

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

189

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

190

so due to congestion and symptoms due to forward failure

191

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

192

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

193

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

194

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

195

if you've got blood not ejecting

196

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

197

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

198

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

199

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

200

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

201

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

202

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

203

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

204

and carbon dioxide to get transported mainly the oxygen

205

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

206

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

207

It's going to be dyspnea, right?

208

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

209

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

210

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

211

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

212

What are the forward failure effects?

213

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

214

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

215

You've got a reduction in cardiac output.

216

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

217

So what you end up getting is what?

218

Fatigue, right?

219

Exhaustion, weakness.

220

So fatigue, weakness.

221

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

222

Exercise or non -exercise induced.

223

Again, can't spell induced.

224

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

225

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

226

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.

227

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

228

So look, this is Left Side Heart Failure.

229

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

230

Thank you.

📺 Zelfde Kanaal

Epithelial Tissue

Cambridge Exam PrepUniversity StudentsWorking Adults

✨ Aanbevolen Video

72 zinnen

Woordenschat en spreektips bij deze les

Deze spreekles is gebaseerd op de video “Left Sided Heart Failure”. Deze woorden komen het vaakst terug: blood, failure, pressure, valve, overload. Deze video bevat 230 zinnen en 2644 woorden om na te spreken. Het gesproken deel duurt 18:57. De spreker praat in een gelijkmatig tempo van ongeveer 140 woorden per minuut, prettig om te shadowen. Slechts 79% van de woorden hoort bij de 3.000 meest gebruikte Engelse woorden, dus de woordenschat is pittig.

Belangrijke woorden in deze video

15 woorden uit de video die het leren waard zijn, met uitspraak en betekenis:

Woord	Uitspraak	Betekenis
valve zelfstandig naamwoord	/ˈvælv/	ventiel
overcome werkwoord	/ˌəʊ.vəˈkʌm/	overwinnen
muscle zelfstandig naamwoord	/ˈmʌs.əl/	spier
thick bijvoeglijk naamwoord	/θɪk/	dik, dikke
circulation zelfstandig naamwoord	/ˌsɝkjʊˈleɪʃən/	omloop
backward bijvoeglijk naamwoord	/ˈbækwɚd/	achteruit, naar achteren
congestion zelfstandig naamwoord	/kənˈd͡ʒɛs.t͡ʃən/	verstopping
narrow bijvoeglijk naamwoord	/ˈnæɹəʊ/	nauw, smal
vessel zelfstandig naamwoord	/ˈvɛsəl/	vaartuig
lung zelfstandig naamwoord	/ˈlʌŋ/	long
output zelfstandig naamwoord	/ˈaʊtpʊt/	productie
pump zelfstandig naamwoord	/pʌmp/	pomp
oxygen zelfstandig naamwoord	/ˈɑksɪd͡ʒən/	zuurstof
symptom zelfstandig naamwoord	/ˈsɪm(p)təm/	symptoom
tissue zelfstandig naamwoord	/ˈtɪʃ.(j)u/	weefsel

Phrasal verbs die je zult horen

Woord	Betekenis
back up werkwoord	teruggaan
end up werkwoord	belanden, terechtkomen
go back werkwoord	teruggaan
lie down werkwoord	gaan liggen, neerliggen
write down werkwoord	opschrijven, neerschrijven

Zinnen om te herhalen

Korte, volledige zinnen uit de video die je in alledaagse gesprekken kunt gebruiken:

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?

Grammatica in deze video

De structuren die de spreker het meest gebruikt, met de exacte woorden uit de video:

Structuur	In de video
Present perfect have/has + voltooid deelwoord — iets uit het verleden dat nu nog telt	I've separated · have increased · we've blocked
Lijdende vorm be + voltooid deelwoord — het gaat om wat er gebeurt, niet om wie het doet	is actually called · is decreased · is blocked
Betrekkelijke bijzinnen who / which + zin — extra informatie over een persoon of ding	alveolus, which is · ventricle which means · one which is

Uitspraak om op te letten

De spreker gebruikt 47 samentrekkingen en verkorte vormen, zoals you've, can't, we're. Spreek ze kort uit, zoals je ze hoort.

De “th”-klanken: thick /θɪk/, breathe /bɹiːð/, thickness /ˈθɪknəs/, pathology /pəˈθɒləd͡ʒi/, chemotherapy /ˌkiːməʊˈθɛɹəpi/
De klanken “sh” en “zh”: circulation /ˌsɝkjʊˈleɪʃən/, tissue /ˈtɪʃ.(j)u/, reduction /ɹɪˈdʌk.ʃən/, representation /ˌɹɛp.ɹə.zɛnˈteɪ.ʃən/, martial /ˈmɑɹʃəl/
Lange woorden — let op de klemtoon: circulation /ˌsɝkjʊˈleɪʃən/, respiratory /ɹɪˈspɪ.ɹət.ə.ɹi/, metabolic /mɛtəˈbɒlɪk/, representation /ˌɹɛp.ɹə.zɛnˈteɪ.ʃən/, mechanism /ˈmɛk.ə.nɪ.zəm/

Klanken die Nederlandstaligen lastig vinden:

Stemhebbende eindmedeklinker — /b/, /d/, /g/, /z/, /v/ niet verscherpen: valve /ˈvælv/, backward /ˈbækwɚd/, fluid /ˈflu.ɪd/, fatigue /fəˈtiːɡ/, dioxide /daɪˈɑksaɪd/
/æ/ — opener dan de Nederlandse “e”: valve /ˈvælv/, backward /ˈbækwɚd/, narrow /ˈnæɹəʊ/, cardiac /ˈkɑɹdiˌæk/, parallel /ˈpæ.ɹəˌlɛl/
/g/ — een harde plofklank, geen Nederlandse “g”: fatigue /fəˈtiːɡ/, exhaust /ɪɡˈzɔst/, undergo /ˌʌndɚˈɡoʊ/, exhaustion /ɪɡˈzɔːs.t͡ʃən/

Zo oefen je met deze video

Luister de hele video één keer zonder te spreken en noteer de woorden die je niet kent.
Spreek zin voor zin na op normale snelheid en herhaal elke zin tot je ritme gelijk is aan dat van de spreker.
Neem jezelf op en vergelijk met het origineel; let daarbij op woorden als valve, overcome, muscle.

Wat is de Shadowing-techniek?

Shadowing is een wetenschappelijk onderbouwde taalleermethode die oorspronkelijk is ontwikkeld voor professionele tolkentraining en gepopulariseerd door polyglot Dr. Alexander Arguelles. De methode is eenvoudig maar krachtig: je luistert naar native Engelse audio en herhaalt het onmiddellijk hardop — als een schaduw die de spreker volgt met slechts 1–2 seconden vertraging. In tegenstelling tot passief luisteren of grammaticadrills, dwingt shadowing je hersenen en mondspieren om echte spraakpatronen tegelijkertijd te verwerken en te reproduceren. Onderzoek toont aan dat het de uitspraaknauwkeurigheid, intonatie, ritme, verbonden spraak, luisterbegrip en spreekvaardigheid aanzienlijk verbetert — waardoor het een van de meest effectieve methoden is voor IELTS Speaking-voorbereiding en echte Engelse communicatie.

Shadowing-techniek: lees de volledige stap-voor-stap-gids →

Shadowing Practice: Left Sided Heart Failure - Learn English Speaking with Video

Epithelial Tissue

Blood Flow Through the Heart (Made Easy in 5 Minutes!)

Huntington's Disease Overview with Francisco Cardoso

This Book Stopped Me From Wasting My Life

Heart Failure Medications: What to Monitor Before You Give Them (Video 4 of 5)

Medium Vessel Occlusion: Should We Thrombectomize?

CHAPTER 7 - The Endocrine System - PART 2

Dr. Andy Galpin: Does Cardio Ruin Muscle Growth?.

How to Present a Patient: Inpatient Bedside Teaching Rounds (Group 12)

Surgical Anatomy 2 (Spleen)

Introduction to ECMO Part 3 - V-A ECMO

Respiratory System 5, Podcast on breathing