Shadowing Practice: Hypertrophic Cardiomyopathy - Patient’s Guide for Better Understanding - Learn English Speaking with Video
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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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Vocabulary and speaking notes for this lesson
This speaking lesson is built on the video “Hypertrophic Cardiomyopathy - Patient’s Guide for Better Understanding”. The speaker keeps coming back to these words: cardiomyopathy, gradient, hypertrophic, valve, pressure. This video has 83 sentences and 1192 words to shadow. The speech runs for 7:40. The speaker talks at a natural 155 words per minute, close to everyday conversation. Only 78% of the words are among the 3,000 most common in English, so the vocabulary is demanding.
Key vocabulary in this video
15 words from the video worth learning, with pronunciation and meaning:
| Word | Pronunciation | Meaning |
|---|---|---|
| echo noun | /ˈɛk.oʊ/ | A reflected sound that is heard again by its initial observer. |
| valve noun | /ˈvælv/ | A device that controls the flow of a gas or fluid through a space, such as a pipe, manifold, or plenum. |
| obstruction noun | /əbˈstɹʌk.ʃən/ | The act of obstructing, or state of being obstructed. |
| muscle noun | /ˈmʌs.əl/ | A contractile form of tissue which animals use to effect movement. |
| chamber noun | /ˈt͡ʃeɪ̯mbɚ/ | The private room of an individual, especially of someone wealthy or noble. |
| symptom noun | /ˈsɪm(p)təm/ | A perceived change in some function, sensation or appearance of a person that indicates a disease or disorder, such as fever, headache or rash; strictly, a… |
| disorder noun | /dɪsˈɔɹdɚ/ | Absence of order; state of not being arranged in an orderly manner. |
| distress noun | /dɪˈstɹɛs/ | Physical or emotional discomfort, suffering, or alarm, particularly of a more acute nature. |
| potentially adverb | /pəˈtɛnʃ(ə)li/ | In a manner showing much potential; with the possibility of happening in a given way. |
| monitor noun | /ˈmɑ.nɪ.tɚ/ | Someone who watches over something; a person in charge of something or someone. |
| genetic adjective | /d͡ʒəˈnɛt.ɪk/ | Relating to genetics or genes. |
| cord noun | /ˈkoɹd/ | A long, thin, flexible length of twisted yarns (strands) of fibre (a rope, for example). |
| hose noun | /hoʊz/ | A flexible tube conveying water or other fluid. |
| tract noun | /tɹækt/ | An area or expanse. |
| finger noun | /ˈfɪŋɡɚ/ | A slender jointed extremity of the human hand, (often) exclusive of the thumb, and the corresponding part, irrespective of including a thumb, in many other… |
Phrasal verbs you will hear
| Word | Meaning |
|---|---|
| get out of verb | To leave, exit or escape from; to become free of. |
| cut out verb | To refrain from (doing something, using something etc.), to stop or cease (doing something). |
| get out verb | To leave or escape. |
| go in with verb | To commit to something with; to partner with. |
| go through verb | To travel from one end of something to the other. |
| look forward to verb | To anticipate, expect, or wait for, especially with a feeling of approval or pleasure; to be excited or eager to. |
Grammar in this video
The structures the speaker uses most, with the exact words from the video:
| Structure | In the video |
|---|---|
| Passive voice be + past participle — the focus is on what happens, not who does it | is accelerated · is thickened · is found |
| Present perfect have/has + past participle — a past action that still matters now | you've put · haven't already had · that's been shown |
| Relative clauses who / which + clause — extra information about a person or thing | people who have · attack, which can |
Pronunciation to watch
The speaker uses 8 contractions and reduced forms, such as don't, haven't, I'm. Say them the short way, as you hear them.
- The “th” sounds: thick /θɪk/, underneath /ˌʌndɚˈniθ/, pathway /ˈpæθˌweɪ/, pathology /pəˈθɒləd͡ʒi/, thicken /ˈθɪkən/
- The “sh” and “zh” sounds: obstruction /əbˈstɹʌk.ʃən/, potentially /pəˈtɛnʃ(ə)li/, occasionally /əˈkeɪʒənəli/, reduction /ɹɪˈdʌk.ʃən/, partially /ˈpɑɹʃəli/
- Long words — get the stress right: potentially /pəˈtɛnʃ(ə)li/, electrical /ɪˈlɛktɹɪkəl/, occasionally /əˈkeɪʒənəli/, definitive /dɪˈfɪn.ɪ.tɪv/, accelerate /ɪkˈsɛl.əˌɹeɪt/
How to practise with this video
- Listen to the whole video once without speaking and note the words you do not know.
- Start at 0.75× speed, shadow it sentence by sentence, then go back to normal speed once it feels easy.
- Record yourself and compare with the original, paying attention to words like echo, valve, obstruction.
What is the Shadowing Technique?
Shadowing is a science-backed language learning technique originally developed for professional interpreter training and popularized by polyglot Dr. Alexander Arguelles. The method is simple but powerful: you listen to native English audio and immediately repeat it out loud — like a shadow following the speaker with just a 1–2 second delay. Unlike passive listening or grammar drills, shadowing forces your brain and mouth muscles to simultaneously process and reproduce real speech patterns. Research shows it significantly improves pronunciation accuracy, intonation, rhythm, connected speech, listening comprehension, and speaking fluency — making it one of the most effective methods for IELTS Speaking preparation and real-world English communication.