Prática de Shadowing: Hypertrophic Cardiomyopathy - Patient’s Guide for Better Understanding - Aprenda a falar inglês com vídeo
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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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Vocabulário e dicas de fala para esta lição
Esta aula de conversação usa o vídeo “Hypertrophic Cardiomyopathy - Patient’s Guide for Better Understanding”. As palavras que mais se repetem: cardiomyopathy, gradient, hypertrophic, valve, pressure. Este vídeo tem 83 frases e 1192 palavras para praticar shadowing. A fala dura 7:40. O falante fala em ritmo natural, cerca de 155 palavras por minuto, próximo de uma conversa do dia a dia. Apenas 78% das palavras estão entre as 3.000 mais comuns do inglês, por isso o vocabulário é exigente.
Vocabulário principal deste vídeo
15 palavras do vídeo que vale a pena aprender, com pronúncia e significado:
| Palavra | Pronúncia | Significado |
|---|---|---|
| echo substantivo | /ˈɛk.oʊ/ | eco |
| valve substantivo | /ˈvælv/ | válvula |
| obstruction substantivo | /əbˈstɹʌk.ʃən/ | obstrução |
| muscle substantivo | /ˈmʌs.əl/ | músculo |
| chamber substantivo | /ˈt͡ʃeɪ̯mbɚ/ | câmara, quarto |
| symptom substantivo | /ˈsɪm(p)təm/ | sintoma |
| disorder substantivo | /dɪsˈɔɹdɚ/ | desordem |
| distress substantivo | /dɪˈstɹɛs/ | desconforto |
| potentially advérbio | /pəˈtɛnʃ(ə)li/ | potencialmente |
| monitor substantivo | /ˈmɑ.nɪ.tɚ/ | monitor, observador |
| genetic adjetivo | /d͡ʒəˈnɛt.ɪk/ | genético |
| cord substantivo | /ˈkoɹd/ | corda, barbante |
| hose substantivo | /hoʊz/ | mangueira, borracha |
| tract substantivo | /tɹækt/ | extensão |
| finger substantivo | /ˈfɪŋɡɚ/ | dedo (da mão) |
Phrasal verbs que você vai ouvir
| Palavra | Significado |
|---|---|
| get out verbo | sair |
| look forward to verbo | ansiar por, estar ansioso para |
Gramática neste vídeo
As estruturas que o falante mais usa, com as palavras exatas do vídeo:
| Estrutura | No vídeo |
|---|---|
| Voz passiva be + particípio passado — o foco está no que acontece, não em quem faz | is accelerated · is thickened · is found |
| Present perfect have/has + particípio passado — uma ação passada que ainda importa agora | you've put · haven't already had · that's been shown |
| Orações relativas who / which + oração — informação extra sobre uma pessoa ou coisa | people who have · attack, which can |
Pronúncia para ficar de olho
O falante usa 8 contrações e formas reduzidas, como don't, haven't, I'm. Diga-as na forma curta, do jeito que você ouve.
- Os sons de “th”: thick /θɪk/, underneath /ˌʌndɚˈniθ/, pathway /ˈpæθˌweɪ/, pathology /pəˈθɒləd͡ʒi/, thicken /ˈθɪkən/
- Os sons de “sh” e “zh”: obstruction /əbˈstɹʌk.ʃən/, potentially /pəˈtɛnʃ(ə)li/, occasionally /əˈkeɪʒənəli/, reduction /ɹɪˈdʌk.ʃən/, partially /ˈpɑɹʃəli/
- Palavras longas — acerte a sílaba tônica: potentially /pəˈtɛnʃ(ə)li/, electrical /ɪˈlɛktɹɪkəl/, occasionally /əˈkeɪʒənəli/, definitive /dɪˈfɪn.ɪ.tɪv/, accelerate /ɪkˈsɛl.əˌɹeɪt/
Sons difíceis para falantes de português:
- Consoante final — sem acrescentar um “i” depois: genetic /d͡ʒəˈnɛt.ɪk/, cord /ˈkoɹd/, tract /tɹækt/, cardiac /ˈkɑɹdiˌæk/, vast /væst/
- /l/ final — a língua toca o céu da boca, não vira “u”: muscle /ˈmʌs.əl/, electrical /ɪˈlɛktɹɪkəl/, vessel /ˈvɛsəl/, surgical /ˈsɝd͡ʒɪkəl/, mitral /ˈmaɪtɹəl/
- /h/ — um sopro suave, diferente do “r”: hose /hoʊz/, helpful /ˈhɛlp.fl̩/, whereas /(h)wɛɹˈæz/, hypertrophic /hʌɪpəˈtɹɒfɪk/
Como praticar com este vídeo
- Ouça o vídeo inteiro uma vez sem falar e anote as palavras que você não conhece.
- Comece na velocidade 0,75×, faça shadowing frase por frase e volte à velocidade normal quando ficar fácil.
- Grave a sua voz e compare com o original, prestando atenção a palavras como echo, valve, obstruction.
O que é a Técnica de Shadowing?
Shadowing é uma técnica de aprendizado de idiomas com base científica, originalmente desenvolvida para o treinamento de intérpretes profissionais. O método é simples, mas poderoso: você ouve áudio em inglês nativo e repete imediatamente em voz alta — como uma sombra seguindo o falante com 1-2 segundos de atraso. Pesquisas mostram melhora significativa na precisão da pronúncia, entonação, ritmo, sons conectados, compreensão auditiva e fluência na fala.