Prática de Shadowing: ST Elevation and Depression on an EKG Rhythm Strip - Aprenda a falar inglês com vídeo

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In this video, we'll take a look at ST segment changes.

How do we identify and measure ST elevation and depression?

And what does it mean for our patient?

The ST segment is the space between the QRS and the T wave.

It should be resting comfortably on the baseline, but in some strips you may see it above or below the baseline.

When you're checking location of the ST segment, sometimes it seems a little variable.

But what we're basing this measurement on is where the J -point is.

That's the junction between the QRS and the ST segment.

It's where we stopped measuring the QRS complex.

So start by identifying where the baseline is.

Where does your PR segment rest?

And where does your diastolic phase between the T -wave and the P -wave come to rest?

That's your baseline.

Now, is the J -point on, below, or above the baseline.

The threshold for this is one millimeter or more elevated or depressed,

so one small box above or below the baseline is considered significant and warrants noting on the interpretation.

Take your calipers.

Place one point on the baseline and one point on the J -point.

You're measuring vertically for this, so take that measurement to a nice clear area where you can count the small boxes.

Vertically, each box represents one millimeter, so count the boxes and note ST elevation or depression

if you have at least one full small box or one millimeter of change from the baseline.

For this strip we have elevation.

The J point is three small boxes above the baseline.

So it's a three millimeter ST elevation.

For this strip we have depression.

The J point is two small boxes below the baseline.

So it's a two millimeter ST depression.

A lot of elevation and depression is chronic, and is indicative of some level of ischemic damage.

You can get a lot more specific with that

if you do a 12 -lead and look at how the ST changes appear on a number of different leads,

but on a 3 and 5 -lead monitor, we'll just say they indicate ischemia.

There are a couple of findings that are a bit more concerning, though.

If you see acute elevation, meaning it wasn't there before, and after the J -point you see a convex curve,

meaning after the j -point the tracing goes back up before returning to the baseline.

It ends up taking on a shape known commonly as a tombstone.

When you see tombstones, think heart attack.

The tombstone shape won't always show in every lead.

Depending on where the infarct is, the tombstone will show itself in the associated leads, and others may show nothing.

Here's an example of a 12 -lead EKG.

If we were looking at lead 2, we would have seen a tombstone shape appear for our patient.

But if we were looking at lead 1, it's only showing a minor depression.

Some other leads, like 3 or AVF, are showing the tombstone, but the rest are showing depression or sometimes no change at all.

This EKG may be indicative of an inferior wall MI,

which can be figured out based on which leads are showing the elevation changes and which are not.

That being Having said, we'll only be viewing leads 1, 2, 3, AVR, AVL, AVF and V1 on our 5 -lead setup.

And primarily, we'll be looking at lead 2.

So we can't see every infarct with a 5 -lead setup.

But when you do see it, check your patient for symptoms and activate the emergency response.

If the patient is showing symptoms, even if the 5 -lead isn't showing any elevation, activate the emergency response.

The 12 -lead may reveal what we couldn't see with the 5.

Another acute change you may see is when after the J -point, the ST segment curves down into a concave curve.

It can be indicative of pericarditis.

This ST change is usually widespread across many leads.

Pericarditis is inflammation of the pericardial sac surrounding the heart.

Symptoms include sharp chest pains, much like infarction.

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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Vocabulário e dicas de fala para esta lição

Esta aula de conversação usa o vídeo “ST Elevation and Depression on an EKG Rhythm Strip”. As palavras que mais se repetem: lead, baseline, elevation, depression, tombstone. Este vídeo tem 56 frases e 693 palavras para praticar shadowing. A fala dura 4:15. O falante fala em ritmo natural, cerca de 163 palavras por minuto, próximo de uma conversa do dia a dia. Apenas 77% 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
baseline substantivo	/ˈbeɪslaɪn/	referência
segment substantivo	/ˈsɛɡmɛnt/	segmento
strip verbo	/ˈstɹɪp/	tirar, retirar
symptom substantivo	/ˈsɪm(p)təm/	sintoma
curve substantivo	/kɚv/	curva
activate verbo	/ˈæktɪˌveɪt/	ativar
indicative adjetivo	/ɪnˈdɪk.ə.tɪv/	indicativo, indicador
measurement substantivo	/ˈmɛʒ.ə.mənt/	medida, medição
acute adjetivo	/əˈkjut/	agudo
sharp adjetivo	/ʃɑɹp/	afiado, aguçado
reveal verbo	/ɹɪˈviːl/	revelar
associate substantivo	/əˈsoʊʃi.ət/	associado
commonly advérbio	/ˈkɑmənli/	comumente
monitor substantivo	/ˈmɑ.nɪ.tɚ/	monitor, observador
indicate verbo	/ˈɪndɪˌkeɪt/	indicar

Phrasal verbs que você vai ouvir

Palavra	Significado
end up verbo	terminar, acabar
figure out verbo	descobrir, deduzir

Pronúncia para ficar de olho

O falante usa 12 contrações e formas reduzidas, como we'll, you're, can't. Diga-as na forma curta, do jeito que você ouve.

Os sons de “sh” e “zh”: elevation /ˌɛlɪˈveɪʃn̩/, measurement /ˈmɛʒ.ə.mənt/, sharp /ʃɑɹp/, associate /əˈsoʊʃi.ət/, interpretation /ɪnˌtɜːpɹəˈteɪʃən/
Palavras longas — acerte a sílaba tônica: indicative /ɪnˈdɪk.ə.tɪv/, primarily /ˈpɹaɪ.mə.ɹə.li/, associate /əˈsoʊʃi.ət/, interpretation /ɪnˌtɜːpɹəˈteɪʃən/, inferior /ɪnˈfɪɹ.i.ɚ/

Sons difíceis para falantes de português:

Consoante final — sem acrescentar um “i” depois: segment /ˈsɛɡmɛnt/, strip /ˈstɹɪp/, activate /ˈæktɪˌveɪt/, measurement /ˈmɛʒ.ə.mənt/, acute /əˈkjut/

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 baseline, segment, strip.

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.

Técnica de shadowing: leia o guia completo passo a passo →

Prática de Shadowing: ST Elevation and Depression on an EKG Rhythm Strip - Aprenda a falar inglês com vídeo

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