Практика Shadowing: Hypertrophic Cardiomyopathy - Patient’s Guide for Better Understanding - Изучайте разговорный английский по видео

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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.

Hypertrophic cardiomyopathy is a genetic disorder, and it results in a thickening of the heart muscle.

There are a number of different forms of this disorder, and so we'll talk a little bit about that.

The classic form of hypertrophic cardiomyopathy involves thickening of what we call the interventricular septum.

So the heart has four chambers, diagrammed here.

The left ventricular chamber and the right ventricular chamber are the two pumping chambers of the heart.

They're separated by this wall that we call the septum.

Normally that septum is about a centimeter thick.

In people who have particularly the obstructive form of hypertrophic cardiomyopathy,

There is a thickening of the septum right here underneath the

aortic valve where the blood is trying to get out of the heart.

And so when blood is trying to get out of the heart,

this thickened muscle gets in the way and obstructs the blood trying to get out.

It's kind of like if you took a hose

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.

And the reason it squirts out is that there's a pressure gradient

or a difference in pressure from on one side of where you've put your finger to the other side.

And that obstruction creates a gradient or a pressure gradient.

And we can actually measure that gradient with our echo technology.

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,

if you measure the pressure in the chamber of the heart, the top number will be higher than that.

So, for example, if you have a 50 millimeter gradient, for example, then the pressure inside the heart will be 170,

whereas the blood pressure is 120.

And that pressure gradient plays a role in the symptoms of this disease, and it's something we follow with echoes.

The other thing that happens in people who have this thickening of the septum is

that right next to the septum is the mitral valve.

And the mitral valve has these cords, kind of like parachute cords.

And when blood is accelerated through this outflow tract, it, for lack of a better word,

sucks these cords into the outflow tract, resulting in more narrowing and more obstruction.

And it also opens this valve and causes the valve to leak.

or something we call mitral regurgitation.

So we also see that in an echo, and depending on how much obstruction there is,

if there's more obstruction, there may be more leakiness of the mitral valve.

That also may contribute to symptoms in this disease.

We typically treat this disease first with medicines to try to reduce how much this heart muscle thickens

and how much it obstructs blood flow coming out of the heart.

And we can follow that with echoes

and with stress echoes to look at the gradient across the

outflow tract as well as the degree of leakiness of the mitral valve.

There are several issues that we need to talk about in patients with hypertrophic cardiomyopathy.

The first one relates to the diagnosis, where in the heart muscle is thickened,

and whether there's obstruction or not.

And we typically look at that with an echo and often times we use MRI for better clarification of the pathology.

So we will typically do an echo if you haven't already had one

and we will often times do an MRI to look at what the heart muscle actually looks like

and what the valve structure looks like.

The next thing we like to assess is what your symptoms are like.

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.

And with a stress echo what we do is we put you on a treadmill

or on a bike and we look at that gradient we talked about

and then we exercise you and see if that gradient changes with exercise.

We also monitor your blood pressure and see how well you can do to see what kind of symptoms you might have.

The third issue is that patients with hypertrophic cardiomyopathy are at risk for certain arrhythmias.

And those arrhythmias can be potentially dangerous.

And in fact, there is a small population of patients with hypertrophic cardiomyopathy who are at risk for something we call sudden cardiac death,

where they basically can have an arrhythmia and die suddenly.

So we look for arrhythmias in a couple of different ways, one of which is with monitoring, something like a Holter monitor.

And the other is that we have a group of colleagues called electrophysiologists who specialize in the electrical system of the heart.

And we will typically make sure that our electrophysiologist goes through all of the information

and has a discussion with you about your particular risks for having an arrhythmia and your risks for having sudden cardiac death.

And the reason that's important is if your risk is found to be elevated,

then in some population of patients with this disorder, we recommend defibrillators.

So as far as therapy,

we will talk about first medical therapy and then potentially the role for something we call an ICD or defibrillator.

Lastly, if patients don't do well with medical therapy,

occasionally we're in a position of talking about more definitive therapy to relieve obstruction.

And there are kind of two different pathways, one of which is called septal myomectomy where a surgeon goes in

and opens your chest and cuts out the thickened heart muscle and potentially repairs any abnormalities with the mitral valve.

And that's been shown to significantly improve symptoms and significantly improve outcomes in patients with this disorder.

There is an alternative called an alcohol septal ablation where we actually go in with a cath

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,

a little heart attack, which can reduce the obstruction.

We typically think of that as a second choice to the myomectomy

and used mostly in patients who are felt to be not surgical candidates.

So we call that whole category what we call septal reduction therapy.

The vast majority of patients don't need that and can be managed medically.

Lastly, as I mentioned, this is a genetic disease.

And so first -degree family members need to be screened.

And we can talk about the best way to screen them.

Typically, family members should be screened first -degree relatives, so siblings, children, parents, with an echo and an EKG.

And we can have a conversation about the role of genetic testing as well.

Thank you very much for your time.

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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Лексика и советы по произношению к этому уроку

Этот урок разговорной практики построен на видео «Hypertrophic Cardiomyopathy - Patient’s Guide for Better Understanding». Чаще всего повторяются слова: cardiomyopathy, gradient, hypertrophic, valve, pressure. В этом видео 83 предложений и 1192 слов для шедоуинга. Речь длится 7:40. Говорящий говорит в естественном темпе, около 155 слов в минуту, близком к повседневной речи. Только 78% слов входят в 3000 самых частых слов английского языка, поэтому лексика сложная.

Ключевая лексика этого видео

15 слов из видео, которые стоит выучить, с произношением и значением:

Слово	Произношение	Значение
echo существительное	/ˈɛk.oʊ/	э́хо, отголо́сок
valve существительное	/ˈvælv/	ве́нтиль, кла́пан
obstruction существительное	/əbˈstɹʌk.ʃən/	препя́тствие, обстру́кция
muscle существительное	/ˈmʌs.əl/	мы́шца, му́скул
chamber существительное	/ˈt͡ʃeɪ̯mbɚ/	ко́мната
symptom существительное	/ˈsɪm(p)təm/	симпто́м, при́знак
disorder существительное	/dɪsˈɔɹdɚ/	беспоря́док, каварда́к
distress существительное	/dɪˈstɹɛs/	го́ре, беда́
monitor существительное	/ˈmɑ.nɪ.tɚ/	наста́вник, наста́вница
genetic прилагательное	/d͡ʒəˈnɛt.ɪk/	генети́ческий
cord существительное	/ˈkoɹd/	верёвка, шнур
hose существительное	/hoʊz/	шланг
tract существительное	/tɹækt/	уча́сток
finger существительное	/ˈfɪŋɡɚ/	па́лец, перст
sudden прилагательное	/ˈsʌd.ən/	неожи́данный, внеза́пный

Фразовые глаголы, которые вы услышите

Слово	Значение
cut out глагол	возде́рживаться, воздержа́ться
look forward to глагол	ждать с нетерпе́нием, не мочь дожда́ться

Грамматика в этом видео

Конструкции, которые говорящий использует чаще всего, с точными словами из видео:

Конструкция	В видео
Пассивный залог be + причастие прошедшего времени — важно, что происходит, а не кто это делает	is accelerated · is thickened · is found
Present Perfect have/has + причастие прошедшего времени — прошлое действие, важное сейчас	you've put · haven't already had · that's been shown
Придаточные определительные who / which + предложение — уточнение о человеке или предмете	people who have · attack, which can

Произношение, на которое стоит обратить внимание

Говорящий использует 8 сокращённых и редуцированных форм, например don't, haven't, I'm. Произносите их коротко, так, как слышите.

Звуки «th»: thick /θɪk/, underneath /ˌʌndɚˈniθ/, pathway /ˈpæθˌweɪ/, pathology /pəˈθɒləd͡ʒi/, thicken /ˈθɪkən/
Звуки «sh» и «zh»: obstruction /əbˈstɹʌk.ʃən/, potentially /pəˈtɛnʃ(ə)li/, occasionally /əˈkeɪʒənəli/, reduction /ɹɪˈdʌk.ʃən/, partially /ˈpɑɹʃəli/
Длинные слова — следите за ударением: potentially /pəˈtɛnʃ(ə)li/, electrical /ɪˈlɛktɹɪkəl/, occasionally /əˈkeɪʒənəli/, definitive /dɪˈfɪn.ɪ.tɪv/, accelerate /ɪkˈsɛl.əˌɹeɪt/

Звуки, трудные для русскоязычных:

/w/ — губы округлены, это не /v/: whereas /(h)wɛɹˈæz/, pathway /ˈpæθˌweɪ/, squirt /skwɝt/
/h/ — лёгкий выдох, а не русское «х»: hose /hoʊz/, helpful /ˈhɛlp.fl̩/, whereas /(h)wɛɹˈæz/, hypertrophic /hʌɪpəˈtɹɒfɪk/
Звонкие согласные в конце слова — не оглушайте их: valve /ˈvælv/, cord /ˈkoɹd/, hose /hoʊz/, relative /ˈɹɛl.ə.tɪv/, whereas /(h)wɛɹˈæz/

Как заниматься с этим видео

Прослушайте всё видео один раз молча и выпишите незнакомые слова.
Начните со скорости 0,75×, повторяйте предложение за предложением и вернитесь к обычной скорости, когда станет легко.
Запишите себя и сравните с оригиналом, обращая внимание на такие слова, как echo, valve, obstruction.

Что такое техника Shadowing?

Shadowing — это научно обоснованная техника изучения языка, изначально разработанная для подготовки профессиональных переводчиков и популяризированная полиглотом доктором Александром Аргуэльесом. Метод прост, но эффективен: вы слушаете аудио на английском от носителей языка и немедленно повторяете вслух — как тень, следующая за говорящим с задержкой в 1–2 секунды. В отличие от пассивного прослушивания или грамматических упражнений, Shadowing заставляет мозг и мышцы рта одновременно обрабатывать и воспроизводить реальные речевые паттерны. Исследования показывают, что это значительно улучшает точность произношения, интонацию, ритм, связную речь, понимание на слух и беглость речи — что делает его одним из самых эффективных методов для подготовки к IELTS Speaking и реального общения на английском.

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