Presented by Xin “Frank” Qi

Chinese Medical Interest Group at DGSOM

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Introduction to Medical Cantonese

Lecture 4

Cardiovascular and Pulmonary System

Chapter 4: CV anatomy

• Blood

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• Artery

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• Vein

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• Capillary

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• Aorta

• Coronary artery

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• Cerebral artery

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• Heart

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• Ventricle

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• Atrium

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• Heart valve

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• Mitral valve

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• Aortic valve

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• Cardiac electrical system

Chapter 4: Respiratory anatomy

• Nasal sinus

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• Larynx

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• Epiglottis

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• Vocal cords

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• Trachea

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• Lung

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• Bronchi

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• Alveoli

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• Diaphragm

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• Chest cavity

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• Oxygen

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• Carbon Dioxide

waang4gaak3mok6

橫 膈 膜

hung1hong1

胸腔

Cultural and translation notes:

• 血 has three pronunciations, and each are used in specific context.
• “xuě” - most commonly used, recommended pronunciation in the 2016 Mandarin pronunciation guide.
• “xiě” - more colloquial, often used when referring to blood outside of the body; it is also the pronunciation used in Taiwan.
• (ex. Bleeding - 流血)
• “xuè” – sometimes used when referring to blood inside of the body.
• (ex. Blood vessels – 血管)
• 氧 refers to the element oxygen, and refers to oxygen gas in gas or dissolved form

• The coronary arteries are branches off the aorta that supply blood to the heart.

hung1hong1

冠狀動脈係從主動脈分出嘅分支，負責供應血液俾心臟。

• The mitral valve separates left ventricle from left atrium. Heart valve defect can cause blood to flow backwards.

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• Alveoli are tiny structures in the lung. This is where oxygen and carbon dioxide exchange between air and blood occur.

Practice:

Chapter 4: Symptoms

• Hypotension

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• Orthostatic hypotension

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• Shock

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• Pale

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• Chest pain

• Chest pressure

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• Shortness of breath

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• Palpitation

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• Wheeze

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• Stridor

• Bleeding

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• Hemorrhage

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• Blood clot

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• Fever

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• Chills

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• Shiver

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• Cough

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• Sputum

• Sweating

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• Night sweats

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• Dizziness

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• Syncope

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• Loss of consciousness

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Chapter 4: Symptoms

Cultural and translation notes:

• 血 is the clot after the blood coagulates. The action of coagulation is
• Thrombosis, either from blood clot or anything else, is
• is a TCM terminology that accurately translates night sweats. However not everyone know the term, so suggest using instead.
• “着凉” is a TCM concept that means exposure to cold temperature, and it is common belief that cold exposure is a cause for common cold and other ailments. This is not the same as chills, which is a subjective feeling regardless of actual temperature.

Practice

• Do you cough up anything? What color is the sputum?

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• Call 911 if you experience chest pain, pressure, or shortness of breath.

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• Persistent fever, chills, cough, and night sweats are symptoms of serious lung infection.

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Chapter 4: Conditions

• Hypertension

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• Heart attack

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• Myocardial infarction

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• Cardiac arrest

• Arrythmia

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• Angina

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• Stable/unstable

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• Atrial fibrillation

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• Heart failure

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• Mitral valve regurgitation

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• Aortic dissection

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• Deep vein thrombosis

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Chapter 4: Conditions

• Coronary artery disease

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• Atherosclerosis

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• Plaque

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• Hyperlipidemia

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• Stroke

• Aneurysm

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• Anemia

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• Influenza

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• Common cold

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• COVID-19

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• Pneumonia

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• Tuberculosis

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• BCG vaccine

Chapter 4: Conditions

• Asthma

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• Bronchitis

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• Bronchiolitis

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• Emphysema

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• COPD

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• Pulmonary embolism

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• Laryngitis

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• Pneumothorax

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• Pleural effusion

Cultural and translation notes:

• 心脏病 can refer to any heart condition, while 心脏病发 only refers to heart attack. So when patient says they have 心脏病, it means that the patent has a PMH of heart condition, not that they are having heart attack right now.
• Constellation of hypertension, hyperglycemia, and hyperlipidemia is referred colloquially as 三高 – the three highs – in Mandarin. The term is basically synonymous to metabolic syndrome.
• 卒中 is medical jargon, most of the population would understand the term 中风 instead.

Cultural and translation notes:

• 结核病 can refer to any infection caused by M. tuberculosis, while 肺结核 specifically refers to the common, active pulmonary form.
• BCG vaccine is mandatory in China and many Asian countries. Interestingly, BCG is only protective against meningitis and disseminated form of TB in children, and it does not prevent pulmonary TB. TB skin test would be false positive if the patient had received the BCG vaccine. A more specific test for TB would be QuantiFERON gold or X-ray.

�Practice

• Atrial fibrillation is a common form of arrythmia, and it puts you at a higher risk for forming blood thrombus and having a stroke.

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I used to have CAD and had surgery. Do I have a high chance of heart attack now?

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• Ever since I had pneumonia, I take the flu vaccine every year now.

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Chapter 4: Physical exam

• Measuring BP

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• Systolic pressure

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• Diastolic pressure

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• Pulse

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• Heart rate

• Auscultate

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• Heart murmur

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Chapter 4: tests

• EKG

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• Echocardiogram

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• Cardiac stress test

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• Ejection fraction

• Complete Blood Count

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• Comprehensive Metabolic Panel

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Chapter 4: blood test

• Red blood cell

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• Hemoglobin

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• Hematocrit

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• White blood cell

• Platelet

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• LDL

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• HDL

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• Troponin

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• Cholesterol

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• Iron

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• Oxygen saturation

Cultural and translation notes:

• Don’t confuse 类固醇 (steroid) with 胆固醇 (cholesterol).

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• In TCM, 把脉/切脉 is a diagnostic technique that use characteristics of pulses to infer the energy status of the patient. It is not simply counting the pulse rate. is thus a more accurate translation for taking one’s pulse.

Practice

• A systolic pressure higher than 130 and diastolic pressure higher than 80 is defined as hypertension.

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I had an EKG in the Emergency Department, and I may seem to have an arrhythmia.

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I have been taking iron supplements because of my anemia, the hemoglobin was still a little low last time.

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Chapter 4: Treatment

• Epinephrine

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• Antihypertensives

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• ACE inhibitor

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• Beta blocker

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• Diuretic

• Anticoagulant

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• Thrombolytics

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• Warfarin/Heparin

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• Statin

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• Coronary artery bypass

• Cardiac catheterization

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• Angioplasty

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• Pacemaker

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• Valve replacement

Chapter 4: Treatment

• Bronchodilator

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• Inhaler

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• Spacer

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• Oxygen mask

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• Intubation

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• Nasal canula

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• Healthy habits

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• Diet changes

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• Reduce salt intake

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• Increase exercise

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Practice:

• Have you had fever, chills, or cough? If yes, we would test you for novel coronal virus.

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• Because of your heart murmur and palpitation, I would like to do an EKG and cardiac ultrasound.

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The doctor said I had hypertension, hyperglycemia, and hyperlipidemia a few years ago and prescribed antihypertensives.

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Eggs have high cholesterol content, because you have coronary artery disease, I wouldn’t suggest eating them.

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The inhaler is for treating chronic bronchitis and emphysema. You don’t require antibiotics for now.

• Due to the serious nature of the arrythmia, we would need to implant a pacemaker to help your heart.

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Conflict of interest

• No conflict of interest

Credit

• Text in slides and workbook written by Xin “Frank” Qi
• With additional help from members of the CMIG @UCLA
• Video editing by Jasmine Deng