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.

gun3 zong6 dung6 mak6 hai6 cung4 zyu2 dung6 mak6 fan1 ceot1 ge3 fan1 zi1, fu6 zaak3 gung1 jing3 hyut3 jik6 bei2 sam1 zong6.

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.

ji6 zim1 faan6 gaak3 hoi1 zo2 sam1 sat1 tung4 zo2 sam1 fong4. sam1 zong6 faan6 mok6 jau5 si6 ho2 nang4 wui5 ling6 dou3 hyut3 jik6 dou3 lau4.

二尖瓣隔開左心室同左心房。心臟瓣膜有事可能會令到血液倒流。

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

fai4 paau1 hai6 fai3 bou6 ge3 mei4 siu2 git3 kau3.

肺泡係肺部嘅微小結構。

nei1 dou6 zau6 hai6 joeng5 hei3 tung4 ji6 joeng5 faan3 haap3 hai2 hung1 hei3 tung4 hyut3 jik6 zi1 gaan1 zeon3 hang4 gaau1 wun6 ge3 dei6 fong1.

呢度就係氧氣同二氧化碳喺空氣同血液之間進行交換嘅地方。

Practice:

Chapter 4: Symptoms

• Hypotension

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• Orthostatic hypotension

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• Shock

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• Pale

min6 sik1 cong1 baak6 / pei4 fu1 cong1 baak6

面色蒼白 / 皮膚蒼白

• Chest pain

• Chest pressure

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• Shortness of breath

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• Palpitation

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• Wheeze

ce2 haa1 seng1 / cyun2 hei3 seng1

扯蝦聲 / 喘氣聲

• Stridor

cyun2 ming4 seng1 / gou1 jam1 ge3 fu1 kap1 zaap6 seng1

喘鳴聲 / 高音嘅呼吸雜聲

• Bleeding

ceot1 hyut3 / lau4 hyut3

出血 / 流血

• 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

kat1

咳

• Sputum

taam4

痰

• Sweating

ceot1 hon6

出汗

• Night sweats

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• Dizziness

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• Syncope

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• Loss of consciousness

sat1 heoi3 zi1 gok3 / wan4 zo2

失去知覺 / 暈咗

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?

nei5 wui5 m4 wui5 kat1 di1 je5 ceot1 lai4? di1 taam4 hai6 me1 sik1 gaa3?

你會唔會咳啲嘢出嚟？啲痰係咩色㗎？

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

jyu4 gwo2 nei5 jau5 hung1 tung3, hung1 mun6, waak6 ze2 tau2 m4 dou3 hei3, zau6 daa2 911 laa1.

如果你有胸痛、胸悶或者唞唔到氣，就打 911 啦。

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

ci4 zuk6 faat3 siu1, faat3 laang5, kat1 tung4 maai4 je6 gaan1 dou6 hon6, dou1 hai6 jim4 zung6 fai3 bou6 gam2 jim5 ge3 zing1 zong6.

持續發燒, 發冷, 咳同埋夜間盜汗, 都係嚴重肺部感染嘅徵狀。

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

wan2 ding6 / m4 wan2 ding6

穩定 / 唔穩定

• 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

sai3 zi1 hei3 gun2 jim4

細支氣管炎

• Emphysema

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• COPD

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• Pulmonary embolism

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• Laryngitis

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• Pneumothorax

hei3 hung1

氣胸

• Pleural effusion

hung1 coeng1 zik1 jik6 / hung1 mok6 zik1 jik6

胸腔積液 / 胸膜積液

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 Cantonese. 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.

sam1 fong4 zaan3 dung6 hai6 jat1 zung2 soeng4 gin3 ge3 sam1 leot6 bat1 zing3, keoi5 wui5 ling6 dou3 nei5 jing4 sing4 hyut3 syun1 tung4 zung3 fung1 ge3 fung1 him2 gang3 gao1.

心房顫動係一種常見嘅心律不正，佢會令到你形成血栓同中風嘅風險更加高。

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ngo5 ji5 cin4 jau5 gun3 sam1 beng6, dou1 zou6 gwo3 sau2 seot6. ngo5 ji4 gaa1 sam1 zong6 beng6 faat3 ge3 gei1 wui6 gou1 m4 gou1 aa3?

• 我以前有冠心病, 都做過手術。我而家心臟病發嘅機會高唔高呀？

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

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zi6 cung4 ngo5 waan6 gwo3 fai3 jim4 zi1 hau6, ngo5 ji4 gaa1 mui5 nin4 dou1 wui5 daa2 lau4 gam2 zam1.

• 自從我患過肺炎之後，我而家每年都會打流感針。

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

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.

sau1 suk1 aat3 gou1 gwo3 130 tung4 maai4 syu1 zoeng1 aat3 gou1 gwo3 80, zau6 ding6 ji6 wai4 gou1 hyut3 aat3.

收縮壓高過130同埋舒張壓高過80, 就定義為高血壓。

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ngo5 hai2 gap1 zing3 sat1 zou6 zo2 sam1 din6 tou4, ngo5 ho2 nang4 hou2 ci5 jau5 sam1 leot6 bat1 zing3.

• 我喺急症室做咗心電圖，我可能好似有心律不正。

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

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ngo5 jat1 zik6 jan1 wai6 pan4 hyut3 sik6 gan2 tit3 jyun2, soeng6 ci3 jim6 hyut3 hung4 daan6 baak6 dou1 zung6 hai6 jau5 di1 dai1.

• 我一直因為貧血食緊鐵丸，上次驗血紅蛋白都仲係有啲低。

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

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

waa4 faat3 lam4 / gon1 sou3

華法林 / 肝素

• Statin

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• Coronary artery bypass

gun1 zong6 dung6 mak6 daap3 kiu4 sau2 seot6

冠狀動脈搭橋手術

• 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

cyu5 mou6 hei3

儲霧器

• Oxygen mask

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• Intubation

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• Nasal cannula

bei6 dou6 gun2 / bei6 joeng5 hau4

鼻導管 / 鼻氧喉

• Healthy habits

gin6 hong1 zaap6 gwaan3

健康習慣

• Diet changes

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• Reduce salt intake

gaam2 siu6 jim4 ge3 sip3 jap6

減少鹽嘅攝入

• Increase exercise

zang1 gaa1 wan6 dung6

增加運動

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Practice:

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

nei5 jau5 mou5 faat3 siu1, faat3 laang5, waak6 ze2 kat1 aa3?

你有冇發燒, 發冷或者咳呀?

jyu4 gwo2 jau5 ge3 waa6, ngo5 dei6 wui5 bong1 nei5 zou6 san1 gaam1 beng6 duk6 caak3 si3.

如果有的話, 我哋會幫你做新冠病毒測試。

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

jan1 wai6 nei5 jau5 sam1 zong6 zaap6 jam1 tung4 sam1 gwai6, ngo5 soeng2 tung4 nei5 zou6 sam1 din6 tou4 tung4 sam1 zong6 ciu1 sing1 bo1.

因為你有心臟雜音同心悸, 我想同你做心電圖同心臟超聲波。

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ji1 sang1 gei2 nin4 cin4 waa6 ngo5 jau5 gou1 hyut3 aat3, gou1 hyut3 tong4 tung4 gou1 hyut3 zi1, zung6 hoi1 zo2 gong3 hyut3 aat3 joek6 bei2 ngo5.

• 醫生幾年前話我有高血壓, 高血糖同高血脂, 仲開咗降血壓藥畀我。

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

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gai1 daan6 ge3 daam2 gu4 seon1 ham4 loeng6 hou2 gou1, jan1 wai6 nei5 jau5 gun1 zong6 dung6 mak6 zat6 beng6, ngo5 m4 gin3 ji5 nei5 sik6.

• 雞蛋嘅膽固醇含量好高, 因為你有冠狀動脈疾病, 我唔建議你食。

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

nei1 go3 kap1 jap6 hei3 hai6 jung6 lai4 ji1 maan6 sing3 zi1 hei3 gun2 jim4 tung4 fai3 hei3 zung2 gaa3. nei5 ji4 gaa1 zaam6 si4 m4 sai2 sik6 kong3 sang1 sou3.

• 呢個吸入器係用嚟醫慢性支氣管炎同肺氣腫㗎。你而家暫時唔使食抗生素。

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.

jan1 wai6 sam1 leot6 bat1 zing3 ge3 cing4 fong3 gei2 jim4 zung6, ngo5 dei6 seoi1 jiu3 bong1 nei5 zong1 sam1 zong6 hei2 bok3 hei3 lai4 bong1 nei5 ge3 sam1 zong6.

因為心律不正嘅情況幾嚴重, 我哋需要幫你裝心臟起搏器嚟幫你嘅心臟。

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Conflict of interest

• No conflict of interest

Credit

• Text in slides and workbook written by
• With additional help from members of the CMIG @UCLA
• Video editing by