医患英文对话 | 心力衰竭
摘要: 心力衰竭(Heart Failure)是一种心脏无法有效泵血以满足身体需求的临床综合征,常表现为呼吸困难、乏力、液体潴留等症状。医患英文对话中常涉及症状描述、病史询问及初步检查安排,有助于跨语言医疗沟通。
- 心力衰竭患者常主诉活动后呼吸困难、夜间需高枕卧位,但未必出现典型踝部水肿。
- 医生通过询问症状起始时间、家族史(如高血压、肾病)及伴随症状(如发热、腰痛)进行鉴别诊断。
- 对话中提及的心电图和胸部X光是心衰初步评估的常用检查手段。
- 患者近期出现发热、寒战及双侧腰痛,提示需排除感染性或肾脏相关并发症。
- 尽管医生表示病情“不很严重”,但仍建议住院以降低风险,体现心衰管理中的谨慎原则。
小白老师说:劳动节不劳动,那跟咸鱼有什么区别?抓住假期的小尾巴,赶紧来发一篇医患英文对话!今天的主题是 Heart Failure,心力衰竭。照例给大家录了音频。
Heart Failure
Doctor: What is troubling you?
你觉得什么不舒服?
Patient: I have great difficulty in catching my breath. My heart is beating very fast.
我呼吸很困难,心跳得很快。
Doctor: When did you begin to notice these symptoms?
你什么时候发现这些症状的?
Patient: Well, five years ago in a routine check-up my school doctor told me that I had heart trouble. But it didn’t bother me and I could carry on as usual. In the last two years, I have noticed when I climb stairs my heart beats faster and I have to stop and catch my breath.
五年前在常规体检时校医告诉我我的心脏有问题。但是我毫无不适,能照常活动。最近两年我发现上楼梯时心跳得很快,并且不得不停下来喘气。

Doctor: How many pillows do you use when you sleep?
你睡觉时用几个枕头?
Patient: Two. I used to need only one, but since last year I’ve had to add another.
两个。我以前都是枕一个枕头,但从去年起,我必须增加一个。
Doctor: Do you ever have to get up at night to pass water?
你夜里需要起来小便吗?
Patient: No. 不需要。
Doctor: Have you had any swelling of your ankles?
你有过踝部水肿吗?
Patient: No, I don’t think so.
没有,没有水肿过。
Doctor: Have you ever had any pain in the small of your back?
你有过腰背部局限性疼痛吗?
Patient: Yes, every once in a while. But it doesn’t last long.
有过,偶尔有过。但是疼痛持续的时间不长。

Doctor: On both sides? 两侧都痛吗?
Patient: Yes. 是的。
Doctor: Have you had this recently?
近来你有过这种疼痛吗?
Patient: Once about a week ago, I believe.
大约一周以前确实有过这种疼痛。
Doctor: Did you have chills and fever at the same time?
与此同时你有寒战和发烧吗?
Patient: Yes. For a couple of days I felt as if I had some fever.
有。近两三天来我感觉好像有点发烧。

Doctor: Have you had any burning when you urinate?
你小便时有过灼烧感吗?
Patient: No. 没有。
Doctor: Has your urine ever been cloudy or bloody?
你的尿液有过浑浊或血样颜色吗?
Patient: Well, I haven’t noticed.
哦,我没有注意到。
Doctor: Has anyone in your family ever had kidney or heart disease?
你家里有人得过肾脏病或心脏病吗?
Patient: Well, my mother died of high blood pressure. And my father had what they called kidney cysts.
嗯,我母亲死于高血压。而我父亲患过他们所说的肾囊肿。
Doctor: Lie on the bed, please. I’ll examine you. I’ll give you an EKG and a chest x-ray. It seems you had better be hospitalized.
请躺在床上,我给你检查一下。我要给你做一个心电图,再做一个X线胸部检查。看来你最好还是住院。
Patient: Is it that bad? 有那么严重吗?
Doctor: No, it is not very serious, but I don’t want to take any risk. You’ll be all right soon.
不,情况不很严重,可是,还是小心点好,你很快就会好的。
常见问题
心力衰竭的典型英文症状描述有哪些?
常见英文描述包括 'difficulty catching my breath'(呼吸困难)、'heart beating very fast'(心跳加快)、'need extra pillows to sleep'(需多个枕头睡觉)等。
医生为何询问患者夜间是否起夜小便?
夜间排尿增多(夜尿)可能是心衰导致体液重新分布的表现,但本例患者否认此症状。
心衰患者为何需要做心电图和胸片?
心电图可评估心律和心肌缺血,胸片可观察心脏大小和肺淤血情况,是心衰初步诊断的重要工具。
家族史对心衰诊断有何意义?
高血压、心脏病或肾病家族史(如患者母亲死于高血压、父亲有肾囊肿)可能提示遗传或共病风险,影响诊疗决策。
参考资料
Heart Failure - Symptoms and Causes
↗Mayo Clinic 关于心力衰竭症状与病因的权威概述
ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure
欧洲心脏病学会心衰诊疗指南,支持症状评估与影像学检查的临床路径