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English to Spanish: Acute Coronary Syndrome and Preeclampsia Detailed field: Medical (general)
Source text - English A 36-year-old healthy nullipara (gravida 2) at 28 weeks of gestation presented to an outlying hospital with chest pain. She described resting substernal chest pain, with radiation down both arms that lasted 10 minutes. She had had 2 similar episodes of chest pain associated with nausea and vomiting, each episode had lasted 5–10 minutes. On arrival at the emergency department, she was asymptomatic, and her electrocardiogram showed normal sinus rhythm, with T wave inversion in leads I and AVL; her blood pressure was 180/106 mm Hg. She had been followed up by her obstetrician and had no history of hypertension before or during her pregnancy. Her first troponin I was negative and a CT scan of her chest was negative for aortic dissection. Her repeat troponin, 6 hours after presentation was positive at 3.2 (normal < 0.1). She was subsequently transferred to our facility for further evaluation and was admitted directly to the cardiac intensive care unit. Her medical regimen upon transfer included low molecular weight heparin, ß-blockade, and a glycoprotein inhibitor. The anticoagulation was discontinued.
An echocardiogram showed normal left ventricular function with mild anterolateral wall hypokinesis. She remained hypertensive, and her urine analysis was positive for 100 mg of protein. Fetal heart rate monitoring showed late decelerations suggestive of fetal distress, and it was advised that the patient have a cesarean delivery. After adequate blood pressure control with intravenous ß-blockade and hydralazine, a cesarean was performed and a 925-g male neonate was delivered. The umbilical cord was found wrapped around the body of the neonate, and old clot was found at the edge of the placenta. The remainder of her hospital course was uneventful. Several weeks after her discharge from the hospital she had a treadmill stress test; she completed 9 minutes of the Bruce protocol with a maximal heart rate of 132 beats/min without symptoms or EKG changes suggestive of ischemia. The patient and her infant boy did well on follow-up.
Translation - Spanish Nulípara sana de 36 años (grávida 2), gestante de 28 semanas que ingresó en un hospital periférico con dolor precordial. Manifestaba dolor retroesternal de reposo, irradiado a ambas extremidades superiores de unos de 10 minutos de duración. Había sufrido 2 episodios similares de dolor torácico acompañado de náuseas y vómitos, cada uno de los cuales con una duración de entre 5 y 10 minutos. A su llegada al servicio de urgencias, estaba asintomática y el electrocardiograma mostraba un ritmo sinusal normal, con inversión del segmento T en derivadas l y AVL y su presión arterial era 180/106 mm HG. En su historial médico realizado por su obstetra no constaban antecedentes de hipertensión antes del embarazo. El primer nivel de troponina l era negativo y el escáner de tórax no mostraba disección aórtica. El siguiente nivel de troponina, 6 horas después del cuadro clínico era positivo con un nivel de 3.2 (normal< 0.1). Posteriormente se trasladó a la paciente a nuestro centro para el seguimiento posterior e ingresó directamente al servicio de cuidados intensivos de cardiología. Su tratamiento al ingreso incluía heparina de bajo peso molecular, beta-bloqueantes e inhibidores de la glicoproteína. El tratamiento anticoagulante se suspendió.
El ECG mostraba una función normal del ventrículo izquierdo con una ligera hipoquinesia de la pared anterolateral. Permaneció hipertensa y el análisis de orina mostraba una proteinuria de 100 mg. La monitorización del latido fetal mostraba desaceleraciones tardías indicadoras de sufrimiento fetal que requirió parto por cesárea. Después de un buen control de la presión arterial con beta-bloqueantes e hidralacina se realizó un parto por cesárea con alumbramiento de un neonato de 925 g. El cordón umbilical estaba enrollado alrededor del cuerpo y se halló un coágulo antiguo en el borde de la placenta. El resto de su transcurso hospitalario no presentó complicaciones. Al cabo de unas semanas del alta, la paciente se sometió a una prueba de esfuerzo en la que realizó 9 minutos del protocolo de Bruce con una frecuencia cardiaca máxima de 132 latidos/min sin hallazgos significativos en el ECG o síntomas de isquemia. La paciente y el bebé tuvieron una buena evolución.
English to Spanish (Imperial College London (Univ. of London)) English to Spanish (University of Barcelona) English to Spanish (City University London)
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