Indonesian Journal of Cardiology
Not a member yet
687 research outputs found
Sort by
Kasus Langka Iskemia Tungkai Akut Vasospastik
No full textBackground: Acute limb ischemia (ALI) requires immediate treatment to maintain limb viability and prevent morbidity and mortality. Nevertheless, vasospastic acute limb ischemia on limb arteries is rarely reported.
Case Illustration: This article reported a 37-year-old woman with sudden pain in her left leg and foot. The absence of peripheral pulsation of the left dorsalis pedis artery and popliteal artery were noted. Her foot was cold and clammy with decreased oxygen saturation in the left toes. The symptoms were partially improved following heparinization therapy. Angiography was conducted, and it revealed the spasms of the left popliteal and dorsalis pedis arteries with no sign of acute embolism or thrombosis. Arterial vasospasm is a rare cause of acute limb ischemia. A theoretical etiology of this vasospasm might be a secondary Raynaud's phenomenon. The associated factors were female, pre-menopausal age, the use of combined injectable contraception containing estrogen, and exposure to cold temperatures.
Conclusion: This case report emphasizes the necessity to consider all possible causes in ALI-presenting cases to provide adequate therapy and prevent limb death.Latar Belakang: Iskemia tungkai akut (ALI) memerlukan penanganan segera untuk mempertahankan viabilitas ekstremitas dan mencegah morbiditas dan mortalitas. Namun demikian, iskemia tungkai akut vasospastik pada arteri tungkai jarang dilaporkan.
Ilustrasi Kasus: Artikel ini melaporkan seorang wanita 37 tahun dengan keluhan nyeri mendadak pada kaki kirinya. Pulsasi perifer dari arteri dorsalis pedis dan arteri poplitea kiri tidak dapat dirasakan. Kaki dingin dan basah, disertai dengan penurunan saturasi oksigen di jari kaki kiri. Gejala mengalami perbaikan parsial setelah terapi heparinisasi dimulai. Angiografi menunjukkan spasme arteri poplitea kiri dan arteri dorsalis pedis tanpa tanda adanya emboli atau trombosis akut. Vasospasme arteri merupakan penyebab iskemia tungkai akut yang jarang ditemui. Etiologi teoritis dari vasospasme ini mungkin merupakan fenomena Raynaud sekunder. Faktor-faktor yang terkait adalah perempuan, usia pra-menopause, penggunaan kontrasepsi suntik kombinasi yang mengandung estrogen, dan paparan suhu dingin.
Kesimpulan: Laporan kasus ini menekankan perlunya mempertimbangkan semua kemungkinan penyebab dalam kasus ALI untuk memberikan terapi yang memadai dan mencegah kematian anggota badan
Case Reports
Get PDFThe 5th Indonesian Intensive and Acute Cardiovascular Care Meeting
Abstracts: Case Report
Reviews and Meta-analyses
Get PDFThe 5th Indonesian Intensive and Acute Cardiovascular Care Meeting
Abstracts: Review Article
Pacing Induced Cardiomyopathy: What is The Solution?
Get PDFABSTRACT
Background
Right ventricular pacing is associated with adverse outcome including increased risks of cardiovascular morbidity and mortality. RV pacing causes abnormal ventricular activation results in an inefficient contraction pattern with ventricular dyssynchrony and loss of myocardial work that may lead to LV dilation, systolic dysfunction, and clinical HF. Pacing induced cardiomyopathy (PICM) is caused by chronic and high burden RV pacing that may occur several months or years after pacemaker implantation.
Objective
To present a case of pacing induced cardiomyopathy (PICM) managed by CRT-P implantation.
Case Illustration
A male, 56 years old, was referred from dr. M. Djamil General Hospital with CHF Fc II-III, s/p PPM DDDR due to high degree AV block (2016) and history of failed CRT-P implantation (2018). He complained DOE (+), PND (+) and OP (+) since April 2017. Physical examination revealed pansystolic murmur grade 2/6 at apex, no rales and no oedema at both legs. ECG showed pacing rhythm and intrinsic rhythm was type 2 second degree AV block and RBBB with QRS duration 150 ms. Echocardiography showed global hypokinetic and dilated LV (LV EDD 71 mm, LV ESD 63 mm) with progressively reduced EF 38% à 33% (Simpson), functional moderate MR and mild TR. CAG showed non-significant coronary artery stenosis with 20% stenosis at distal LAD. Patient was diagnosed as pacing induced cardiomyopathy (PICM). At catheter laboratory, there was stenosis of left subclavian vein. His-Bundle pacing (HBP) was planned at first, however CRT-P with biventricular epicardial pacing was then performed in which LV lead was inserted through right axillary vein. During follow up at general ward, ECG showed biventricular pacing rhythm. There was no signs and symptoms of heart failure. Patient was hospitalized for 3 days and then discharged in a good condition.
Summary
We reported a case of pacing induced cardiomyopathy in male patient 56 years old. Pacing induced cardiomyopathy is a complication of high burden RV pacing. Options to treat PICM once it has developed, or to prevent it from developing in the first place, may include conduction system pacing (e.g.: HBP) or CRT-P implantation.
 
Case Reports/Series
Get PDFAbstracts of the 31st Annual Scientific Meeting of the Indonesian Heart Association (ASMIHA) 202
Acute Anterior Reinfarction Complicating with Transient Symptomatic Total Atrioventricular Block
Get PDFBackground
Acute stent thrombosis is a frequent cause of myocardial infarct (MI) after stent placement. Total atrioventricular (AV) block is frequently become the conductive disturbance complication of acute reinfarct. Inferior MI has Low long-term mortality and greater reversibility than anterior MI which has higher in-hospital and long-term mortality.
Case Illustration
A 44-year-old man, came to emergency department Cardiovascular Centre Harapan Kita with altered mental status since 12 hours ago. PPCI stenting at proximal LAD of his acute anterior MI 2 days ago. Patient had acute stent thrombosis then underwent urgent PCI at referring hospital. Patient present with blood pressure 57/30, heart rate 20 -30 with TAVB rhythm. Laboratory showed increased serum lactate level 5.2. Patient was diagnosed with Total AV block caused by MI. Patient was planned for emergency temporary pacemaker (TPM) implantation. After 24 hours close monitoring, the patient intrinsic rhythm resolved with spontaneous recovery. Patient was hemodynamically stable until discharge.
Discussion
Stent thrombosis of proximal stent of LAD will cause TAVB because of the source of the distal portion of the AV node is originating from septal branch of LAD. It is caused by extensive necrosis with higher in-hospital and long-term mortality, often culminated in permanent pacemaker. However, spontaneous recovery of TAVB into sinus rhythm take place. This could be caused by transient reversible ischemia of infra nodal region of AV node which supplied by septal perforator branch
Conclusion
This case reporting a complete atrioventricular block during the course of acute anterior reinfarct and had spontaneous resolution of the AV block. Mechanisms of spontaneous resolution of complete AV block in the setting of acute MI is associated transient ischemia after occlusion of proximal LAD.This article has a related Erratum
Research
Get PDF9th Annual Scientific Meeting of the Indonesian Heart Rhythm Society 2022
Abstracts: Research
 
Blok atrioventrikel pada bayi: sebuah laporan kasus
No full textBackground: Atrioventricular (AV) block in children may pose a challenge for phycisians. However, it can be detected with careful physical examination.
Case illustration: A 4 month old infant presented with bradycardia that did not improve during observation period. Her electrocardiography (ECG) showed complete atrioventricular block and her echocardiography showed secundum atrial septal defect (ASD) and patent ductus arteriosus (PDA). Her father’s ECG showed first degree AV block. She was recovered well after pacemaker implantation and PDA ligation.
Conclusion: An infant who suffered from complete AV block was successfully treated with pacemaker.This article has a related Erratum
The Importance of Hyperthyroid Screening in Acute Decompensated Heart Failure with Persistent Tachycardia Despite Optimal Decongestion: A Case Report
Get PDFBackground: Hyperthyroid has various effects on the cardiovascular system. Cardiac arrhythmias ranging from sinus tachycardia to atrial fibrillation and low/high cardiac output state to congestive heart failure are observed in patients with hyperthyroidism. If hyperthyroidism is recognized and treated early, the cardiac dysfunction could be corrected. This case presentation will discuss the importance of thyroid function screening.
Case Illustration and Discussion: A man was admitted to the emergency department with signs and symptoms of acute decompensated heart failure. Further examination was performed to confirm the diagnosis, namely ECG, laboratory examination including thyroid function test, and echocardiography. During hospitalization, heart failure medication was given and up titrated. The patient was still tachycardia until hyperthyroid was corrected with anti-thyroid medicines.
Conclusion: Hyperthyroidism can cause or worsen left ventricular dysfunction, especially in individuals with a history of cardiovascular disease. Thus, thyroid function tests should be assessed during initial laboratory examination, especially on patients with acute decompensated heart failure.This article has a related Erratum