Indonesian Journal of Cardiology
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Review Articles
Get PDFAbstracts of the 5th InaPrevent in Conjunction with the 1st InTension Summit, 25-27 June 202
Ventricular Septal Rupture in ST-Elevation Myocardial Infarct in Low Resource Setting: a case series
Get PDFBackground: The mortality rate caused by myocardial infarct (MI) escalates in the presence of ventricular septal rupture (VSR). This article aimed to analyze clinical factors that might be valuable as predictors of VSR.
Case Illustration: We found and presented six documented post-infarction VSR out of 1,613 MI cases between January 2015 to December 2019.
Conclusion: Based on the analysis, clinicians should be aware of these factors as they were potential to be the predictors: advanced age, first MI, anterior location of the infarct, infranodal conduction disorder, no reperfusion treatment, high systolic blood pressure on admission, and no smoking history
Perbandingan dua aplikasi penapis fibrilasi atrium berbasis ponsel cerdas pada populasi Indonesia
No full textBackground: Due to its adverse outcomes and thromboembolic complications, early detection of atrial fibrillation (AF) is advisable in the general population. This study aims to compare the diagnostic ability of two distinct method in smartphone application format, namely : AliveCor KardiaMobile and FibriCheck.
Methods: This study was conducted in Mohammad Hospital General Hospital Palembang with convenience sampling of 170 participants aged 18 years or older. The subjects underwent Fibricheck and KardiaMobile recordings followed by 12 lead electrocardiogram read by board-certified cardiologist as the diagnostic standard.
Results: After the exclusion of previous pacemaker implantation (n=7), 163 patients were included in the study. The mean age was 51±15 years with gender distribution of 74.8% men and 25.2% women. Most of the subjects were asymptomatic (87.1%) with mean blood pressure of 130/80 mmHg. The Fibricheck readings showed sensitivity of 73% and specificity of 93%, meanwhile Kardiamobile was able to detect AF with sensitivity of 77% and specificity of 98%.
Conclusion: In our study, KardiaMobile demonstrated overall greater sensitivity and specificity when compared to FibriCheck. However, KardiaMobile requires an external metal sensor that must be puchased separately. To the best of our knowledge, this is the first study to directly compare both methods in the Indonesian population
Heart Failure with Preserved Ejection Fraction: A Case Report
No full textBackground: The prevalence of Heart Failure with Preserved Ejection Fraction (HFpEF) currently reaches 50% of heart failure cases and continues to increase every year. HFpEF is an important clinical condition, but the diagnosis is far more challenging than HFrEF (Heart Failure with Reduced Ejection Fraction), and there has not been any proven effective treatment. In this case presentation, the latest HFpEF diagnosis and therapy will be discussed.
Case illustration and discussion: A man and a woman came to the emergency room with signs and symptoms of congestion suggestive of heart failure. Additional examination was performed to support the working diagnosis of HFpEF, namely ECG, NTproBNP and echocardiography. HFA-PEFF scores of the first and second patient was 3 and 4 respectively. During hospitalization, diuretics was given to overcome congestion according to guidelines, as well as ACE-inhibitor and beta-blocker. Both patients were also screened for cardiovascular and non-cardiovascular comorbidities, and were given appropriate therapy.
Conclusion: The diagnosis of HFpEF does not have a gold standard yet, meanwhile, the HFA-PEFF scoring can be used. Recommended HFpEF therapy includes diuretics for congestion and management of comorbidities. Several studies of HFpEF treatment are ongoing
Patent Foramen Ovale Closure Procedure
Get PDFPatent foramen ovale is strongly associated with cryptogenic stroke. Variousclinical trials has shown the association between cryptogenic stroke andincidence of undelrying patent foramen ovale, these trials also shown thedecrease of cryptogenic stroke incidence with the treatment of patentforamen ovale Lesion. In the absence of absolute contraindications, patientswith patent foramen ovale are advised to undergo closure. Preproceduralexaminations such as trans esophageal echocardiography and pretreatmentwith anticoagulants are required to prevent peri and postprocedural adverseevents. Currently, patent foramen ovale Closure can be done through apercutaneous access with minimal risk. Treatment of patent foramen ovalecan help decrease future incidences of stroke
How to manage QT prolongation in COVID-19 patients
Get PDFIndonesia has declared a COVID-19 outbreaks because of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in March 2020. COVID-19 has significantly increased morbidity and mortality worldwide. Some studies have shown good clinical outcomes with the use of combination of chloroquine or hydroxychloroquine and azithromycin. That drugs can prolong the QT interval and increase the risk of Torsade de Pointes (TdP). The risk is increasing in several conditions such as in critical patients, metabolic disorders, sepsis, multiorgan dysfunction and with drug-drug interactions. Cardiologists need to know how to manage this condition to reduce the risk of TdP
Primary PCI in COVID-19 Pandemic: Be Cautious, It Might Reveal Itself Later
Get PDFBackground: Acute ST-segment–elevation myocardial infarction (STEMI) is a disease of high mortality and morbidity, and primary percutaneous coronary intervention (PPCI) is the preferred therapy for patient in golden period or with hemodynamic instability.1,2 Currently the world has been declared under COVID-19 (coronavirus disease 2019) pandemic by the World Health Organization (WHO).3 Signs and symptoms of COVID-19 patients can mimic acute decompensated heart failure, or induce acute cardiovascular problem.3 Screening is key, but there are conditions where physicians might miss positive COVID-19 cases, especially in critical cardiovascular emergency.
Case Illustration: A 60-year old male came to emergency room with breathlessness and chest pain 8 hours prior. He was diagnosed as acute inferior STEMI with acute lung edema and cardiogenic shock (KILLIP IV, acute heart failure wet and cold). COVID-19 screening was negative. Patient underwent PPCI, found to have total occlusion of right coronary artery (RCA) with thrombus and tight stenosis in left coronary artery (LAD). Successful PPCI to RCA was performed with TIMI 3 flow result, and hemodynamic improved. Ten hours after PPCI, hemodynamic deteriorated and peripheral oxygen saturation dropped. Patient was intubated and put on ventilator. Repeated chest X-Ray and thoracic CT showed lung condition has abruptly worsened – with ground glass opacity (GGO) found. His condition worsened quickly, and family agreed to a do not resuscitate (DNR) consent.
Conclusion: Acute cardiovascular condition in COVID-19 Pandemics represent big challenges, especially in early diagnostic and cardiovascular intervention decision. We were presenting a case where signs and symptoms of COVID-19 might appear later. Therefore, in this pandemic era every emergency cardiovascular intervention with signs of respiratory problem should be performed as if patient was a positive COVID-19 case
Wire Crossing Time Correlate with Left Ventricular End-Diastolic Pressure in Patients with ST Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
Get PDFBackgrounds: Mortality and morbidity in acute myocardial infarction depend on the extent of the infarct area. Rapid recovery of coronary artery blood flow with primary percutaneous coronary intervention (pPCI) can limit the extent of infarction and improve left ventricular function. Acute myocardial infarction reduce diastolic function, which in the early stage of diastolic dysfunction, there is an increase in left ventricular end-diastolic pressure (LVEDP). The non-invasive marker of E/e’ ratio is an accurate parameter of increased LVEDP.Methods: This was a cross-sectional study enrolled consecutive patients with ST Segment Elevation Myocardial Infarction (STEMI) who underwent pPCI at Dr. Sardjito Hospital. The wire crossing time was calculated from the onset of chest pain until the guidewire crossed the infarct-related artery during the pPCI procedure. The E/e’ ratio was determined by transthoracic echocardiography which performed within 48 hours after the primary PCI. Correlation between the wire crossing time and the E/e’ ratio was assessed by the Pearson correlation test. The value of p <0.05 was considered statistically significant.Results: A total of 40 patients were enrolled in this study. The mean wire crossing time was 12.73±5.22 hours. The median value of the E/e’ ratio was 8.36 (range: 4.71-22.00). There was a moderate strength and significant correlation between the wire crossing time and the E/e’ ratio (r = 0.572; p <0.001). Patients with E/e’ ratio >15 had significantly longer wire crossing time than in patient with E/e’ ratio ≤15 (20.21±2.5 hours vs. 11.41±4.39 hours; p <0.001; respectively). The wire crossing time was independently associated the E/e’ ratio (r = 0.463; p = 0.003).Conclusion: There was a moderate strength and significant positive correlation between the wire crossing time and increased LVEDP, an earlier marker of diastolic dysfunction, measured by E/e’ ratio using TTE in patients with STEMI underwent pPCI
Original Articles
Get PDFAbstracts of the 29th Annual Scientific Meeting of the Indonesian Heart Association (ASMIHA)
1st ASMIHA Digital Conference, 23-25 October 202
Review Articles
Get PDFAbstracts of the 29th Annual Scientific Meeting of the Indonesian Heart Association (ASMIHA)
1st ASMIHA Digital Conference, 23-25 October 202