ACI (Acta Cardiologia Indonesiana)
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Surgical and Non Surgical Interventions in Adult Congenital Heart Disease: Our Experience from COHARD registry
No full textSurgical and Non Surgical Interventions in Adult Congenital Heart Disease:Our Experience from COHARD registr
Rehabilitation Program in a Patient Undergoing Mitral and Aortic Valve Replacement Surgery
No full textHeart disease due to valvular anomaly has increased prevalence along with increasing age. The operative management including reparation or substitution with prosthetic valve is the main therapy. Still becoming question mark either rehabilitation program is benefcience for patient undergoing valvular surgery. We report a patient with heart failure due to valvular heart disease and underwent double valve replacement surgery. Cardiac rehabilitation phase 1 and phase 2 was done. Patient feel physical condition is much better than before.
Significance of Six Minute Walking Distance in Predicting Functional Capacity Status of Patients with Pulmonary Hypertension Complicating an Atrial Septal Defect
No full textBackground: Six minute walk test (6 MWT) is a sub-maximal exercise test that measures an integrated response of all systems responsible during exercise. Pulmonary arterial hypertension (PAH) is a problem encountered by patients with atrial septal defect (ASD). Assessment of functional capacity in patients with PAH based on the WHO functional classifi cation remains a powerfulpredictor of survival in these patients. The World Health Organization functional classifi cation is a subjective tool because it is based on anamnesis of ordinary activity. On the contrary, 6 MWT is an objective tool to measure functional capacity of patients with pulmonary hypertension. Objective: To determine the walking distance obtained using 6 MWT as a measurement of functionalcapacity in ASD patients with PAH. Methods: A cross sectional study was used to determine the walking distance as a measurement of functional capacity in ASD patient with PAH. This study was a sub-study of an Atrial Septal DefectRegistry done in RSUP Dr. Sardijto, Yogyakarta, since 2012. Pulmonary arterial pressure was measured using Pulmonary Arterial Systolic Pressure (PASP) obtained from echocardiography. Pulmonary hypertension was divided into three categories based on PASP, mild with PASP of less than 45 mmHg, moderate with PASP of 45-59 mmHg and severe with PASP of more than 60 mmHg. All patients did 6 MWT to measure their functional capacity. The relationship between 6 MWT distance and severity of PAH was measured using Pearson correlation analysis. Results: Forty-three patients were included in this study with 32 female patients (74%) and 11 male patients (26%) with an age range of 17-70 years old. Forty-four patients (44%) with ASD had severe PAH. The mean of 6 MWT distance was 337 m. There were signifi cant differences between mild, moderate and severe PAH in correlation with the 6 MWT distance (p= 0.001). The patients with severe PAH had only 278 m walking distance compared to those with mild PAH who had 394 m walking distance. There was a significant relationship between the 6 MWT distance and severity of PAH (p=0.01). This study showed that 6 MWT correlates negatively with the severity of PAH. We found that the higher pulmonary arterial pressure, the shorter walking distance (p=0.01, r -0,506). Conclusion: ASD defect patients with severe PAH had shorter walking distance compared to those with mild PAH. The 6 MWT is a reliable and objective measurement of functional capacity for ASD patients with PAH
ST Elevation Myocardial Infarction in Young Women Caused by a Coronary Embolism Generated from Mitral Valve Disease: a Case Report
No full textCoronary emboli causing ST elevation myocardial infarction (STEMI) is a rare condition. Intracardiac thrombus generated by valvular disease is the most common source of intracoronary embolism and mitral stenosis is frequently affected by intraatrial thrombus. Therapeutic strategy of coronary embolism is challenging because there were still no recommendation regarding coronary embolism published to day. We reported A 25 years old woman was admitted to the emergency department because of STEMI with complication of acute pulmonary edema and cardiogenic shock, and recurrent cardiac arrest. Angiographically showed total occlusion of left main artery with thrombotic lesions. Unfortunately after unfractionated heparin (UFH) was given and performed catheter cannulation, thrombus run to distal part of left coconary artery. Procedure is stopped and then patient transferred to cardiac care unit, but death shortly after arrival. Transthroracic echocardiography revealed mild to mild-modertae mitral stenosis with severe regurgitation due to mitral valve prolaps, aortic regurgitation, and left atrial and ventricular dilatation with no thrombus or spontaneous echo contrast, and failed to fi nd thrombus with in atrium. The presence af atrial dilatation and aortic regurgitation increased risk of thrombosis, meanwhile mitral regurgitation were reported as protective factor of atrial thrombosis. The pathophysiology of arterial thrombus or whitethrombus involving platelet activation leads to double antiplatelets and GbIIb/IIIa inhibitior to be more cruciale in coronary embolism. Double antiplatelet dan UFH administration did not improve survival in these patients. So that further research was needed to make a consensus of therapy. Careful assessment of intracardiac thrombus and risk of thromboembolism were important to prevent systemic embolization.Keywords: STEMI, coronary embolism, mitral valve disease
NSTEMI Presenting with Acute Pulmonary Edema with Culprit Lession Total Occluced Left Circumflex: a case report
No full textCurrent guidelines for the management of patients with acute coronary syndromes (ACSs) focus on the ECG to dichotomize patients into having ST elevation myocardial infarction (STEMI) or non-ST elevation myocardial infarction (NSTEMI)/ Unstable Angina (UA) in order to rapidly triagepatients to receive reperfusion therapy. Left circumfl ex artery occlusion is often categorized as NSTEMI because of the absence of signifi cant ST elevation on the 12 standard ECG leads. ST elevation is the condition ‘sine qua non’ for diagnosing acute total coronary occlusion causing transmural infarction. However, ST elevation when there is circumfl ex artery occlusion is seen onthe 12 standard ECG leads in fewer than 50% of patients. We reported a 77 years old women who diagnosed with NSTEMI. Twelve lead ECG showed ST depressed in V2-V5. On angiography we found a totaly ocluded of left circumfl ex as culprit lession.Keywords: NSTEMI; culprit lession; total occlusion; left circumflex arter
29-Years Old Woman Presenting with ST Elevation Myocardial Infarction
No full textMyocardial infarction in young female is rare condition, but carries significant morbidity and mortality. The recognition management for MI in young female is challenging due to its unspecific clinical presentation and lack of guidance in the current guidelines. We reported a 29-years old woman presenting with infarction type chest pain, showing ST- elevation in the inferior leads with total AVblock as complication. The risk factors in this patient were smoking, family history, cardiomyopathy, and preeclampsia history. The cause for myocardial infarction in this patient was atherosclerotic plaque rupture, but we did not manage to performed coronary intervention due to her low ventricular function and unavailability data for myocardial viability at the time of hospitalization
Common Atrium in Ellis Van-Creveld Syndrome
No full textSingle atrium is a complete absence of atrial septum.1 It is often found in Ellis-van Creveld Syndrome. Ellis-van Creveld Syndrome is a chondral and ectodermal dysplasia that is characterized by short ribs, polydactyly, growth retardation and also ectodermal and heart defects. We report a male, 18 years old who came with worsening of dyspnea. At physical examination we found short stature, polydactyly, cardiomegaly, severe scoliosis, genu valgum and nail hypoplasia. Transthoracic echocardiography showed the complete absence of atrial septum with signs of pulmonary hypertension.Keywords: common atrium, Ellis-van Creveld Syndrome, polydactyl
Brain Abscess in Young Adult with Double Outlet Right Ventricle (DORV): A Case Report
No full textIntracranial lesions frequently occur in association with congenital malformation of the heart. Intracranial abscess and cerebral thrombosisare the two most serious complications of the brain due to congenital cyanotic heart disease. We reported a case of brain abscess occurring in patients with double outlet right ventricle (DORV). The identification of focal infection and appropriate treatment with parenteral antibiotics,steroid, antiplatelet and anticonvulsant improved patients clinically.Keywords: brain abscess; congenital; double outlet right ventricl
Is Hypertension Preventable Disease: Primary and Secondary Prevention
No full textHypertension remains one of the most important preventable contributors to disease and ....
Association between Blood Pressure and 6 Minutes Walk Distance on Elderly Pilgrims
No full textIntroduction: Hypertension as one of the cardiovascular disease risk factors was known to be ....