ACI (Acta Cardiologia Indonesiana)
Not a member yet
176 research outputs found
Sort by
Obesity in Patient with Grown Up Congenital Heart Disease Ventricular Septal Defect with Pulmonary Hypertension in Sanglah Hospital, Bali, Indonesia
No full textVentricular septal defect (VSD) is a congenital heart disease (CHD) which characterized bya hole in the wall that separate between the right and left ventricle. There are several typesof VSD based on its location, which are perimembranous/conoventricular, subpulmonary/conotruncal, supracristal/doubly commited, muscular and atrioventricular canal/inlet. AVSD is one of the most common CHD which occurs in approximately 2-6 of every 1,000live births and accounts for more than 20% of all CHDs. However, the population of VSDpatients with grown up congenital heart disease (GUCH) is still uncertain. We are presentinga rare case of a 19 year old patient with congestive heart failure NYHA functional class IVdue to uncorrected left-to-right shunt supracristal VSD with body mass index of 35.5 kg/m2. He presented in the emergency room with acute decompensated heart failure profileB. Echocardiography revealed decreased left ventricle (LV) systolic function, normal rightventricle (RV) systolic function, decreased LV diastolic function, and dilated left atriumand LV. We plan to perform right heart catheterisation and pulmonary artery oxygenresponsiveness test followed by VSD closure in this patient. Another explanation will bediscussed in this paper
Abstracts of Symposium I: Stable Coronary Artery Disease: The Stable Plaque
No full textAbstracts of Symposium I: Stable Coronary Artery Disease: The Stable Plaqu
Correlation between Mitral Valve Area and Right Ventricle Function based on TAPSE (Tricuspid Annular Plane Systolic Excursion) Parameter in Mitral Stenosis Patient
No full textBackground: Mitral stenosis is the most common mitral valve disease found in Indonesia. Mechanical obstruction of blood flow from left atrium to left ventricle is compensated by pressure elevation in the left atrium and pulmonary circulation. It leads to right ventricle dysfunction which can be scored using TAPSE (Tricuspid Annular Plane Systolic Excursion) Parameter.Aim: The goal of this study is to assess the relationship between mitral valve area and right ventricle function based on TAPSE parameter in mitral stenosis patient.Methods: This study was conducted in Dr. Sardjito Hospital from May until July 2017. This was a part of mitral stenosis registry study. The parameter used was planimetry mitral valve area and TAPSE from echocardiography. The relationship between mitral valve area and TAPSE score we reanalyzed using Spearman correlation test in SPSS software.Results: The total sample included in this study was 132 people, consisted of thirty-eight (28.79%) males and ninety-four (71.21%) females. The range of the subjects’age was 18 68 year oldand the mean was 43.31±11.13 year old. The body mass index median was 21.24 (14.24–35.38) kg/m2. The subjects were dominated by severe degree mitral stenosis patients, those were ninety-three (70.45%) people, followed by moderate degree patients, those were thirty-two (24.24%) people, and mild degree patients, those were seven (5.30%) people. Twenty-eight (21.21%) people had isolated mitral stenosis. The mitral valve area median was 0.8 (0.27–1.90) cm2. The TAPSE score range was 6–30 mm and the mean was 17.48±4.58 mm. The result from Spearman correlation test showed that the relationship strength between mitral valve area and TAPSE score were very weak (r=0.167) with significant p-value (p=0.028).Conclusion: There is a statistically significant positive relationship with very weak strength between mitral valve area and TAPSE score as a right ventricle function parameter in mitral stenosis patients (r = 0.167, p = 0.028)
Correlation between Triglyceride/HDL Ratio with Severity of Coronary Artery Lesion in Non-Diabetic Stable Angina Pectoris Patients
No full textBackground: Triglycerides (TG) as a risk factor for coronary artery disease (CAD) is still a matter of controversy but when used as a single ratio with high density lipoprotein (HDL) the predictive value for CAD is better. The TG/HDL ratio is also associated with the presence of small dense LDL (sdLDL) in the body. SdLDL is a more atherogenic LDL subfraction and has been proven to be associated with CAD progression.Aims: This study aims to find the correlation between the TG/HDL ratio and the degree of coronary lesion severity based on the Gensini score in stable non diabetic angina pectoris patients.Methods: This study was a cross sectional study conducted at Dr. Hasan Sadikin Hospital and Hasna Medika Palimanan Hospital. Subjects were non diabetic stable angina pectoris patients ≥18 years old who underwent elective coronary angiography. Blood collection for TG and HDL examination was performed after coronary angiography. Gensini scoring system was used to assess the severity of coronary lesions. The relationship between the TG/HDL ratio and the Gensini score was analyzed using multiple linear regression tests against confounding variables.Results: This study involved 60 patients with stable angina pectoris with a mean age of 60±8 years. The mean TG/HDL ratio is 2.56 ± 1.04. The average Gensini score was 51 ± 36. The TG/HDL ratio was significantly associated with the Gensini score (R = 0.637; p <0.001). Analysis of confounding variables showed age, hypertension, and metabolic syndrome had a weak correlation with Gensini score (r values of 0.321, 0.270, and 0.333, p <0.05, respectively), while those correlating with TG/HDL ratios were men, hypertension, and metabolic syndrome (r values of 0.290, 0.287, and 0.362, p <0.05, respectively).Conclusion: TG/HDL ratio was significantly positively correlated significantly with the severity of coronary lesions based on Gensini score in non diabetic stable angina pectoris patients
Intracerebral and Subarachnoid Hemorrhage as a Result of Infective Endocarditis: A Case Report
No full textInfective endocarditis (IE) may have devastating and life-threatening neurological complications. The incidence of intracranial hemorrhage (e.g. subdural hematoma, subarachnoid hemorrhage (SAH), and intracerebral hemorrhage(ICH)) is rare. A 39 years old male, came to emergency unitwith heart failure clinical features, accompanied with fever for 2 weeks, and apical systolic murmur found in the physical examination. In the second day of admission, the patient experienced a sudden decrease of conciousness, weakness of the right limbs, and slurred speech. CT scan examination showed left parietal lobe ICH with volume ± 20 cc, and SAH in left parietal lobe, basalsystern, to pontine systern. Echocardiography revealed AML flail with severe mitral regurgitation and vegetation in AML. Empirical parenteral antibiotics ceftriaxone and gentamicin were given. In the following day, the conciousness was increasing. Later, the blood culture examination showed growing of Staphylococcus saprophyticus.Intracranial hemorrhage may cause worseningin patient’s condition, and require withdrawal in anticoagulant therapy. Cardiac surgery should be delayed.Despite of its uncommon incidence, physician should be aware of the neurological complication of IE to recognize and do the prompt treatment of the disease
Correlation between Carotid Intimal-Media Thickness and Coronary Artery Disease Severity in Stable Coronary Artery Disease Patients
No full textBackground: Atherosclerosis is a fundamental process in the natural course of coronary heart disease (CHD), carotid artery disease and peripheral artery disease. Atherosclerosis is caused by an imbalance of homeostasis in the level of the endothelial layer and the presence of risk factors. The manifestations of coronary atherosclerosis have a wide spectrum of diseases, ranging from subclinical to clinical phases. In patients without CHD symptoms, changes incarotid artery morphology include carotid intimal-media thickness (CIMT) and carotid plaques which correlated with CHD. This study aims to see the relationship between CIMT with the severity of coronary lesions in stable coronary artery disease.Methods: The study was an analytical observational research using cross sectional design. Data was taken by consecutive sampling from outpatient hospital clinic. The CIMT score was obtained from the examination of a communis carotid artery using a B-mode ultrasound device. The value ofCIMT is divided into 2 groups based on the value of the sensitivity curve and the specifcity curve. The value of Syntax was obtained from the catheterization laboratory and the factors that influenced it were recorded. Pearson correlation test is used to analyze the relationship of CIMT and Syntax value. The logistic regression test used for multivariate test.Results: Of the 58 patients, there were 33 subjects who had a CIMT score of > 0.71 mm and 25 subjects who had a CIMT score of ≤0.71 mm. There is a positive correlation (r = 0.403; p 0.71 mm compared to CIMT values ≤0.71 mm were 29 versus 4 (RR: 1.831; CI 95%:1.194-2.807; p = 0.01). A multivariate test showed CIMT consistently as a independent risk factor of Syntax value in stable coronary artery disease with RP 5.27 (CI 95%: 1.306-25.047; p = 0.021).Conclusion: The increase in CIMT value has a signifcant positive correlation with the Syntax value. A CIMT > 0.71 mm is a independent risk factor of high Syntax value in stable coronary artery disease with prevalence ratio 5.2
Pulmonary Artery Hypertension Associated with HIV Infection in Nine Year-Old Child
No full textPulmonary arterial hypertension (PAH) is a serious life threatening and severe complication ofHIV infection. A PAH presentation in patient with HIV tends to non specific, result in recognizeddiagnosis at a later stage. A 9 year-old HIV patient came to Pediatric Clinic with a chief complaint of worsening dyspneu for 1 month, leg edema and difficulty lying on a flat bed. Patient showed signs and symptoms that lead to pulmonary hypertension. An ECG findings were sinus rhythm, right axis deviation, and right ventricular hypertrophy. Echocardiography findings showed rightventricular and atrial enlargement, and high probability of pulmonary hypertension. Blood examination showed CD 4 was 84 cells/μL. The patient was managed as pulmonary arteryhypertension associated with HIV (HIV-PAH) infection.The patient was admitted for 3 weeksand eventually discharged with relieve condition
Comparison of Predicted Significant Coronary Lesion by Duke Treadmill Score among Coronary Heart Disease Risk Factors in Patients with Positive Ischemic Response Treadmill Test
No full textBackground: According to Framingham Study, independent risk factors for coronary heart disease (CHD) are diabetes, hypertension, smoking, dyslipidemia, family history of CHD and obesity. Previous study reported cut-off value of Duke Treadmill Score (DTS) < -0.5 represents a significant coronary lesion with positive predictive value 88.4%. Objective: To compare the incidence of predicted significant coronary lesions by DTS among various risk factors for coronary heart disease. Methods: A cross sectional study was done on 292 patients age 18 to 74 years old who had positive exercise testing for CAD screening during period of June 1st 2016 until May 30th 2017. DTS was calculated from treadmill test as: exercise time - (5 x ST deviation in mm) - (4 x exercise angina). A coronary lesion was predicted significant with DTS cut off value < -0.5. Results: Subjects mean age was 57 years old, male were 60.4%. The risk factors for CHD were found sequentially from the most frequent were hypertension 51.9%, smoking 35.3%, diabetes mellitus 23.1%, dyslipidemia 11.9%, obesity 4.2% and family history of CHD 6.3%. It was found that diabetes was significantly different from its effect on DTS value with p value = 0.021, while hypertension, obesity, dyslipidemia and family history CHD had no significant effect. Logistic regression found consistently that diabetes was significant (p=0.019). Conclusion: Predicted significant coronary lesions by DTS developed more frequent in diabetes compared to, hypertension, smoking, dyslipidemia, obesity and family history of coronary heart disease
Atrial Fibrillation in Dengue Infection: A Self-limiting Phenomenon? (Two Case Reports)
No full textDengue fever (DF) is highly prevalent in Indonesia as evidenced by 129,650 cases in 2015.Atrial fibrillation (AF) in dengue is exceptionally rare and usually self-limiting with resolution after recovery of illness. The aim of this case report is to depict two patients with AF in DF which resolves spontaneously in one and persists after infection in the other. Case 1 was 50 years old male presented with fever since 4 days before admission. NS1 antigen and IgM anti-Dengue virus were positive. An electrocardiogram (ECG) showed AF with rapid ventricular response (AFRVR). Case 2 was 53 years old male presented with dyspnea and palpitations 1 hour before admission. Patient had fever since 5 days before admission. Laboratory exams showed leukopenia, thrombocytopenia and positive IgM anti-Dengue virus. An electrocardiogram showed AFRVR. Intravenous fluids (normal saline), paracetamol, and digoxin were administered in both patients. They were admitted for close monitoring. Pre-discharge ECG of Case 1 showed resolution of AF. However, in Case 2, AF persists in pre-discharge ECG. In conclusion, physicians should be aware that a potentially reversible atrial fibrillation might be caused by this infection. It should be ensured that in those persisting cases, they should not be dismissed as just an ‘irreversible’ AF and progress into full-blown heart failure