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All Journal GANESHA MEDICINA
Ernest Jonathan Hartiono
General Physician, Sanjwani General Hospital, Gianyar, Bali, Indonesia
Health Professions Medicine & Pharmacology Public Health

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Vicious Cycle of Malnutrition and Rheumatic Heart Disease: Prognostic Impact of Non-Adherence Ngurah Agung Reza Satria Nugraha Putra; Ernest Jonathan Hartiono; Ida Bagus Komang Arjawa; Nyoman Suciawan
Ganesha Medicina Vol. 6 No. 1 (2026)
Publisher : Universitas Pendidikan Ganesha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23887/gm.v6i1.107468

Abstract

Rheumatic heart disease (RHD) is a major burden in nations with low or middle incomes. Malnutrition is a typical issue that sets off a vicious cycle in which increasing cardiac dysfunction worsens nutritional status. As a result, patients' clinical conditions rapidly deteriorate. We report the case of a 12-year-old boy, previously diagnosed with RHD but lost to follow-up, who came to the ER with symptoms of acute heart failure in a chronic condition. Clinical examination showed extensive anasarca, a typical heart murmur, and signs of muscle atrophy. Echocardiography confirmed severe mitral regurgitation and moderate tricuspid regurgitation. Severe hypoalbuminemia (2.8 g/dL) also confirmed the patient's poor nutritional status, indicating a poor catabolic state, which contributed to the acute cardiac event. Because of the complexities of handling both of these concurrent medical conditions, the patient was transferred to a tertiary hospital for further treatment after stabilization in the ICU. The increasing complexity of RHD, non-adherence with treatment, and malnutrition will considerably worsen the patient's prognosis. Integrated and multidisciplinary management, emphasizing nutritional support and intense treatment adherence education, is a long-term strategy for breaking the vicious cycle in vulnerable populations.
Co-Authors Ida Bagus Komang Arjawa Ngurah Agung Reza Satria Nugraha Putra Nyoman Suciawan