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The Unusual Presentation of Acute Pericarditis Mimicking Acute Coronary Syndrome Intan, Ryan Enast; Octora, Tan Nicko; Alkaff, Firas Farisi; Balti, Dimas Rio
Biomolecular and Health Science Journal Vol. 2 No. 2 (2019): Biomolecular and Health Science Journal
Publisher : Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (141.114 KB) | DOI: 10.20473/bhsj.v2i2.14608

Abstract

Pericarditis is a common disorder that might present in various settings, including primary-care and emergency department. However, the clinical features in some cases did not match with the written theory, which could lead to a misdiagnosis. A 46-year-old man presented to the emergency room with progressive tightness chest pain, epigastric pain, nausea, and vomiting in the past 2 days. Based on the clinical, electrocardiograph (ECG), and laboratory evaluation, the patient was diagnosed with unstable angina pectoris and treated accordingly but did not showed an improvement. Clinical re-examination and echocardiography evaluation showed a pathognomonic finding of pericarditis feature. Combination therapy of colchicine and ibuprofen was given for 3 weeks. One-month follow-up evaluation showed normal ECG and echocardiography result without any remaining symptoms. Acute pericarditis does not always show typical finding. Therefore, clinician must always aware with other differential diagnosis of chest pain and ECG variation of acute pericarditis.
Outcome Analysis and Determinants of Major Adverse Cardiac Events in Young Adults After Coronary Artery Bypass Graft Surgery Who Participated in Early Phase II Cardiac Rehabilitation Program: A single-centre study Radi, Basuni Radi; Intan, Ryan Enast; Dwiputra, Bambang; Desandri, Dwita R; Ambari, Ade Meidian
Jurnal Kardiologi Indonesia Vol 45 No 4 (2024): Online First - Indonesian Journal of Cardiology April-June 2021
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1727

Abstract

Background: Cardiac rehabilitation (CR) program is proven to reduce mortality risk after coronary artery bypass surgery (CABG). Our study aimed to investigate the determinants of survival in young adult patients after CABG. Method: This was a single-centre, longitudinal study with a survival analysis method from MACE of consecutive patients under 55 years old who underwent CABG and participated in the early phase II CR program between January 2017 and December 2018. The major adverse cardiac events (MACE) rates were determined over a 2-year follow-up time. Cox regression and Kaplan-Meier analysis were used to determine the predictors of the events based on the data registry. Result: 279 patients who fulfilled the inclusion criteria were recruited in this study. MACE happened to 23 (8.45%) of them (3 patients died, 20 patients were hospitalised). Patients who dropped out (12%) from the CR program had a higher risk of developing events (HR 3.86, 95% CI 1.36-10.99). Of those who completed the CR program (245 patients), beta-blocker usage, chronotropic index, resting heart rate, and functional capacity after the CR program independently correlated with MACE. Six-minute walk distance (6-MWD) 376 meters was a significant predictor (p=0.001), with a shorter mean survival time of 6 months. Conclusion: The early phase II CR program after CABG in young adult patients reduced the risk for cardiovascular mortality, major adverse events, and related readmission. It also increased the survival rate and mean survival time for participants who completed the CR program compared to dropouts. Optimum beta blocker medication, chronotropic index, resting heart rate, and functional capacity after the CR program are essential predictors of survival after CABG in young adults.