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Rustiari Dewi, Ni Luh Putu
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Health Professions Medicine & Pharmacology Public Health

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Hypertrophic Cardiomyopathy Rustiari Dewi, Ni Luh Putu
Cermin Dunia Kedokteran Vol 46, No 12 (2019): Kardiovaskular
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (300.458 KB) | DOI: 10.55175/cdk.v46i12.393

Abstract

Hypertrophic Cardiomyopathy (HCM) merupakan kelainan jantung primer yang diturunkan secara genetik dengan karakteristik penebalan abnormal jaringan otot terutama ventrikel kiri tanpa kelainan jantung dan sistemik lainnya.Sekitar 60% kasus HCM diturunkan secara autosomal dominan berupa mutasi protein sarkomer jantung. Diagnosis berdasarkan klinis, elektrokardiogram, ekokardiogram, cardiac magnetic resonance (CMR), dan pemeriksaan genetik. Terapi ß-blocker dan penyekat kanal kalsium untuk mengurangi gejala sesak nafas, nyeri dada, penurungan aktivitas fisik. Intervensi invasif dengan ventricular septal myectomy (Morrow procedure) atau alcohol septal ablation. Evaluasi berkala dan konseling genetik juga direkomendasikan termasuk pada pasien tanpa gejala.Hypertrophic cardiomyopathy (HCM) is a primary cardiac disorder characterised by hypertrophy, usually of the left ventricle, in the absence of other conditions. Around 60% HCM patients have an autosomal dominant trait in cardiac sarcomere protein genes mutations. Diagnosis is established by clinical manifestation, electrocardiogram, echocardiogram, or cardiac magnetic resonance (CMR). Genetic test should be considered. Management consists of medications; ß-blocker and calcium channel-blocker are used to treat breathing difficulty, chest pain, decreased activity tolerance or fatigue. Invasive management are ventricular septal myectomy (Morrow procedure) or alcohol septal ablation. Periodic re-evaluation and genetic counseling is recommended, including in asymptomatic patients.
Diseksi Aorta Akut Stanford Tipe B dengan Gejala Akut Abdomen Rustiari Dewi, Ni Luh Putu; Aryasa, IGM Ardika; Dharma, Kadek Susila Surya
Cermin Dunia Kedokteran Vol 46, No 2 (2019): Penyakit Dalam
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (678.635 KB) | DOI: 10.55175/cdk.v46i2.522

Abstract

Diseksi aorta akut merupakan kegawatdaruratan aorta dengan presentasi klinis tidak spesifik dan mortalitas tinggi terutama bila tidak dikenali dini menyebabkan penanganan terlambat di unit gawat darurat. Kami melaporkan kasus laki-laki 71 tahun dengan diseksi aorta Stanford tipe B dengan presentasi atipik yaitu gejala nyeri abdomen akut. Pasien memiliki riwayat hipertensi tidak terkontrol sejak satu tahun. CT Angiography menunjukkan gambaran diseksi aorta Stanford tipe B dari arteri subclavia menurun hingga setinggi percabangan aorta. Terapi awal berupa kontrol tekanan darah. Selanjutnya pasien dirujuk untuk terapi thoracic endovascular aortic repair (TEVAR). Gejala akut abdomen perlu dipertimbangkan sebagai salah satu gejala klinis diseksi aorta.Acute aortic dissection is an emergency aortic disease with unspecific clinical presentations and high mortality especially if not early recognized. Its unspecific clinical presentations contributes to lack of proper initial emergency treatment. A case of 71 year-old male with Stanford type B aortic dissection with atypical presentation of acute abdomen was reported. Patient had uncontrolled hypertension since one year ago. CT Angiography described Stanford type B aortic dissection with dissection flap seen just beyond the origin of left subclavian artery extending downwards to terminate just above aortic bifurcation. Initial treatment was pain management and blood pressure control. Tha patient was referred for thoracic endovascular aortic repair (TEVAR). Acute abdomen must be considered as one of clinical presentations of acute aortic dissection.
Co-Authors Dharma, Kadek Susila Surya IGM Ardika Aryasa, IGM Ardika