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A Case Report of Wellens’ Syndrome: An Ominous Sign of Left Anterior Descending Artery Critical Stenosis and Impending Anterior Myocardial Infarction Willim, Herick Alvenus; Agustyana, Andini; Arilaksono, Dwisetyo Gusti; Proklamartina, Nurnajmia Curie; Furqon, Muhammad
Indonesian Journal of Medicine Vol. 5 No. 3 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (32.217 KB)

Background: Wellens’ syndrome is a potentially life-threatening condition, characterized by biphasic or deeply inverted T-waves changes in electrocardiographic (ECG) precordial leads, which associated with critical stenosis of left anterior descending (LAD) coronary artery and impending anterior myocardial infarction in patients presenting with unstable angina. This syndrome is an important sign for clinicians because delay in coronary angiography and revascularization may lead toanterior myocardial infarction, left ventricular dysfunction, and even death.Case presentation: A 50-year-old woman came to emergency department in a hospital in Bontang, with new onset intermittent typical chest pain lasting since 3 days. She had history of hypertension without regular medication. Physical examination was in normal ranges. An ECG obtained during chest pain-free period showed Wellens’ type A with biphasic T waves in V2-V6 and preserved R-wave progression. Troponin T was slightly elevated. During observation, the ECG pattern changed from Wellens’ type A to Wellens’ type B with deep T-wave inversions in V2-V6 and preserved R-wave progression.Results: The patient was initially treated with conservative treatment. On the next day, she was referred to percutaneous coronary intervention-capable hospital in Samarinda. Coronary angiography revealed 90% stenosis of mid LAD. A drug-eluting stent was successfully implanted with restoration of LAD flow. She was discharged on the following day in good condition with medication of dual antiplatelet therapy, angiotensin-converting enzyme inhibitor, beta-blocker, and statin.Conclusion: Clinicians should be aware of the ECG changes in Wellens’ syndrome, which may occur during pain-free period. Early recognition is crucial to avoid the development of anterior myocardial infarction. Immediate coronary angiography and revascularization is needed.Keywords: Wellens’ syndrome, critical stenosis, myocardial infarctionCorrespondence: Herick Alvenus Willim. Dr. Agoesdjam General Public Hospital, Ketapang, West Kalimantan. Email: herick_alvenus@yahoo.co.id.Indonesian Journal of Medicine (2020), 05(03): 246-252https://doi.org/10.26911/theijmed.2020.05.03.10

Clinical Characteristics of Coronavirus Disease 2019 in Dr. Agoesdjam Regional Public Hospital, Ketapang, West Kalimantan, Indonesia Willim, Herick Alvenus; Cristianto, Cristianto; Sihombing, Yohana Roy Ito Br; Munthe, Eva Lydia; Mujono, Widi; Enny, Enny
Journal of Epidemiology and Public Health Vol. 5 No. 3 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (33.261 KB)

Background: Coronavirus disease 2019 (COVID-19) is a new pandemic caused by SARS-CoV-2 infection. COVID-19 has spread to almost all countries with increasing cases, including Indonesia. Data on the clinical characteristics of COVID-19 in Indonesia is still limited. This study aimed to determine the clinical characteristics of COVID-19.Subjects and Method: This study was a descriptive study with a retrospective design conducted in Dr. Agoesdjam Regional Public Hospital. The data were obtained from the medical records of all patients with confirmed COVID-19 from April 1 to July 31, 2020. There were 50 patients as the sample of the study. The data collected were demographics, expo

Diagnosis dan Tatalaksana Perikarditis Akut Willim, Herick Alvenus; Supit, Alice Inda
Cermin Dunia Kedokteran Vol 46, No 12 (2019): Kardiovaskular
Publisher : PT. Kalbe Farma Tbk.

Penyakit perikardium dapat mencakup perikarditis, efusi perikardium, tamponade jantung, dan tumor perikardium. Perikarditis akut merupakan penyakit perikardium yang paling sering dalam klinis. Perikarditis akut ditemukan pada 0,1% seluruh kasus pasien nyeri dada di rumah sakit dan 5% seluruh kasus nyeri dada non infark miokard akut di instalasi gawat darurat. Perikarditis akut penting dibedakan dari penyebab nyeri dada lainnya.Pericardial diseases consist of pericarditis, pericardial effusion, cardiac tamponade, and pericardial tumors. Acute pericarditis is the most common form of pericardial disease in clinical practice. It is diagnosed in approximately 0,1% patients hospitalized for chest pain and in 5% patients admitted to emergency for chest pain unrelated to acute myocardial infarction. Clinician should be able to differentiate acute pericarditis with other causes of chest pain.

Endokarditis Infektif : Diagnosis, Tatalaksana dan Pencegahan Willim, Herick Alvenus
Cermin Dunia Kedokteran Vol 47, No 8 (2020): Kardiologi
Publisher : PT. Kalbe Farma Tbk.

Endokarditis infektif (EI) disebabkan infeksi mikroorganisme di permukaan endokardium, paling banyak mengenai katup jantung. EI berhubungan dengan komplikasi dan mortalitas yang signifikan. Diagnosis berdasarkan modifikasi kriteria Duke. Tatalaksana meliputi terapi empiris, terapi spesifik dan pembedahan. Strategi pencegahan EI perlu diterapkan pada populasi umum, terutama pada pasien risiko tinggi.Infective endocarditis (IE) is caused by microorganism infection of the endocardial surface, most commonly affects cardiac valves. IE is associated with significant complication and mortality. Diagnosis is according to modified Duke criteria. Management includes empiric therapy, specific therapy, and surgery. IE prevention strategies is necessary in general population, especially in high-risk population.

Diagnosis dan Tatalaksana Sindrom Brugada Willim, Herick Alvenus; Ketaren, Infan
Cermin Dunia Kedokteran Vol 46, No 5 (2019): Pediatri
Publisher : PT. Kalbe Farma Tbk.

Sindrom Brugada (SB) adalah abnormalitas listrik jantung bawaan yang langka. SB merupakan salah satu penyebab utama kematian mendadak pada usia muda tanpa penyakit jantung organik. SB dapat bersifat asimtomatik maupun simtomatik. Beberapa pasien dapat mengalami sinkop, bahkan aritmia yang mengancam nyawa seperti fibrilasi ventrikel. EKG menjadi kunci utama diagnosis SB. Diperlukan stratifikasi risiko dan strategi lanjutan untuk mencegah henti jantung mendadak.Brugada syndrome (BS) is a rare inherited abnormality of heart electrical activity. BS is one of the leading causes of sudden cardiac death among youth without underlying organic heart disease. BS can be asymptomatic or symptomatic. Some patients may experience syncope, even life-threatening arrhythmia such as ventricular fibrillation. ECG test is the main key of diagnosis. Risk stratification and further strategies are needed to prevent sudden cardiac death.

Lung Adenocarcinoma Complicated By Hydropneumothorax And Pericardial Effusion With Impending Cardiac Tamponade: A Rare Case Report From A Rural Hospital In Ketapang Regency: english Saputra, Gede Ardi; Kalua, Kesih; Willim, Herick Alvenus; Munthe, Eva Lydia
Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan Vol 18 No 2 (2024): Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan
Publisher : Fakultas Kedokteran UPN Veteran Jakarta Kerja Sama KNPT

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33533/jpm.v18i2.9259

Lung adenocarcinoma is often associated with pulmonary complications such as hydropneumothorax and pleural effusion, and cardiac complications such as cardiac tamponade and pericardial effusion, but are very rare. In our case, a 52-year-old woman presented with worsening shortness of breath for 1 month. The patient underwent thoracentesis after chest X-ray showed right pleural effusion. Pleural fluid cytology showed pulmonary adenocarcinoma. Chest CT scan showed hydropneumothorax and pericardial effusion. In conclusion, pleural effusion is common in lung malignancies. In this case, hydropneumothorax occurred due to repeated thoracentesis of massive pleural effusion. Pericardial effusion is uncommon. This is due to the presence of metastases in the pericardium that obstruct lymphatic drainage, so pericardial fluid analysis is needed.

Clinical Characteristics of Coronavirus Disease 2019 in Dr. Agoesdjam Regional Public Hospital, Ketapang, West Kalimantan, Indonesia Willim, Herick Alvenus; Cristianto, Cristianto; Sihombing, Yohana Roy Ito Br; Munthe, Eva Lydia; Mujono, Widi; Enny, Enny
Journal of Epidemiology and Public Health Vol. 5 No. 3 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar

Background: Coronavirus disease 2019 (COVID-19) is a new pandemic caused by SARS-CoV-2 infection. COVID-19 has spread to almost all countries with increasing cases, including Indonesia. Data on the clinical characteristics of COVID-19 in Indonesia is still limited. This study aimed to determine the clinical characteristics of COVID-19.Subjects and Method: This study was a descriptive study with a retrospective design conducted in Dr. Agoesdjam Regional Public Hospital. The data were obtained from the medical records of all patients with confirmed COVID-19 from April 1 to July 31, 2020. There were 50 patients as the sample of the study. The data collected were demographics, expo

Platelet Transfusion in Clinical Practice: A Narrative Literature Review Willim, Herick Alvenus; Wandi
Open Access Indonesian Journal of Medical Reviews Vol. 3 No. 6 (2023): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v3i6.398

Platelet transfusion plays a vital role in clinical practice, serving as a cornerstone in the management of various medical conditions. Thrombocytopenia, characterized by a low platelet count, can result from decreased platelet production, increased peripheral platelet destruction, increased splenic sequestration, or dilutional thrombocytopenia. Platelet transfusion is commonly administered for prophylactic purposes to prevent bleeding in patients with hypoproliferative thrombocytopenia and before invasive procedures or surgeries. In cases of bleeding or significant bleeding risk, therapeutic platelet transfusion is employed. This review article aims to provide an understanding of platelet transfusion and its applications in daily clinical practice. The dosage and administration of platelet transfusion, as well as potential complications, are discussed. Understanding the indications, contraindications, and appropriate use of platelet transfusion is crucial for optimizing patient outcomes and ensuring safe and effective clinical practice.

Efficacy of cilostazol in promoting the maturation of newly created arteriovenous fistula in patients with end-stage renal disease: a systematic review and meta-analysis Willim, Herick Alvenus; Sugandi, Erica; Rosa; Sani, Alvin Ariyanto; Khouw, Hengky
Medical Journal of Indonesia Vol. 33 No. 1 (2024): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247252

BACKGROUND Arteriovenous fistula (AVF) is considered the gold standard for vascular access in hemodialysis. However, achieving the successful maturation of AVF remains a challenge. Cilostazol, a phosphodiesterase-3 inhibitor, has shown promise in enhancing AVF maturation. This study aimed to assess the clinical efficacy of cilostazol in promoting AVF maturation. METHODS This meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive systematic literature search was performed using PubMed, ScienceDirect, Cochrane Library, ProQuest, and Google Scholar to identify studies investigating the efficacy of cilostazol on the maturation of newly created AVF in patients with end-stage renal disease and published up to August 2023. The intervention group received perioperative cilostazol therapy, while the control group did not receive cilostazol. The outcomes were the maturation rate of AVF and AVF-related complications. Meta-analysis was conducted using Review Manager software version 5.3. RESULTS 5 studies involving 549 patients were included. The intervention group comprised 228 patients, while the control group comprised 321 patients. In the pooled analysis, patients in the intervention group had a significantly higher rate of AVF maturation (odds ratio [OR] = 2.18, 95% confidence interval [CI]: 1.29–3.68, p = 0.003, I2 = 47%) and a lower rate of AVF-related complications (OR = 0.46, 95% CI: 0.28–0.77, p = 0.003, I2 = 27%) compared to the control. CONCLUSIONS Cilostazol was associated with a higher rate of AVF maturation and a lower rate of AVF-related complications.

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