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All Journal Heart Science Journal Asian Journal of Health Research
Niazta, Nisa Amnifolia
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Precision in practice, save the limb, save the life: Early detection of grade IIA acute limb ischemia and management using catheter-directed thrombolysis - A case report Niazta, Nisa Amnifolia; Kurnianingsih, Novi; Kurniawan, Dea Arie
Heart Science Journal Vol. 6 No. 2 (2025): The Complexity in the Management of Heart Rhythm Disorder
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.02.20

Abstract

Background: Acute limb ischemia is an emergency condition that causes high morbidity and mortality. Endovascular revascularization in acute limb ischemia showed better in-hospital clinical outcomes than surgical revascularization. Case illustration: A 67-year-old man was referred by internal medicine at the rural area hospital with a diagnosis of acute limb ischemia. He complained of sudden left leg pain and numbness of the left leg 2 days prior to hospital admission. He was a heavy smoker and had a predisposition for atrial fibrillation. He received heparinization at the previous hospital. Upon arriving at Saiful Anwar Hospital, a physical examination showed severe left leg pain and was difficult to move. His left leg was pulseless, paresthesia and poikilothermia. Duplex ultrasound revealed a thrombus in the left popliteal artery with no flow downwards. We diagnosed the patient with Acute Limb Ischemia Rutherford IIA left inferior extremity. We decided to perform catheter-directed thrombolysis with the Alteplase regiment. Post catheter-directed thrombolysis angiography evaluation showed TIMI flow II at the left leg after 24-hour catheter-directed thrombolysis. The patient did not complain of leg pain or numbness anymore. Conclusion: Good outcomes in this patient were obtained through the ability to make correct initial diagnosis, early administration of heparin, and immediate referral to a cardiovascular center that can provide endovascular treatment. Catheter-directed thrombolysis is the right choice for grade IIA acute limb ischemia
Comprehensive Management of Peripartum Cardiomyopathy with Acute Renal Failure: From Prepartum to Renal Replacement Therapy – A Case Report Niazta, Nisa Amnifolia; Putri, Valerinna Yogibuana Swastika
Asian Journal of Health Research Vol. 4 No. 2 (2025): Volume 4 No 2 (August) 2025
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55561/ajhr.v4i2.240

Abstract

Introduction: Peripartum cardiomyopathy (PPCM) is a rare but potentially serious that poses significant diagnostic and therapeutic challenges, particularly in previously healthy women. We report a complex case of severe PPCM in a primigravida patient who needed intensive multidisciplinary care due to respiratory failure and acute renal failure. Case Presentation: A 21-year-old primigravida in 34 weeks of gestation presented with progressive dyspnea and signs of acute heart failure. Despite an unremarkable medical history, she exhibited severe left ventricular dysfunction (LVEF of 28%), cardiomegaly, and pulmonary congestion. Rapid deterioration necessitated urgent caesarean delivery under general anesthesia due to maternal and fetal distress. Postoperatively, the patient developed cardiogenic shock and acute kidney injury (AKI) necessitating vasopressor and continuous renal replacement therapy (CRRT). Intensive heart failure management, including bromocriptine therapy and guideline-directed medical treatment, led to gradual hemodynamic stabilization. She was successfully weaned off mechanical ventilation and CRRT within days, ultimately being discharged after 12 days of treatment with improved cardiac function. Conclusion: This case underscores the unpredictable nature and rapid progression of PPCM, even in the absence of traditional risk factors. Early recognition, prompt multidisciplinary intervention, and individualized therapy are critical to improving maternal and neonatal outcomes.
Assessing left atrial function in acute decompensated heart failure: Insights from echocardiography Niazta, Nisa Amnifolia; Karolina, Wella; Rahimah, Anna Fuji; Prasetya, Indra
Heart Science Journal Vol. 7 No. 2 (2026): The Evolving Landscape of Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.02.2

Abstract

Acute heart failure remains a major cause hospitalization, especially in older adults and is associated with mortality and frequent readmissions. Several factors associated with heart failure outcomes include left ventricular dysfuction, left atrial dysfunction, and LA enlargement. LA enlargement has been recognized as a dependable imaging marker, closely tied to adverse outcomes such as heart failure, stroke, atrial fibrillation, and mortality. LA is not merely a passive conduit for transport. LA plays an active role and responds to distension by releasing atrial natriuretic peptides. LA enlargement has been shown to correlate with poor cardiovascular prognosis. In patients experiencing acute heart failure, fluid overload and its reduction can alter LA mechanical performance. Decongestive treatment has been associated with improved LA reservoir function, which can be assessed through parameters like LA reservoir strain rate also peak atrial longitudinal strain. In more advanced heart failure—characterized by reduced left ventricular ejection fraction, increased filling pressures, then diminished cardiac output—both PALS and strain rate are often markedly impaired, reflecting significant dysfunction in LA reservoir. Evaluating left atrial function via echocardiographic techniques is proving to be a vital tool in predicting outcomes for individuals with acute decompensated heart failure. As the understanding of LA physiology evolves, its role is increasingly seen as dynamic rather than passive. Echocardiography is showing potential imaging biomarker for risk stratification and therapeutic guidance in heart failure management.
Acute cardiac care in rheumatic mitral stenosis Niazta, Nisa Amnifolia; Prasetya, Indra
Heart Science Journal Vol. 7 No. 2 (2026): The Evolving Landscape of Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.02.4

Abstract

Rheumatic heart disease (RHD) is prevented, although productive-age people may develop consequences. Indonesia, as an endemic country of RHD, predominantly reported isolated mitral stenosis among RHD patients. Acute worsening of mitral stenosis can lead to acute heart failure and cardiogenic shock, arrhythmias, stroke, pulmonary hypertension, systemic embolic events, infective endocarditis, and pregnancy-related issues. The diagnosis of critical valvular emergency, especially rheumatic mitral stenosis in acute cardiac care, is often overlooked due to the clinical history potentially resembling other disease entities. This review highlights clinical emergency manifestation and comprehensive management of rheumatic mitral stenosis in acute cardiac care.  
A systematic review and meta-analysis of drug-coated balloons versus drug-eluting stents in de novo and in-stent restenosis coronary bifurcation lesions Dzikrul Haq Karimullah, Muchammad; Saputra, Pandit Bagus Tri; Alkaff, Firas Farisi; Oktaviono, Yudi Her; Nugraha, Ricardo Adrian; Faizah, Novia Nurul; Widiarti, Wynne; Aufazhafarin, Nadhifa Tanesha; Doman, Zahras Azimuth; Sahara, Rendy Asmaradhana; Niazta, Nisa Amnifolia
Heart Science Journal Vol. 7 No. 3 (2026): Predicting Restenosis in Coronary Artery Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.03.6

Abstract

Background: Coronary bifurcation lesions are notoriously difficult to treat percutaneously and may require advanced techniques. Drug-eluting balloons (DCBs) have several advantages over drug-eluting stents (DESs), including the ability to maintain arterial physiology, reduce the risk of stent thrombosis, and eliminate the need for permanent metal implants. However, it remains uncertain which treatment will work best. Objective: This study evaluated DCBs and DESs in coronary bifurcation lesions using subgroup analyses based on lesion type and location. Methods: We searched scientific databases for relevant publications up until May 31, 2025. In order to synthesise the results, a random-effects model was employed. To determine the possibility of bias, the ROBINS-I was utilized, and to measure the level of heterogeneity across the studies, the I³ statistic was used. Results were analyzed clinically and angiographically. This subgroup analysis focused on the position of the bifurcation and the kind of lesion (new, internal, or all sites). Result: Eleven research were deemed eligible for inclusion. There was a trend toward fewer major adverse cardiac events (MACE) with DCB compared to DES in the whole cohort, however the trend was not statistically significant (OR0.77, 95% CI0.58-1.02; p=0.07; I²=0%). Both major adverse cardiac events (MACE) and target lesion revascularization (TLR) were significantly reduced in de novo bifurcations when DCB was used (OR0.61, 95% CI 0.41-0.89; p=0.01). Myocardial infarction, target vessel revascularization, in-stent thrombosis, and cardiac mortality were not significantly different among groups. Both the early and late lumen loss and gain seen on angiograms were within the normal range. Conclusion: In de novo bifurcation lesions, DCB demonstrates reduced MACE and TLR versus DES, supporting its role as a stent-free alternative. Randomized controlled trials with greater sample sizes and prolonged follow-up are warranted.
Co-Authors Alkaff, Firas Farisi Aufazhafarin, Nadhifa Tanesha Doman, Zahras Azimuth Dzikrul Haq Karimullah, Muchammad Faizah, Novia Nurul Indra Prasetya Karolina, Wella Kurnianingsih, Novi Kurniawan, Dea Arie Nugraha, Ricardo Adrian Putri, Valerinna Yogibuana Swastika Rahimah, Anna Fuji Sahara, Rendy Asmaradhana Saputra, Pandit Bagus Tri Widiarti, Wynne Yudi Her Oktaviono, Yudi Her