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Karolina, Wella
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Health Professions Immunology & microbiology Medicine & Pharmacology

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Challenge case of ventricular arrhythmia in young women Kaputrin, Nur; Rizal, Ardian; Karolina, Wella; Widito, Sasmojo
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.16

Abstract

Background: Torsade de pointes (TdP) and ventricular fibrillation can cause rapid mortality. The etiological cause the ventricular arrhythmia must be detected and treated early, especially in the ER. Objective: We report a patient with severe hypokalemia and TdP following the administration of Amiodarone in QT-interval prolongation Case Report: A 32-year-old girl with diarrhea and vomiting for two days arrived to the ED with a seizure with her hand flexed and leg straight down. Her family reported she didn't take prescriptions regularly. She was GCS 224, hemodynamically stable, typical ECG showed extended QTc and her head CT was normal. During observation at the ED, she had seizure and the monitor revealed a Torsade de Pointes (TdP) ) with a pulse rate of 160-180 bpm. She was given Amiodarone and peroral Bisoprolol 5 mg. She returned to sinus rhythm with PVC bigeminy and was admitted to the ICU Laboratory data showed hypokalemia (1.9) improved (2.9) after treatment. Eight hours later, she experienced a TdP without pulse palpability for less than 1 minute, then Ventricular Fibrillation, began CPR, and the doctor in charge gave her a defibrillation operation once. She returned with sinus tachycardia 110-130 bpm. The next day, she was having recurring TdP episodes without a pulse. The doctor conducted CPR and defibrillation and returned with 120-130 bpm sinus tachycardia. The patient consulted a cardiologist and was prescribed lidocaine 1 mg/hour and continued Bisoprolol 5 mg for long QT problem. Observation The seizure ended 12 hours later, the patient was alert, GCS 456, and the ECG showed sinus rhythm with extended QTc. Over the days before discharge, electrocardiography demonstrated reduced QT-interval prolongation. Conclusion: Life-threatening ventricular arrhythmia in a young female can be caused by QT-interval prolongation. It must be diagnosed and treated immediately to avoid mortality.
Effect of decaffeinated green tea and green coffee combination on improving blood glucose levels in metabolic syndrome patients Nugroho, Ira Vori; Rohman, Mohammad Saifur; Karolina, Wella; Tjahjono, Cholid Tri; Kurnianingsih, Novi
Heart Science Journal Vol. 7 No. 1 (2026): Accelerating Clinical Breakthroughs: The Journey from Molecular Discovery to Pa
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.01.12

Abstract

Background: Metabolic syndrome (MS) contributes to high mortality and morbidity not only in developing countries but also in developed countries, with central obesity and insulin resistance as primary risk factors. Our previous study demonstrated that combined decaffeinated green tea and green coffee extracts more effectively improved lipid and glucose profiles in an MS rat model. Objective: This study evaluates the efficacy of the extracts on top guideline-directed medical treatment optimal therapy in metabolic syndrome patients. Methods: The study was a randomized controlled trial (RCT) involving 90 patients diagnosed with metabolic syndrome, ages 45-70. Participants were randomly sorted into three groups: the first group received 2x2.5 g, the second group received 1x5 g, and the third one received a placebo. Researchers measured baseline and final values for fasting blood glucose (FBG), post-meal glucose levels (PPBG), and glycated hemoglobin (HbA1C) to evaluate treatment effects. Result: After 90 days of treatment with decaffeinated green tea and green coffee combination, both experimental groups (Groups 1 and 2) revealed significant decreases in PPBG and HbA1c compared to the control group. (-14.10 ± 2.00 vs. -28.63 ± 4.61 vs. -5.03 ± 0.74 mg/dL and -0.23 ± 0.01 vs. -0.22 ± 0.03 vs. -0.13 ± 0.01; p = < 0.05). FBG decreased across all groups but was not statistically significant. Conclusion: After 90 days, the combination of decaffeinated green tea and green coffee significantly reduced PPBG and HbA1C levels in patients with metabolic syndrome compared to the placebo. These findings suggest that this combination may serve as an effective adjunctive therapy for glucose management in metabolic syndrome, translating efficacious preclinical dosages to clinical application.
A case of cardiac myxoma with obstructive symptoms: Recognizing key early signs for improved diagnosis Filano, Marco; Kuhn, Corinna Maria; Zhao, Zihan; Laukkanen, Noora Julia; Rahimah, Anna Fuji; Karolina, Wella; Prasetya, Indra; Rohman, Mohammad Saifur
Heart Science Journal Vol. 7 No. 1 (2026): Accelerating Clinical Breakthroughs: The Journey from Molecular Discovery to Pa
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.01.21

Abstract

Background: LA myxoma is the most common primary cardiac tumor, often presenting with obstructive symptoms when the tumor prolapses into the mitral valve during diastole. On the other hand, rheumatic MS leads to fixed obstruction of the mitral valve. The coexistence of both conditions is extremely rare and can exacerbate the severity of mitral inflow obstruction. Early recognition of this dual pathology through careful clinical evaluation and echocardiographic assessment is crucial for timely and effective management. Case Presentations: A 66-year-old female patient presented with progressive dyspnea. Transthoracic echocardiography detected a mobile mass in the left atrium and later identified it as a cardiac myxoma. Further evaluation revealed severe rheumatic mitral stenosis (MS) with a mitral valve area (MVA) measured by planimetry at 1.23 cm², restricting the mass from slipping into the left ventricle during the diastolic phase. Based on the conference decision, tumor resection was performed, and the histopathological examination revealed a left atrial (LA) myxoma. The dual obstruction caused by mitral valve stenosis and a left atrial myxoma resulted in life-threatening symptoms due to diastolic obstruction of mitral inflow. In isolated LA myxoma, the tumor pushes into the mitral valve opening during the heart's relaxation phase, blocking blood flow from the left atrium to the left ventricle and raising pressure in the atrium and lungs. When significant MS is present, the narrowed valve further worsens this obstruction, leading to higher atrial pressure and more severe heart failure symptoms. Both conditions commonly present with early symptoms such as exertional dyspnea, palpitations, signs of heart failure like edema and pulmonary crackles, diastolic murmur, and sometimes syncope caused by reduced cardiac output. Conclusions: This case highlights the critical importance of identifying early obstructive symptoms indicative of cardiac myxoma. Timely identification of these clinical manifestations can facilitate earlier diagnosis, improve patient outcomes, and prevent potentially fatal complications.
Co-Authors Abadi, Sahlan Anjarwani, Setyasih Anna Fuji Rahimah Cholid Tri Tjahjono Dwigustiningrum, Nur Kaputrin Filano, Marco Firdaus, Achmad Jauhar Indra Prasetya Kaputrin, Nur Kuhn, Corinna Maria Kurnianingsih, Novi Laukkanen, Noora Julia Martini, Henny Martini, Heny Millisani, Hayla Iqda Mohammad Saifur Rohman Noverike, Nikhen Nugroho, Ira Vori Nurudinulloh, Akhmad Isna Putri, Valerinna Yogibuana Swastika Rahimah, Anna Fuji Rizal, Ardian Saerang, Gebryel Dennis Saputri, Vemmy Lian Setiawan, Dion Widito, Sasmojo Yogibuana, Valerinna Zhao, Zihan