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All Journal Indonesian Journal of Cardiology
Zulkarnain, Edrian
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Health Professions Medicine & Pharmacology

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Traumatic Coronary Artery Dissection as A Potential Cause of Acute Myocardial Infraction in Motorcycle Accident Tondas, Alexander Edo; Tandri, Fredy; Zulkarnain, Edrian
Jurnal Kardiologi Indonesia Vol 43 No 1 (2022): Indonesian Journal of Cardiology: January - March 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1140

Abstract

Background: Chest pain in blunt chest trauma can be caused by various intrathoracic injuries. Pneumothorax, hemothorax, and rib fractures are commonly seen in the emergency department. Although cardiac involvement is very rare, the probability should not be excluded. Case Illustration: A-31-years-old male who complained of chest pain and diaphoresis was brought to the emergency department after a high-speed motorcycle collision. Chest X-ray revealed no abnormality but a 12-lead Electrocardiogram (ECG) demonstrated ST-segment elevation in lead I, AvL, V2-6, and atrial fibrillation. Because of the unusual presentation, the decision was to proceed with percutaneous coronary intervention (PCI). Coronary Angiography detected a thrombus at proximal LAD and spiral dissection at mid LAD (TIMI 2 Flow). After the procedure, he was transferred to the High Care Unit. Conclusion: Following blunt chest trauma, chest pain in the setting of a vehicle collision can be caused by dissection of the coronary artery. Prompt cardiac workup (ECG, cardiac enzyme, and echocardiography) must be done in a highly suspected patient.
2023 Indonesian Guidelines for Heart Failure Treatment: Working Group on Heart Failure and Cardiometabolic Diseases, Indonesian Heart Association Hasanah, Dian Yaniarti; Zulkarnain, Edrian; Arifianto, Habibie; Prameswari, Hawani Sasmaya; Suciadi, Leonardo Paskah; Yamin, Paskariatne Probo Dewi; Pratikto, Rarsari Soerarso; Nauli, Siti Elkana; Putri, Vebiona Kartini Prima; Soedarsono, Wahyu Aditya; Sarastri, Yuke
Jurnal Kardiologi Indonesia Vol 45 No 2 (2024): April - June, 2024
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1671

Abstract

Heart failure is a health problem with high mortality and morbidity rates in developed and developing countries such as Indonesia. The prevalence of heart failure itself is increasing because patients who experience acute heart failure can progress to chronic heart failure. Guidelines-Directed Medical Therapy (GDMT) with recommended doses is still underutilized in heart failure patients with reduced ejection fraction (HFrEF). In Indonesia itself, even though it has a fairly high rate of use of ACE-inhibitors (ACE-I) or angiotensin receptor blockers (ARB), Indonesia has the lowest rate of use of β-blockers and aldosterone inhibitors (also called Mineralocorticoid Receptor Antagonists, MRA) of the entire ASIAN-HF registry.84 Therefore, the writing of this guideline was carried out as an effort to provide practical guidance regarding the diagnosis, assessment and management of acute and chronic heart failure. Thus, it is hoped that efforts can be made to prevent the increase in prevalence and reduce the number of rehospitalization with complete management. This book was written as an update to the 2020 Guideline for the Management of Heart Failure: Indonesian Heart Association. The sources of our updates came from many references and literatures carried out by each contributor and reviewed by EBM team.
Management of Decongestion in Acute Heart Failure: Time for a New Approach? Pramudyo, Miftah; Putra, Iwan Cahyo Santosa; Zulkarnain, Edrian; Danny, Siska Suridanda; Bagaswoto, Hendry Purnasidha; Anjarwani, Setyasih; Mazwar, Irmaliyas; Juzar, Dafsah Arifa; Pratama, Vireza; Habib, Faisal; Ispar, Akhtar Fajar Muzakkir Ali; Widyantoro, Bambang
Jurnal Kardiologi Indonesia Vol 43 No 2 (2022): Indonesian Journal of Cardiology: April - June 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1381

Abstract

As the primary cause of hospitalization in acute heart failure (AHF) patients, congestion was responsible for a higher risk of mortality, rehospitalization, and renal dysfunction in AHF patients. Although loop diuretic was routinely used as the mainstay of AHF therapy, it is still ineffective to obtain the euvolemic state in most hospitalized AHF patients. Therefore, a higher loop diuretic dose was often required to increase the decongestion effect. However, consequently, it can cause several detrimental complications, including renal dysfunction, neurohormonal activation, hyponatremia, hypokalaemia, and reduced blood pressure, which eventually result in poor prognosis. Hence, the new approach may be proposed to optimize decongestion in acute phase, including the use of arginine vasopressin V2 receptor antagonist – Tolvaptan. As an additive therapy to loop diuretic in AHF patients, it can be considered due to its several beneficial effects, including greater decongestion effect, lowered worsening renal function incidence, counteract neurohormonal activation, neutralized hyponatraemic state, no alteration of potassium metabolism, stabilize the blood pressure, and reduced requirement of a higher dose of loop diuretic to achieve an equal or even greater decongestion effect compared to a high dose of loop diuretic alone. Tolvaptan provided favourable outcomes in several specific populations and was considered safe with several mild adverse effects. Several guidelines across countries have approved the use of Tolvaptan in AHF patients with or without hyponatremia. The initial dose of Tolvaptan was 7.5 to 15 mg and can be titrated up to 30 mg. However, further studies were still required to determine the timing dose and optimal dose of Tolvaptan in general and elderly populations with AHF, respectively.
Co-Authors Alexander Edo Tondas Anjarwani, Setyasih Arifianto, Habibie Bambang Widyantoro Habib, Faisal Hasanah, Dian Yaniarti Hendry Purnasidha Bagaswoto Ispar, Akhtar Fajar Muzakkir Ali Juzar, Dafsah Arifa Leonardo Paskah Suciadi Mazwar, Irmaliyas Prameswari, Hawani Sasmaya Pramudyo, Miftah Pratama, Vireza Pratikto, Rarsari Soerarso Putra, Iwan Cahyo Santosa Putri, Vebiona Kartini Prima Sarastri, Yuke Siska Suridanda Danny Siti Elkana Nauli Soedarsono, Wahyu Aditya Tandri, Fredy Yamin, Paskariatne Probo Dewi