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All Journal e-CliniC JURNAL BIOMEDIK Syntax Literate: Jurnal Ilmiah Indonesia Medical Scope Journal (MSJ)
Edmond L. Jim
Universitas Sam Ratulangi Manado
Humanities Biochemistry, Genetics & Molecular Biology Education Environmental Science Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Nursing Public Health Social Sciences Other

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Percutaneous Coronary Intervention in a Saphenous Vein Graft Failure: A Case Report Jim, Edmond L.
e-CliniC Vol. 12 No. 2 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i2.52514

Abstract

Abstract: Recent published data from the Society of Thoracic Surgery (STS) national database displayed that among patients aged >65 years old who survived following an initial coronary artery bypass graft (CABG) operation, rates of repeat revascularization at 1, 5, 10, and 18 years were 2%, 8%, 16%, and 25%, respectively. The most preferred mode of revascularization was percutaneous coronary intervention (PCI). While remain the most frequently used conduits beside left internal mammary artery (LIMA), saphenous vein grafts (SVGs) have high failure rates. Percutaneous coronary intervention in SVGs is associated with an increased risk of distal coronary embolization, commonly resulting in periprocedural MI. We reported a 79-year-old male patient admitted due to progressive symptoms of chronic coronary syndrome. The patient had a history of hypertension and a CABG surgery in 2012. Electrocardiogram showed ischemia and old myocardial infarction (OMI) in inferior leads as well as poor R wave progression in the precordial leads. Transthoracic echocardiogram displayed a normal ejection fraction but impaired left ventricular (LV) diastolic relaxation. Diagnostic coronary angiography revealed a 70% tubular stenosis in proximal part of SVG supplying posterior descending artery, patent LIMA graft to left anterior descending artery, and complex lesion on native vessel (chronic total occlusion in mid right coronary artery). Implantation of drug eluting stent in SVG-posterior descending artery was performed. Direct-stenting PCI technique using undersized-stent was done to prevent any complications. In conclusion, despite the high risk of complications, vein graft intervention was successfully performed without any complications. Since the high rates of in-stent restenosis following PCI in SVGs, long-term dual antiplatelet therapy should be commenced in this patient. Keywords: saphenous vein graft; vein graft intervention; percutaneous coronary intervention
Hubungan Gagal Jantung Iskemik dengan Jumlah Faktor Risiko Penyakit Jantung Koroner terhadap Lama Rawat Inap di Rumah Sakit Tandipanga, Mayprengki B.; Rampengan, Starry H.; Jim, Edmond L.
e-CliniC Vol. 13 No. 1 (2025): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v13i1.54949

Abstract

Abstract: Heart failure is one of the cardiovascular diseases with high hospitalization and mortality rates. Ischemic heart failure is a type of heart failure that is caused by coronary heart disease. Risk factors for coronary heart disease include age, sex, family history, early menopause, smoking, hypertension, dyslipidemia, and diabetes mellitus. Length of Hospital Stay (LOS) is a matrix to measure the length of time a patient stays in the hospital. This study aimed to evaluate the relationship between ischemic heart failure and many risk factors for coronary heart disease on the length of stay at RSUP Prof. Dr. R. D. Kandou. This was an observational and analytical study with cohort studies with a retrospective approach during the period September 2021 – October 2023. The results showed that there were 112 cases with 70 samples that met the inclusion criteria and found 26 cases with a length of stay of >7 days and 44 cases with a length of stay of ≤7 days. Based on the bivariate analysis that has been performed on patients with ischemic heart failure who undergo hospitalization, it shows that there is no significant relationship between the number of risk factors for coronary heart disease and the longer length of hospitalization. In conclusion, there is no significant association between the number of risk factors for coronary heart disease and the longer length of stay in patients with ischemic heart failure. Keywords: ischemic heart failure; coronary heart disease risk factors; length of stay    Abstrak: Gagal jantung merupakan salah satu penyakit kardiovaskular dengan angka kematian dan perawatan di rumah sakit yang tinggi. Gagal jantung iskemik merupakan gagal jantung yang diakibatkan oleh penyakit jantung koroner. Faktor risiko penyakit jantung koroner antara lain, usia, jenis kelamin, riwayat keluarga, menopause dini, merokok, hipertensi, dislipidemia, dan diabetes melitus. Lama rawat inap atau Length of Hospital Stay (LOS) merupakan matriks untuk mengukur lama waktu rawat inap pasien di rumah sakit. Penelitian ini bertujuan untuk mengetahui hubungan gagal jantung iskemik dengan Jumlah faktor risiko penyakit jantung koroner terhadap lama rawat inap di RSUP Prof. Dr. R. D. Kandou. Jenis penelitian ialah analitik observasional dengan studi kohort dengan pendekatan restrospektif selama periode September 2021 - Oktober 2023. Hasil penelitian mendapatkan 112 kasus dengan 70 sampel yang memenuhi kriteria inklusi dan didapatkan 26 kasus dengan lama rawat >7 hari dan 44 kasus dengan lama rawat ≤7 hari. Berdasarkan analisis bivariat yang telah dilakukan pada pasien gagal jantung iskemik yang menjalani rawat inap menunjukkan bahwa tidak didapatkan hubungan yang bermakna antara jumlah faktor risiko penyakit jantung koroner dengan lama rawat inap yang lebih lama. Simpulan penelitian ini ialah tidak didapatkan hubungan bermakna antara jumlah faktor risiko penyakit jantung koroner dengan lama rawat yang lebih lama pada pasien gagal jantung iskemik. Kata kunci: gagal jantung iskemik; faktor risiko penyakit jantung koroner; lama rawat inap
Hubungan Faktor Risiko Penyakit Jantung Koroner dengan Kejadian Henti Jantung Ghosalim, Aurell H.; Jim, Edmond L.; Joseph, Victor F. F.
e-CliniC Vol. 12 No. 3 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i3.59446

Abstract

Abstract: One of the causes of death from cardiovascular disease is cardiac arrest. The most common cause of cardiac arrest is coronary heart disease (CHD). This study aimed to determine the relationship between CHD risk factors and cardiac arrest events at Prof. Dr. R. D. Kandou Hospital.  This was an analytical and descriptive study with a retrospective cross-sectional approach. Samples were all patients with cardiac arrest at Gedung CVBC RSUP Prof. Dr. R. D. Kandou from August to November 2023 who had complete medical recors. The sampling technique used total sampling and research instruments using medical record data. The results obtained 37 patients as samples consisting of male (64.9%) and female (35.1%) patients. The chi-square test showed a significant relationship between sex variable and the incidence of cardiac arrest (p=0.011). There was no significant relationship (p>0.05) between the variables of age, family history, hypertension, hyperlipidemia, diabetes mellitus, obesity and smoking with the incidence of cardiac arrest. In conclusion, gender has a significant relationship with the incidence of cardiac arrest. Meanwhile, age, family history, hypertension, hyperlipidemia, diabetes mellitus, obesity and smoking were not significantly related to the incidence of cardiac arrest. Keywords: coronary heart disease risk factors; cardiac arrest    Abstrak: Salah satu penyebab kematian akibat penyakit jantung ialah henti jantung. Penyebab tersering terjadinya henti jantung dikarenakan oleh penyakit jantung koroner (PJK). Penelitian ini bertujuan untuk mengetahui hubungan antara faktor risiko PJK terhadap kejadian henti jantung di RSUP Prof. Dr. R. D. Kandou.  Jenis penelitian ini ialah deskriptif analitik dengan desain potong lintang retrospektif. Sampel penelitian ialah semua pasien henti jantung di Gedung CVBC RSUP Prof. Dr. R. D. Kandou pada bulan Agustus sampai November 2023 dengan data rekam medik lengkap. Teknik pengambilan sampel menggunakan total sampling dan instrumen penelitian menggunakan data rekam medik. Hasil penelitian mendapatkan 37 pasien sebagai sampel penelitian terdiri dari pasien berjenis kelamin laki-laki (64,9%) dan perempuan (35,1%). Hasil uji chi-square memperoleh hubungan bermakna antara variabel jenis kelamin terhadap kejadian henti jentung (p=0,011). Tidak terdapat hubungan bermakna (nilai p>0,05) antara variabel usia, riwayat keluarga, hipertensi, hiperlipidemia, diabetes melitus, obesitas, dan merokok terhadap kejadian henti jantung. Simpulan penelitian ini ialah jenis kelamin memiliki hubungan bermakna dengan kejadian henti jantung. Pada faktor usia, riwayat keluarga, hipertensi, hiperlipidemia, diabetes melitus, obesitas dan merokok tidak didapatkan hubungan bermakna dengan kejadian henti jantung di RSUP Prof. Dr. R. D. Kandou.  Kata kunci: faktor risiko penyakit jantung koroner; henti jantung
Right Ventricular Septal Pacing to Produce Narrow QRS Duration in Patient with High Degree 2:1 AV Block Santoso, Michael; Setiadi, Benny; Rampengan, Starry H.; Jim, Edmond L.
e-CliniC Vol. 13 No. 2 (2025): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v13i2.56247

Abstract

Prolonged right ventricular (RV) apical pacing has been recognized to be associated with progressive left ventricular (LV) dysfunction. This impairment of LV function resultant from RV apical pacing is a remodelling process consequent to abnormal ventricular activation and contraction. RV septal pacing theoretically is associated with a more physiological ventricular activation results in shorter electrical activation delay and consequently less mechanical dyssynchrony. We reported A-75-year-old woman presented to emergency department (ED) with dyspnea only on exertion in the last 3 weeks before admission, she also complaint near syncope episode while doing activities. Electrocardiogram (ECG) result was high degree AV block with 2:1 conduction with ventricular rate 40 beats per minute. PPM implantation was performed with VVIR mode, ventricle lead inserted into mid-septal RV. ECG post implantation showed pacing rhythm with narrow QRS duration. Pacemaker-related LBBB is associated with an adverse prognosis. RV septal pacing produces more synchronous contraction denoted by narrow QRS, preventing the deterioration of LV structure and function. RV septal pacing, although not as good as intrinsic conduction or His bundle pacing, may be more desirable for chronic RV pacing compared to the RV apex as a narrow QRS is associated with improved LV dynamics. RV septal pacing was safely done in this patient, but further study needed to evaluate its long-term effect. Keywords: AV block; permanent pacemaker; septal; right ventricle
Co-Authors Agnes L. Panda Agung D. Harikatang, Agung D. Alia, Jaka K. Alitu, Moh. A. R. Anjani, Ni Made Biancha Tumade, Biancha Ghosalim, Aurell H. Haris, Devina E. Herdy Munayang Joulanda A. M. Rawis Kalangi, Cathleen S. Lantang, Eka Y. Loretta C. Wangko Moningka, Brigita L. M. Niluh, Cecilia E. Pritartha S. Anindita Santoso, Michael Saroinsong, Lifi Setiadi, Benny Starry H. Rampengan Tandipanga, Mayprengki B. Victor F. F. Joseph, Victor F. F. Wambrauw, Jery Wenas, Mercilia F.