Manoefris Kasim
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, National Cardiovascular Center Harapan Kita, Jakarta

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Journal : Medical Journal of Indonesia

QRS distortion increased risk re-occurrence acute coronary events Kasim, Manoefris; Sunanto, Sunanto; Sewianto, Albertus; Kusmana, Dede
Medical Journal of Indonesia Vol 16, No 4 (2007): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (189.679 KB) | DOI: 10.13181/mji.v16i4.287

Abstract

Nearly 50% of patients suffering inferior myocardial infarction will have complications or distinguishing features associated with an increased mortality. This study aimed to identify dominant risk factors related to re-occurrence of acute coronary events in patients with inferior myocardial infarction. This historical cohort included patients with inferior myocardial infarction who received fibrinolytic therapy at emergency department of National Cardiovascular Center Harapan Kita, Jakarta during 2001 to 2004 and was followed-up for two years. Patients with previous myocardial infarction, left bundle branch block, ventricular rhythm, and ventricular pacing were excluded. QRS distortion is ratio between J-point and R wave more than 50% at 2 or more inferior leads. Re-occurrence of acute coronary events is incident of myocardial infarction and unstable angina pectoris. Of 181 subjects with inferior AMI, there were 21 (11.6%) incidents of acute coronary event. Those who had positive than negative QRS distortion had almost three-fold increased risk for re-occurrence of acute coronary events [adjusted relative risk (RRa) 2.88; 95% confidence interval (CI) = 1.05 – 7.90]. In term of TIMI risk score, those with higher than lower risk score had 6.7 times higher risk to be re-occurrence of acute coronary events (RRa = 6.66; 95% CI = 1.94 – 22.92). However, those who had than did not have successful fibrinolysis had 57% lower risk to be re-occurrence of acute coronary event (RRa = 0.43; 95% CI = 0.18 – 1.05; P = 0.065). Re-occurrence acute coronary events were related to QRS distortion, TIMI risk score, and successful fibrinolysis. (Med J Indones 2007; 16:240-4) Keywords: QRS distortion, fibrinolysis, inferior myocardial infarction
Clinical presentation of myocarditis in pediatric: the role of cardiac magnetic resonance in diagnosis Natalia, Sisca; Lilyasari, Octavia; Wicaksono, Sony H.; Kasim, Manoefris
Medical Journal of Indonesia Vol 23, No 3 (2014): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1156.201 KB) | DOI: 10.13181/mji.v23i3.654

Abstract

Myocarditis is an inflammatory disease of myocard with varied onset and clinical presentation which lead to diagnosis difficulties. These difficulties often cause incoming patients with acute condition are not diagnosed as acute myocarditis that subsequently may lead to improper therapy. This circumstance will probably cause more severe myocardial injury and even sudden death. On another circumstance, patients may also come late in conditions of dilated cardiomyopathy (DCM) or aritmogenik cardiomyopathy (ARVD) due to complexities of myocarditis early detection. Therefore, myocarditis diagnosis is extremely important. This case shows how CMR is important and highly accurate in diagnosing myocarditis through a case whereby a boy had complaints of chest pain and his CMR examination showed normal cardiac morphology with normal function of right and left ventricular, but with myocardial edema and tissue fibrosis, which confirmed the diagnosis of myocarditis according to the Lake Louise Consensus criteria. CMR is an important and high accuracy non-invasive diagnostic tool in myocarditis diagnosis.
Role of cardiac MRI in acute myocardial infarction Mulia, Erwin; Wicaksono, Sony H.; Kasim, Manoefris
Medical Journal of Indonesia Vol 22, No 1 (2013): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (932.66 KB) | DOI: 10.13181/mji.v22i1.513

Abstract

Mortality in patients with acute myocardial infarction (AMI) has decreased significantly and appears to be the result of current reperfusion therapeutic strategies. Reperfusion itself may develop into reperfusion injury. Therefore, management of these patients poses several challenges, such as diagnosing and managing heart failure, identifying persistent or inducible ischaemia, estimating the need for anticoagulation, and assessing overall cardiovascular risk. This case presentation will demonstrate the impact of cardiac magnetic resonance imaging (MRI) in the assessment of the pathophysiology of AMI in the current reperfusion era. Cardiac MRI can provide a wide range of clinically useful information which will help clinicians to manage and choose specific therapeutic strategies for AMI patients. (Med J Indones. 2013;22:46-53)Keywords: Acute myocardial infarction, cardiac magnetic resonance imaging, reperfusion injury
Dissolution of large intracardiac thrombus, potential role of the emerging oral fibrinolytic agent Candrasatria, Rony M.; Kasim, Manoefris
Medical Journal of Indonesia Vol 25, No 1 (2016): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (526.11 KB) | DOI: 10.13181/mji.v25i1.1311

Abstract

Intracardiac thrombus may persist in some cases even after anticoagulant therapy. This opens a possibility to add a potent thrombolytic agent into therapeutic regimen without increasing bleeding risk any further. Increasing evidence showed a promising efficacy and safety of oral fibrin specific lumbrokinase as a thrombolytic agent. To the best of our knowledge, report of the use of lumbrokinase on intracardiac thrombus is limited. We reported two cases of intracardiac thrombi. In first patient, after two-month therapy with lumbrokinase, the previous 8 cm2 left atrial thrombus was completely disappeared. Second patient had left ventricular thrombus due to low left ventricular ejection fraction caused by coronary artery disease. A significant dissolution in thrombus size on repeated follow-up was found. Both patients did not experience any significant adverse effect. This case series aims to present the potential use of lumbrokinase as as oral antithrombotic therapy in intracardiac thrombus.