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All Journal Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya Majalah Biomorfologi (Biomorphology Journal) Cardiovascular and Cardiometabolic Journal (CCJ) Cerdika: Jurnal Ilmiah Indonesia
Agus Subagjo
Departmenet Of Cardiology And Vascular Medicine, Faculty Of Medicine, Universitas Airlangga, RSUD Dr. Soetomo, Surabaya, Indonesia
Humanities Biochemistry, Genetics & Molecular Biology Economics, Econometrics & Finance Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Social Sciences

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Journal : Cardiovascular and Cardiometabolic Journal (CCJ)

 1 
Difficult Atrial Fibrillation Rate-Control and Digitalis Toxicity in Mitral-Valve Prolapse Patient with Hyperthyroidism Suryo Ardi Hutomo; Agus Subagjo
Cardiovascular and Cardiometabolic Journal Vol. 1 No. 2 (2020): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v1i2.2020.57-68

Abstract

Rate-control is important management in patient with atrial fibrillation. The optimum rate control provides a decrease of symptoms, improves hemodynamics and prevents tachycardia-induced cardiomyopathy. Rate-control could be difficult to achieve because of  patient's comorbidities and special treatment strategy is needed to resolve it. A-46-yo. male, came to ER with palpitation. Holosystolic murmur was heard at apex, radiating to axilla. ECG showed atrial fibrillation, with rapid ventricular response 180 bpm. Echocardiography showed dilated LA and LV, false-normal LV function with EF 59% and anterior mitral-valve prolapse with moderate mitral regurgitation. Acute treatment was administration of digoxin and beta blockers, but ventricular rate wasn’t controlled, until 1.5 mg doses of digoxin was administered. Then patient develops acute digitalis intoxication. After toxicity management, rapid ventricular rate recurs. Patient reevaluation showed hyperthyroidism with low TSH and high T4. Methimazole and propranolol was given and rate-control was achieved shortly after euthyroid state, in 2 months treatment. This patient suffered difficult rate-control despite guidelines-based management. Digitalis intoxication was developed after administration of several therapeutic doses. The diagnosis of hyperthyroidism is central in management of this case. Coexistent of hyperthyroidism and mitral-valve prolapse may be explained by genetic, autoimmune, and thyroid hormone effects in myocardium.
Infective Endocarditis: A Case with Prolonged Fever Maulia Prismadani; Agus Subagjo
Cardiovascular and Cardiometabolic Journal Vol. 2 No. 2 (2021): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v2i2.2021.84-89

Abstract

Infective endocarditis (IE) is associated with a high rate of mortality and morbidity in patients with anomalies of heart valves. We present a case of a 23-year-old male known to have severe mitral regurgitation (MR) with a history of prolonged fever for 5 months. According to The Modified Duke Criteria, clinical sign and symptoms fulfilled one major criterion (echocardiography finding of vegetation on mitral valve) and three minor (fever of at least 380 Celsius, valvular heart disease as a predisposing heart condition, and positive blood culture for Lactococcus sp. and Pediococcus sp.) considered as definite IE. Fever is one of the most common symptoms of IE (>90% of cases). Patient with prolonged fever and structural abnormality of heart valve should be considered for acute or subacute of IE. Establishing an diagnosis of IE and appropriate antibiotic therapy will improve the patient's clinical condition, and reduce morbidity and mortality. Keywords: Infective endocarditis (IE), Prolonged fever
Profile of Major Risk Factors in Acute Coronary Syndrome (ACS) at Pusat Pelayanan Jantung Terpadu (PPJT) Dr. Soetomo Public Hospital Surabaya Between the Period of January-December 2019 Ikhsanuddin Qothi; Muhamad Robi’ul Fuadi; Agus Subagjo
Cardiovascular and Cardiometabolic Journal Vol. 2 No. 2 (2021): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v2i2.2021.59-72

Abstract

Background: Coronary heart disease (CHD) is a leading cause of death worldwide. One type of CHD that most often causes clinical manifestations and death is Acute Coronary Syndrome (ACS). In 2013 the prevalence of SKA in Indonesia reached 1.5% and it is estimated that it will continue to increase every year. Objective: This study aims to determine the profile of major risk factors for ACS sufferers in the Pusat Pelayanan Jantung Terpadu (PPJT) Dr. Soetomo Public Hospital Surabaya in the period January-December 2019. Methods: This study used a retrospective descriptive method to analyze the patient's electronic medical record (e-MR). Results: Out of 623 patients diagnosed with ACS, 429 were excluded from the research. 194 patients who met the inclusion criteria were studied with the following details: 19 APTS patients, 43 N-STEMI patients, and 132 STEMI patients. It was found that 73% of ACS patients were male, with the 55-64 years’ age group dominating by 46%. Based on blood pressure and serum cholesterol examination data, it was found that 51% of patients had hypertension and 77% of patients had dyslipidemia (40% hypercholesterolemia, 42% hypertriglyceridemia, 40% low HDL-C levels, and 34% high LDL-C levels). 60% patients had type-2 diabetes mellitus and 52% of patients had a history of smoking. Conclusion: 73% of ACS patients in this study were men. Most common age groups were 55-64 years old (46%), had hypertension by 51%, had dyslipidemia by 77% (40% hypercholesterolemia, 42% hypertriglyceridemia, 40% low HDL-C levels, 34% high LDL-C), had type-2 diabetes mellitus by 60%, and had a smoking history by 52%.
Reperfusion Therapy for ST-Elevation Myocardial Infarction at Dr. Soetomo General Academic Hospital Surabaya Rosavelina Sintaasih Budihardjo; Agus Subagjo; Subur Prajitno
Cardiovascular and Cardiometabolic Journal Vol. 2 No. 1 (2021): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v2i1.2021.1-9

Abstract

Background: Cardiovascular disease is the number one cause of death in the world by killing 17,9 million people every year. The most frequent cardiovascular disease occurs as STEMI which related to the depiction of persistent depiction of EKG elevation with ST segment. This research is aiming for figure out the profile of reperfusion therapy at Dr. Soetomo General Academic Hospital, Surabaya. Methods: In this research, the data is collected using observation method, without any treatment applied with descriptive statistical analysis using table. The data collection techniques used is simple random sampling. Results: The STEMI patients at Dr. Soetomo General Academic Hospital Surabaya are dominated by referral patients (79,2%) from approximately 40 hospitals in East Java. Most of the patients were male, the ages between 51 – 60 years old with the most frequent risk factors was the combination of type 2 diabetes mellitus, hypertension, and smoking. The reperfusion therapy given was PCI with a door to balloon <120 minutes was 59.6%. Fibrinolytic that was done in <12 hours after onset was 82.9%. Patients with STEMI managed at Dr. Soetomo General Academic Hospital Surabaya, had mortality rates around 12.2%. Conclusion: Most of the STEMI patients in Dr. Sutomo General Academic Hospital Surabaya was a referral patient and had sufficiently good PCI and fibrinolytic reperfusion therapy, resulting in a low mortality rate.
A Late Prosthetic Mitral Valve Infective Endocarditis Caused by Micrococcus spp. that Fully Recovered by Antibiotics Treatment : A Rare Case Imam Mahbub Zam Zami; Agus Subagjo
Cardiovascular and Cardiometabolic Journal Vol. 3 No. 2 (2022): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v3i2.2022.112-118

Abstract

Prosthetic valve endocarditis is the most severe form endocarditis with prevalence of 5.7% at 5 years and mortality with medical treatment is 26%-75%. Case Summary: Male, 46 years old, with mechanic mitral prosthetic valve >5 years, hemiparesis sinistra due to embolic stroke >4 weeks prior, was suffering from persistent fever >38,5⁰ for 2 weeks without heart failure. Three separate blood cultures came positive with Micrococcus spp. and Osler’s node was noticed. Echocardiography shown 1.0 cm x 0.9 cm vegetation at mitral prosthetic valve without paravalvular leakage. Patient was assessed as late mitral PVE. Discussion: Gentamycin, Levofloxacin, and Erythromycin were given based on susceptibility test continued by Meropenem as therapy of urinary tract infection based on susceptibility test after second blood culture result was negative. The patient underwent 42 weeks of antibiotics course. The patient was discharged with good condition, no signs and symptoms of infection or heart failure, blood test was within normal limit, no vegetations with prosthetic mitral valve functioned normally. This case shows that late PVE caused by Micrococcus spp. can be treated by 42 weeks course of antibiotics according to microbial susceptibility test.
Identification of The Effect of Hyberbaric Oxygen Therapy (HBOT) on Blood Pressure Lowering Effects in Hypertension Patients Karindra Amadea Susetiyo; Agus Subagjo; Primadita Syahbani; Iqlima Rahmawati; Ikhsanuddin Qothi
Cardiovascular and Cardiometabolic Journal Vol. 3 No. 1 (2022): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v3i1.2022.52-59

Abstract

Hypertension is a leading cause of death worldwide including in Indonesia. The World Health Organization (WHO) estimates that currently the global prevalence of hypertension is 22% (WHO, 2019). In 2018 the prevalence of hypertension in Indonesia reached 34,11% (Riskesdas, 2018). Every year, it is estimated that 10.4 million deaths are caused by hypertension (Unger et al., 2020). Hyperbaric Oxygen Therapy (HBOT) is a therapy with pure oxygen concentration (100%) in a high pressure room (Ortega et al., 2021). In previous studies it was found that HBOT improves the effects of vasodilation (Mihaljevic et al., 2018). However, other studies mention different results. It was found that HBOT initiates vasoconstriction and increases systemic vascular resistance. This causes a decrease in nitrite oxide (NO) production and increase NO oxidation (Goyal et al., 2021). Apart from a variety of different study results, the use of HBOT has indeed been widely studied even though it has not found a clear meeting point on the effects of blood pressure reduction on hypertension patients. Therefore, the author aims to find out more clearly the mechanism and benefits of hyperbaric oxygen therapy against decreased blood pressure in hypertension patients.           Keywords: Hyperbaric Oxygen Therapy, Hypertension
Co-Authors Adityo Basworo Fhahira Rizkhika Admadiani Ikhsanuddin Qothi Ikhsanuddin Qothi Imam Mahbub Zam Zami Iqlima Rahmawati Karindra Amadea Susetiyo Maulia Prismadani Muhamad Robi’ul Fuadi Notopuro, Paulus Budiono Ogiska Chaherfa Nadasya Okky Wahyu Firmansyah Primadita Syahbani Putranto, J.Nugroho Eko Rosavelina Sintaasih Budihardjo S.Pd. M Kes I Ketut Sudiana . Soebroto, Heroe Subur Prajitno Suryo Ardi Hutomo