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All Journal e-CliniC JURNAL BIOMEDIK PREPOTIF : Jurnal Kesehatan Masyarakat Medical Scope Journal (MSJ)
Starry H. Rampengan
Departement of Cardiology and Vascular Medicine, Faculty of Medicine, University Sam Ratulangi, Manado, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Nursing Public Health

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Gambaran pasien gagal jantung akut yang menjalani rawat inap di RSUP Prof Dr. R. D. Kandou periode September-November 2016 Haris, Devina E.; Rampengan, Starry H.; Jim, Edmond L.
e-CliniC Vol 4, No 2 (2016): Jurnal e-CliniC (eCl)
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.4.2.2016.14471

Abstract

Abstract: Acute Heart Failure is marked by a fast/rapid attack or sudden changes in symptoms or signs of Heart Failure. Heart failure has become a main issue in cardiology, because of an increasing number of Heart Failure patients and frequent re-hospitalization and death and disability. The most common cause of heart failure is coronary artery disease and hypertension. Patients with heart failure have typical symptoms, such as shortness of breath at rest or activity, easily tired, leg edema, and also tachycardia, tachypnea, pulmonary ronkhi, pleural effusion, increased jugular venous pressure, peripheral edema, hepatomegaly, and structural abnormalities or functional heart symptoms at rest, such as cardiomegaly, third heart sound, and increased levels of natriuretic peptides.Keywords: acute heart failure, inpatients care Abstrak: Gagal jantung akut adalah serangan yang cepat/rapid onset atau terjadinya perubahan mendadak dari gejala atau tanda gagal jantung. Gagal jantung telah menjadi masalah yang utama pada bidang kardiologi, karena bertambahnya jumlah penderita gagal jantung dan seringnya terjadi rawat ulang serta kematian dan kecacatan. Penyebab tersering gagal jantung di adalah penyakit arteri koroner dan hipertensi. Pasien yang mengalami gagal jantung memiliki gejala yang khas yaitu sesak napas saat istirahat atau aktifitas, mudah lelah, edema tungkai, dan terdapat juga tanda-tanda khas yaitu takikardi, takipnea, ronkhi paru, efusi pleura, peningkatan tekanan vena jugularis, edema perifer, hepatomegali, dan terdapat kelainan struktural atau fungsional jantung saat pasien istirahat yaitu kardiomegali, suara jantung ketiga, meningkatnya kadar peptida natriuretik. Kata kunci: gagal jantung akut, rawat inap
Angka Keberhasilan Terapi Reperfusi pada Pasien ST Elevasi Miokard Infark Ermiati, . .; Rampengan, Starry H.; Joseph, Victor F.F
e-CliniC Vol 5, No 2 (2017): Jurnal e-CliniC (eCl)
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v5i2.18279

Abstract

Abstract: ST-Elevation Myocardial Infarction (STEMI) is a kind of acute myocardial infarctions (AMI) with a high rate of mortality. Patients with STEMI are usually treated with reperfusion therapy consisting of primary percutaneous coronary intervention (primary PCI) and fibrinolytic therapy. This study was aimed to determine the success rate of reperfusion therapy in patients with STEMI at Prof. Dr. R. D Kandou Hospital Manado from January to December 2016. This was a descriptive observational study with a retrospective approach. Samples were patients with STEMI treated with reperfusion therapy at Prof. Dr. R. D Kandou Hospital Manado from January to December 2016, obtained by using consecutive sampling method. There were 73 patients in this study consisted of 82.2% of males and 17.8% of females. Most patients were >60 years old; 39.0% treated with primary PCI and 43.8% with fibrinolytic therapy. According to duration of therapy administration, most primary PCI were given at >90 minutes (80.5%) and fibrinolytic therapy at >30 minutes (75%). The success rate of primary PCI was higher in patients treated at ≤90 minutes (100%) compared to patients treated at >90 minutes. Moreover, the success rate of fibrinolytic therapy was higher in patients treated at ≤30 minutes (100%) compared to patients treated at >30 minutes (75%). Ventricular tachycardia (34.6%) was the most common type of reperfusion arrhythmia. Conclusion: The success rate of reperfusion therapy (primary PCI and fibrinolytic) in STEMI patients was higher if it was administered according to the optimum recommendations and targets.Keywords: STEMI, success rate of reperfusion therapy Abstrak: ST elevasi miokard infark (STEMI) merupakan jenis infark miokard akut (IMA) dengan mortalitas yang tinggi. Penatalaksanaan pasien STEMI dilakukan dengan terapi reperfusi yang terdiri primary percutaneous coronary intervention (primary PCI) dan fibrinolitik. Penelitian ini bertujuan untuk mengetahui angka keberhasilan terapi reperfusi pada pasien STEMI di RSUP Prof. Dr. R. D. Kandou Manado periode Januari-Desember 2016. Jenis penelitian ialah deskriptif observasional dengan pendekatan retrospektif. Sampel penelitian ialah pasien STEMI yang menerima terapi reperfusi, dirawat di RSUP Prof. Dr. R. D. Kandou Manado periode Januari-Desember 2016, yang diperoleh dengan teknik consecutive sampling. Dari total 73 pasien STEMI didapatkan pasien berjenis kelamin laki-laki (82,2%) lebih banyak dibandingkan perempuan (17,8%). Kelompok usia terbanyak ialah >60 tahun; 39,0% untuk terapi primary PCI dan 43,8% untuk terapi fibrinolitik. Waktu dilakukannya terapi reperfusi terbanyak dengan waktu terapi >90 menit untuk terapi primary PCI (80,5%) dan >30 menit (75%) untuk terapi fibrinolitik. Angka keberhasilan terapi primary PCI <90 menit lebih tinggi (100%) dibandingkan dengan terapi primary PCI >90 menit (96,6%), dan angka keberhasilan terapi fibrinolitik <30 menit lebih tinggi (100%) dibandingkan dengan terapi fibrinolitik >30 menit (75%). Jenis aritmia reperfusi ditemukan terbanyak ialah aritmia ventrikel takikardi 34,6%). Simpulan: Angka keberhasilan terapi reperfusi (primary PCI dan fibrinolitik) pada pasien STEMI lebih tinggi jika dilakukan tepat waktu sesuai dengan sasaran terapi optimal.Kata kunci: STEMI, angka keberhsilan terapi reperfusi.
Diagnosis dan Tatalaksana Terkini Gagal Jantung Akut Saroinsong, Lifi; Jim, Edmond L.; Rampengan, Starry H.
e-CliniC Vol 9, No 1 (2021): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v9i1.31857

Abstract

Abstract: Acute heart failure (AHF) is an emergency condition with rapid onset that requires immediate treatment. Many factors play a role in the incidence of AHF thus providing various of clinical manifestation. Prevalence and mortality of AHF is still a major health problem in Asia with the highest prevalence rate. This study intended to determine the tests needed to establish a diagnosis and recent treatment needed for AHF. This was a literature review study. The results showed the development of diagnosis and management of AHF based on the class of recommendation and levels of evidence updated by ESC 2016 and ACC/AHA/HFSA 2017. Furthermore, 4 journals discussed the development of troponin as biomarkers, multiple biomarkers, miRNA, and Lung Ultrasound (LUS). The development in AHF management was using tolvaptan, serelaxin, and neuromuscular electrical stimulation (NMES). In conclusion, diagnosis through anamnesis, physical examination, and supporting AHF can be done by understanding the causes of fluid retention and decreased cardiac output of the patient, therefore, it can provide pharmacological and non-pharmacological treatment appropriately.Keywords: diagnosis, treatment, acute heart failure Abstrak: Gagal jantung akut (GJA) merupakan kondisi darurat dengan tipe serangan yang cepat sehingga membutuhkan penanganan segera. Banyak faktor yang berperan dalam kejadian GJA sehingga memberikan gambaran klinis yang beragam. Prevalensi dan mortalitas GJA di dunia terus mengalami peningkatan dan masih merupakan masalah kesehatan utama di Asia. Penelitian ini bertujuan untuk mengetahui pemeriksaan yang diperlukan untuk menegakkan diagnosis GJA dan perkembangan tatalaksana terkini GJA. Jenis penelitian ialah literature review. Hasil penelitian mendapatkan perkembangan diagnosis dan tatalaksana GJA berdasarkan kelas rekomendasi dan tingkatan bukti yang diperbaharui oleh ESC 2016 dan ACC/AHA/HFSA 2017. Selain itu, 4 jurnal membahas perkembangan penggunaan biomarker troponin, biomarker multipel, miRNA, serta USG Paru. Perkembangan tatalaksana GJA menggunakan tolvaptan, serelaksin, dan neuromuscular electrical stimulation (NMES). Simpulan penelitian ini ialah penegakan diagnosis lewat anamnesis, pemeriksaan fisik dan penunjang GJA dapat dilakukan dengan memahami penyebab retensi cairan dan penurunan curah jantung pasien sehingga dapat memberikan tatalaksana farmakologis dan non-farmakologis dengan tepat.Kata kunci: diagnosis, tatalaksana, gagal jantung akut 
Diagnosis dan Tatalaksana Terkini Penyakit Jantung Hipertensi Moningka, Brigita L. M.; Rampengan, Starry H.; Jim, Edmond L.
e-CliniC Vol 9, No 1 (2021): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.9.1.2021.31962

Abstract

Abstract: Hypertensive heart disease is a response to a prolonged increase in blood pressure that causes various changes in the myocardial structure. This study was aimed to obtain the recent diagnosis and management of hypertensive heart disease. This was a literature review study using 4 databases, as follows: Pubmed, Clinical Key, Science Direct, and Google Scholar. The keywords used were Hypertensive Heart Disease diagnosis of Hypertensive heart disease OR Screening of hypertensive heart disease OR imaging of hypertensive heart disease AND therapy OR treatment OR management of hypertensive heart disease. The results showed that there were 10 literatures that fulfilled the criteria, consisting of 6 randomized controlled trials and 4 article reviews. Among patients with hypertensive heart disease, left ventricle hypertrophy, left ventricular dilation, and diastolic and systolic disfunction were the most commonly found in ECG, echocardiography, chest X-ray, and CMR. Therapy of hypertensive heart disease was according to ACC/AHA guidelines with non-pharmacological therapy by adopting the DASH diet and pharmacological therapy of choice was ACE-I or ARB. In conclusion, in hypertensive heart disease, the most common structural changes were left ventricle hypertrophy, left ventricular dilation, diastolic and systolic disfunction found in ECG, echocardiography, chest X-ray, and CMR. Therapy of hypertensive heart disease was according to ACC/AHA guidelines.Keywords: hypertensive heart disease Abstrak: Penyakit jantung hipertensi merupakan respon terhadap peningkatan tekanan darah berkepanjangan yang menyebabkan berbagai perubahan pada struktur miokard. Penelitian ini bertujuan untuk mendapatkan diagnosis dan tatalaksana terkini mengenai penyakit jantung hipertensi. Jenis penelitian ialah literature review menggunakan 4 database, yaitu Pubmed, Clinical Key, Science Direct, dan Google Scholar. Kata kunci yang digunakan ialah Hypertensive Heart Disease diagnosis of Hypertensive heart disease OR Screening of hypertensive heart disease OR imaging of hypertensive heart disease AND therapy OR treatment OR management of hypertensive heart disease. Hasil penelitian mendapatkan 10 literatur yang memenuhi kriteria penelitian, terdiri dari 6 randomized controlled trial dan 4 review article. Pada penyakit jantung hipertensi kelainan struktural yang sering ditemukan ialah hipertrofi ventrikel kiri (konsentrik maupun eksentrik), dilatasi ventrikel kiri, disfungsi diastolik dan sistolik, yang dapat dideteksi lewat pemeriksaan EKG, ekokardiografi, rontgen toraks, dan CMR. Terapi penyakit jantung hipertensi menurut pedoman ACC/AHA yakni nonfarmakologi seperti pola diet DASH dan terapi farmakologi pilihan yaitu ACE-I atau ARB. Simpulan penelitian ini ialah pada penyakit jantung hipertensi terdapat hipertrofi ventrikel kiri, dilatasi ventirkel kiri, disfungsi diastolik maupun sistolik, dideteksi menggunakan EKG, ekokardiografi, rontgen toraks dan CMR. Terapi penyakit jantung hipertensi sesuai dengan pedoman penatalaksanaan ACC/AHA.Kata kunci: penyakit jantung hipertensi
Gambaran pasien gagal jantung dengan penyakit hipertensi yang menjalani rawat inap di RSUP Prof. Dr. R. D. Kandou Manado periode September – November 2016 Tambuwun, Christa F.D.; Panda, Agnes L.; Rampengan, Starry H.
e-CliniC Vol 4, No 2 (2016): Jurnal e-CliniC (eCl)
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v4i2.14680

Abstract

Abstract: Heart failure is still one of the public health concerns with high morbidity and mortality rate, especially in developed as well as developing countries, including Indonesia. In heart failure with hypertension there will be diastolic or systolic dysfunction of left ventricle that is closely related with heart failure incidents. This study was aimed to obtain the profile of patients with heart failure associated withn hypertension that were admitted to Prof. Dr. R. D. Kandou Hospital Manado from September to Desember 2016. This was a descriptive prospective study with a cross sectional design. The results showed that of the total 167 heart failure patients, it was found that 70 patients (41.9%) had hypertension. Males (65.7%) were more commonly than females (34.3%). Based on the echocardiography examination, diastolic heart failure was the most common which accounted for 38 patients (54.9%), meanwhile 19 patients had systolic heart failure (27.2%), and 13 patients had the combination of systolic and diastolic heart failure (18.5%). Conclusion: In patients with heart failure associated with hypertension, diastolic heart failure in the form of relaxation disturbance was the most commonly found.Keywords: description, heart failure, hypertension Abstrak: Gagal jantung masih merupakan suatu masalah kesehatan masyarakat dengan angka morbiditas dan mortalitas yang tinggi baik di negara maju maupun di negara sedang berkembang termasuk Indonesia. Pada gagal jantung dengan hipertensi akan ditemukan disfungsi diastolik atau sistolik dari ventrikel kiri yang berhubungan erat dengan peningkatan insiden gagal jantung. Penelitian ini bertujuan untuk mendapatkan gambaran pasien gagal jantung disertai hipertensi yang menjalani rawat inap di RSUP Prof. Dr. R. D. Kandou Manado periode September – Desember 2016. Jenis penelitian ialah deskriptif prospektif dengan desain potong lintang. Hasil penelitian mendapatkan dari total 167 pasien gagal jantung, ditemukan gagal jantung disertai hipertensi sebanyak 70 pasien (41,9%). Berdasarkan hasil pemeriksaan ekokardiografi didapatkan klasifikasi terbanyak ialah gagal jantung diastolik sebanyak 38 pasien (54,3%), gagal jantung sistolik sebanyak 19 pasien (27,2%), dan kombinasi gagal jantung sistolik diastolik sebanyak 13 pasien (18,5%). Prevalensi terbanyak terdapat pada laki-laki (65,7%). Simpulan: Pada pasien gagal jantung dengan hipertensi yang tersering ditemukan ialah gagal jantung diastolik ventrikel kiri, berupa gangguan relaksasi.Kata kunci: gambaran, gagal jantung, hipertensi
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
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 A. Lucia Panda Agnes L. Panda Agnes Lucia Panda Agung D. Harikatang, Agung D. Budhi Setianto Cahyono, Alvin E. Christin Tatukude, Christin Donsu, Rudolof A. Edmond L. Jim Erling David Kaunang Ermiati, . . Erwin Kristanto Eva Nur Faridah, Eva Nur Frans Wantania Haris, Devina E. Harmani Kalim Janry A. Pangemanan Jimmy Posangi Judo Prihartono Kurniawan, James C. Kussoy, Kevin D W Lolaen, Cristina Lucky A. Tulung, Lucky A. Minarma Siagian Moningka, Brigita L. M. Murdani Abdullah Nancy Sasube, Nancy Niluh, Cecilia E. Patricia Ratna Sari Pertiwi, Junita Maja Polii, Natalia Rezuanto Pualillin Santoso, Michael Saroinsong, Lifi Sarwono Waspadji Setiadi, Benny Setiadi, Benny M. Sirowanto Inneke Suzanna Immanuel Syahfitri, Annisa Tambuwun, Christa F.D. Tandipanga, Mayprengki B. Toliu, Feiby C. Tracey C. C. W. Rompas Victor F. F. Joseph, Victor F. F.