Leonardo Paskah Suciadi
Siloam Hospital Kebon Jeruk, Jakarta

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Acute Embolic Stroke as the Sole Presentation of Infective Endocarditis in Mitral Valve Prolapse Santoso, Andreas Hartanto; Suciadi, Leonardo Paskah; Susatia, Frandy
Cermin Dunia Kedokteran Vol 46, No 11 (2019): Kesehatan Anak
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (254.947 KB) | DOI: 10.55175/cdk.v46i11.410

Abstract

Case : A 43 yo. male was hospitalized with acute drowsiness and left-sided hemiparesis. Stroke was confirmed by head CT scan. Diagnosis of definite infective endocarditis (IE) was made by 1 major criterion (vegetation at mitral valve on echocardiography) and 3 minor criteria (mitral valve prolapse, persistent fever, and stroke). However, blood cultures were negative presumably due to early antibiotics administration. He was treated with parenteral antibiotics for 10 days, and continued with outpatient parenteral antibiotic therapy (OPAT). A clinical improvement was observed. Conclusion: Acute stroke can be an early manifestation of IE without any cardiac symptoms.Kasus :Laki-laki 43 tahun masuk rumahsakit dengan penurunan kesadaran dan hemiparesis sinistra. CT scan kepala sesuai gambaran stroke nonhemoragik. Diagnosis endokarditis infektif berdasarkan kriteria Duke yaitu 1 kriteria mayor (vegetasi katup mitral pada ekokardiografi) dan 3 kriteria minor (prolapsus katup mitral sebagai faktor predisposisi, demam menetap, dan stroke). Hasil kultur darah negatif dapat disebabkan pemberian antibiotik dini. Pasien diterapi dengan antibiotik parenteral selama 10 hari di rumahsakit dilanjutkan pada rawat jalan. Kondisi klinis pasien membaik. Simpulan: Stroke akut dapat merupakan manifestasi awal endokarditis infektif, meskipun tanpa keluhan jantung. 
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.