Claim Missing Document
Check
Articles

Found 2 Documents
Search

Right Ventricle Dysfunction in COVID-19 Patients Nikita P. Toding Labi; Agnes L. Panda; Edmond L. Jim
e-CliniC Vol. 10 No. 1 (2022): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v10i1.37751

Abstract

Abstract: Coronavirus disease 2019 (COVID-19) has become a global pandemic. Related to its pathomechanisms and complications, COVID-19 is identified as a complex multi-organ disease. Cardiac involvement is reported in COVID-19 patients. One of the cardiovascular complications of COVID-19 is right ventricular dysfunction. This study aimed to provide an overview of right ventricular dysfunction in COVID-19 patients and its association with the patient's clinical outcomes. This was a literature review study conducted by searching and reviewing literatures on online databases as follows: PubMed, ScienceDirect, and ProQuest. There were 14 literatures obtained in this study with a total of 1,435 patients. All articles were observational studies conducted in January-April 2020 across various countries. Samples of patients with right ventricular dysfunction ranged from 3.6 to 41.7% of the total population of each study. Most studies defined right ventricle dysfunction as TAPSE<16-17 mm. Several echocardiography parameters and their threshold values were as follows: RV S' <9,5-10 cm/s; RVFAC <35%; right ventricular free wall strain (RVFWS); and right ventricular global longitudinal strain (RVGLS) according to ASE guidelines. In conclusion, right ventricular dysfunction has a high prevalence and is associated with poor outcomes of COVID-19 patients. Transthoracic echocardiography examination might become a risk stratification modality in hospitalized COVID-19 patients.Keywords: right ventricular dysfunction; coronavirus disease 2019; transthoracic echocardiography Abstrak: Coronavirus disease 2019 (COVID-19) telah menjadi pandemi global. Terkait dengan patomekanisme dan komplikasinya, COVID-19 dinyatakan sebagai penyakit multi-organ kompleks. Telah dilaporkan adanya keterlibatan jantung pada COVID-19. Salah satu komplikasi kardiovaskular dari COVID-19 ialah disfungsi ventrikel kanan. Penelitian ini bertujuan untuk memberikan gambaran disfungsi ventrikel kanan pada pasien COVID-19 dan hubungannya terhadap luaran klinis pasien. Jenis penelitian ialah literature review. Melalui penelusuran pada tiga database (PubMed, ScienceDirect, ProQuest), didapatkan 14 literatur dengan total 1.435 pasien. Semua artikel merupakan studi observasional yang dilakukan pada Januari-April 2020 dan tersebar di berbagai negara. Sampel pasien dengan disfungsi ventrikel kanan tercatat berkisar antara 3,6-41,7% dari total populasi tiap studi. Sebagian besar studi menetapkan definisi disfungsi ventrikel kanan dengan nilai TAPSE<16-17 mm. Beberapa parameter ekokardiografi lain beserta nilai ambang yang digunakan yaitu: RV S' <9,5-10 cm/s; RVFAC <35%; serta right ventricular free wall strain (RVFWS) dan right ventricular global longitudinal strain (RVGLS) berdasarkan panduan ASE. Simpulan penelitian ini ialah disfungsi ventrikel kanan pada COVID-19 memiliki prevalensi tinggi dan berhubungan dengan luaran pasien yang buruk. Pemeriksaan ekokardiografi transtorakal dapat menjadi modalitas stratifikasi risiko pada pasien COVID-19 yang dirawat inap.Kata kunci: disfungsi ventrikel kanan; coronavirus disease 2019; ekokardiografi transtorakal
Sindrom Wellens Tipe B dengan Penyumbatan pada Satu Pembuluh Darah Koroner: Laporan Kasus Edmond L. Jim
Medical Scope Journal Vol. 6 No. 1 (2024): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v6i1.52494

Abstract

Abstract: Wellens syndrome describes a pattern of electrocardiographic (ECG) changes, especially typical T waves, that threaten the patient's safety if further examination and management are delayed. We reported a 52-year-old male with a history of previous heart attacks. The patient had a history of hypertension, hypercholestrolemia, and active smoker. Vital signs indicated stable hemodynamics. On ECG examination, a deep inversion T wave was obtained in the V2-V6 leads. In echocardio-graphy, normal heart chamber dimensions, concentric LVH, with grade I diastolic dysfunction, LV EF 52% (SIMPSONS BP), apical to mid-anterior hypokinetics, other normokinetic segments, MR Mild, with normal RV contractility. Patient was carried out elective percutaneous coronary intervention (PCI) with the results of one kulprit lesion found in LAD, 50-60% proximal-mid stenosis, 80% distal tubular stenosis, discrete stenosis 50-60% D2, and Promus Premiere 2.5x20 mm stent installation in the distal LAD. The result of TIMI flow 3 angiography evaluation was no dissection or residual stenosis that concluded CAD 1VD post DCA-PCI with 1 Stent in LAD. After the PCI, complaint of chest pain was absent, vital sign examination and physical examinations were within normal limits. The therapy provided consisted of 0.9% NaCl infusion 500cc/24 hours intravenously for hydration after PCI, and dual antiplatelets After day-3 treatment there was no increase in urea and creatinine; therefore, outpatient treatment was carried out followed by phase 2 cardiac rehabilitation. Keywords: Wellens’ syndrome; typical T wave; stenosis; left anterior descending artery    Abstrak: Sindrom Wellens menggambarkan pola perubahan elektrokardiografi (EKG), terutama gelombang T tipikal yang mengancam keselamatan pasien bila terlambat dilakukan pemeriksaan dan penatalaksanaan lebih lanjut. Kami melaporkan seorang laki-laki beruria 52 tahun dengan riwayat serangan jantung sebelumnya. Pasien memiliki riwayat hipertensi, riwayat hiperkolestrolemia, dan perokok aktif. Tanda vital menunjukkan hemodinamik stabil. Pada pemeriksaan EKG  didapatkan gelombang T inversi dalam pada sadapan V2-V6. Pada ekokardiografi didapatkan dimensi ruang jantung normal, LVH konsentrik, dengan disfungsi diastolik grade I, LV EF 52% (SIMPSONS BP), hipokinetik apikal hingga mid anterior, segmen lain normokinetik, MR Mild , dengan kontraktilitas RV normal. Pasien dilakukan intervensi koroner perkutan elektif dengan hasil satu lesi kulprit terdapat pada LAD, stenosis 50-60% proksimal-mid, stenosis tubular 80% distal, stenosis diskret 50-60% D2, dan dilakukan pemasangan stent Promus Premiere 2,5x20mm di distal LAD. Hasil evaluasi angiografi TIMI flow 3, tidak terdapat diseksi, ataupun stenosis residual yang menyimpulkan CAD 1VD post DCA-PCI dengan 1 Stent di LAD. Pasca tindakan, keluhan nyeri dada tidak ada, pemeriksaan tanda vital dan pemeriksaan fisik dalam batas normal. Terapi yang diberikan terdiri dari infus NaCl 0,9% 500cc/24jam intravena untuk hidrasi setelah IKP dan dual antiplatelet. Setelah perawatan hari ke 3 tidak didapatkan peningkatan ureum dan kreatinin, dilakukan rawat jalan yang dilanjutkan dengan rehabilitasi jantung fase 2. Kata kunci: sindrom Wellens; gelombang T tipikal; stenosis; left anterior descending artery