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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Respiratory Science
Eko Budiono
Division Of Pulmonology, Department Of Internal Medicine, Faculty Of Medicine, Public Health And Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia
Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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Reconsidering the limited role of right heart catheterization on severe pulmonary hypertension-due to progressive interstitial lung disease in young male patient : a case report Megawati Abubakar; Anggoro Budi Hartopo; Ika Trisnawati; Eko Budiono; Dyah Wulan Anggrahini; Lucia Kris Dinarti
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 2 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005502202307

Abstract

Pulmonary hypertension (PH)-associated with interstitial lung disease (ILD) develops as a consequence of progressive underlying lung disease or disproportionately to the underlying disease. The PH investigation by right heart catheterization (RHC) for defining PH severity is recommended in patients with ILD who show more severe symptoms than expected from lung disease, appearance of right heart failure, and clinical deterioration not matched by the declining lung function. In patient with progressive ILD, RHC is only considered if it affects the future treatment such as lung transplantation or enrollment in clinical trial/registry. The decision to undertake the RHC in progressive ILD was still fraught with doubts. Here we reported a young adult male patient with ILD whom developed progressive signs and symptoms.  By RHC, he had severe precapillary PH with hemodynamic parameters indicated the presence of pulmonary vascular disease. A PH-specific treatment, sildenafil citrate, was administered, and patient responded well and was clinically stable during the addition of sildenafil citrate. This case highlights the clinical implication of performing RHC in progressive ILD, which can change the treatment decision by PH-specific drugs. Therefore, the RHC decision making in patient with progressive ILD need reconsideration.
Mycobacterium tuberculosis Involvement in Tetralogy of Fallot: A Case Report of Tetralogy of Fallot Patient with Pulmonary Tuberculosis in A Tertiary Health Care in Indonesia Harik Firman Thahadian; Sumardi Sumardi; Eko Budiono
Respiratory Science Vol. 3 No. 3 (2023): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v3i3.87

Abstract

ckground: Pulmonary tuberculosis in patients with congenital heart disease is a rare case and remains challenging to diagnose and treat. This study aimed to emphasize the association between pulmonary tuberculosis infection and management in patients with congenital heart disease. Case: This case study presents 18-year-old male with Tetralogy of Fallot (ToF) who had pulmonary tuberculosis. The tuberculosis diagnosis was confirmed clinically, followed by positive IGRA. The patient underwent standard care within the hospital and upon discharge, he was prescribed with standard anti-tuberculosis regimen consisting of rifampicin, isoniazid, pyrazinamide, and ethambutol (RHZE) for a week then discontinued it. After 3 months the patient initiated intensive phase (RHZE) for 2 months and followed by 4-month maintenance phase of Isoniazid and Rifampicin. Immediate evaluation showed improved patient’s chest radiography and symptoms’ remission. This study presented provisioning therapy regimen and nutritional care delivery for pulmonary tuberculosis patient with ToF. Further patient’s clinical evaluation suggested a substantial recovery process. The patient prescribed with infection control and dietary management upon hospital discharge. Counseling to improve patient’s knowledge was performed to prevent recurrent TB. Collaborative care established between internal medicine specialists, cardiologist, pulmonologist, and clinical nutritionist appeared to be effective to promote patient’s recovery and quality of life (QoL). Conclusion: Appropriate management of cases improves patient outcomes and QoL. Early screening, diagnosis and treatment should be introduced regardless of the patient’s clinical status. Adequate support from the patient’s family and relatives are required to eliminate TB infection.
Co-Authors Anggoro Budi Hartopo Deshinta Putri Mulya Dyah Wulan Anggrahini Harik Firman Thahadian Ika Trisnawati Lucia Kris Dinarti Megawati Abubakar Sekar Satiti Sumardi Sumardi Triyanti Kurniasari Ananta Putri Sudibyo