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All Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Archives of The Medicine and Case Reports Bioscientia Medicina : Journal of Biomedicine and Translational Research
Trisna Ardani, Nyoman Intan
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Complete Atrioventricular Block in Acute Rheumatic Fever with Clinical Presentation of Syncope and Abdominal Pain: A Case Report Trisna Ardani, Nyoman Intan; Gede Aditya
Archives of The Medicine and Case Reports Vol. 5 No. 3 (2024): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v5i3.594

Abstract

Acute rheumatic fever (ARF) is a systemic inflammatory disease following group A streptococcus infection that can affect various organs, including the heart. The most common cardiac manifestation is pancarditis, which can cause various arrhythmias. Complete atrioventricular (AV) block is a rare cardiac complication of ARF, especially in adult patients. We report the case of a 30 year old man who came to the emergency room with the main complaint of abdominal pain, nausea, vomiting, and a history of syncope. He also had a history of fever and joint pain. Physical examination and electrocardiogram (ECG) showed complete AV block. The patient was admitted to the ICU and given medical therapy for ARF and complete AV block. After several days of treatment, his complete AV block recovered to sinus rhythm, and his clinical symptoms improved. This case report highlights the importance of considering ARF as a differential diagnosis in young adult patients with complete AV block and systemic symptoms. Fast and appropriate treatment can improve the patient's prognosis.
Rheumatic Heart Disease in East of Bali Indonesia Trisna Ardani, Nyoman Intan; Gede Aditya
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 8 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i8.1044

Abstract

Background: Rheumatic heart disease remains to be the most acquired heart disease among people aged <25 years. Despite improvements in high sociodemographic countries, low and low-middle sociodemographic countries have been less successful in lowering the burden of RHD.1 However, data of patient with RHD is still lacking in Indonesia, especially in Bali. Karangasem is a rural area, one of the regencies in the eastern part of Bali. Methods: This retrospective study was performed between January 2023 and January 2024 at two hospitals in Karangasem Regency, Karangasem Regional General Hospital and BaliMed Karangasem Hospital. These two hospitals were the only hospital in Karangasem regency. The study population comprised all patients who were diagnosed with RHD. Patient characteristics and echocardiographic parameters were collected retrospectively from medical records. Results: Data from 101 patients with RHD were collected. They were predominantly female (73.3%) young adults (mean ages 41.97 years), graduated from primary school (58.4%), unemployed (26.7%), and mostly from the Karangasem subdistrict (34.7%). Mitral stenosis and mitral regurgitation were the same counts (65.3%), with mixed valve lesions (mitral and aortic) as the most common lesion (45.5%). Fifty-eight patients (57.4%) had secondary tricuspid regurgitation, with 6 patients with TR V-Max >3.4m/s. Atrial fibrillation was a common complication (47.5%). Most patient with RHD had preserved Left Ventricular Ejection Fraction (LVEF >50%). Only a quarter of patients had reduced RV contractility (TAPSE <17mm). All of the patients with AF were given warfarin. All under 40-year-old patients were given a benzathine penicillin G injection. Only 7 patients had a history of valve surgery. Conclusion: Mixed valve lesion (mitral and aortic) was the most observed condition of valve lesion in RHD with the same count of mitral stenosis and mitral regurgitation. Characteristic of patients in this study were predominantly female, young adult, graduated from primary school, unemployed, had preserved LV function, normal RV contractility, high prevalence of AF with all prescribed warfarin, all of under 40 years were given antibiotics prophylaxis.
Rheumatic Heart Disease in East of Bali Indonesia Trisna Ardani, Nyoman Intan; Gede Aditya
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 8 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i8.1044

Abstract

Background: Rheumatic heart disease remains to be the most acquired heart disease among people aged <25 years. Despite improvements in high sociodemographic countries, low and low-middle sociodemographic countries have been less successful in lowering the burden of RHD.1 However, data of patient with RHD is still lacking in Indonesia, especially in Bali. Karangasem is a rural area, one of the regencies in the eastern part of Bali. Methods: This retrospective study was performed between January 2023 and January 2024 at two hospitals in Karangasem Regency, Karangasem Regional General Hospital and BaliMed Karangasem Hospital. These two hospitals were the only hospital in Karangasem regency. The study population comprised all patients who were diagnosed with RHD. Patient characteristics and echocardiographic parameters were collected retrospectively from medical records. Results: Data from 101 patients with RHD were collected. They were predominantly female (73.3%) young adults (mean ages 41.97 years), graduated from primary school (58.4%), unemployed (26.7%), and mostly from the Karangasem subdistrict (34.7%). Mitral stenosis and mitral regurgitation were the same counts (65.3%), with mixed valve lesions (mitral and aortic) as the most common lesion (45.5%). Fifty-eight patients (57.4%) had secondary tricuspid regurgitation, with 6 patients with TR V-Max >3.4m/s. Atrial fibrillation was a common complication (47.5%). Most patient with RHD had preserved Left Ventricular Ejection Fraction (LVEF >50%). Only a quarter of patients had reduced RV contractility (TAPSE <17mm). All of the patients with AF were given warfarin. All under 40-year-old patients were given a benzathine penicillin G injection. Only 7 patients had a history of valve surgery. Conclusion: Mixed valve lesion (mitral and aortic) was the most observed condition of valve lesion in RHD with the same count of mitral stenosis and mitral regurgitation. Characteristic of patients in this study were predominantly female, young adult, graduated from primary school, unemployed, had preserved LV function, normal RV contractility, high prevalence of AF with all prescribed warfarin, all of under 40 years were given antibiotics prophylaxis.
Co-Authors Gede Aditya