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All Journal Indonesian Journal of Cardiology
Putra, Teuku Muhammad Haykal
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Health Professions Medicine & Pharmacology

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When Positive Ischemic Response on Treadmill Test Implies Otherwise: One Overlooked Pitfall on TMT Rifanda, Dmitri Muhammad; Parama, M. A. L.; Putra, Teuku Muhammad Haykal; Widodo, Wishnu Aditya
Jurnal Kardiologi Indonesia Vol 43 No 1 (2022): Indonesian Journal of Cardiology: January - March 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1197

Abstract

Background:Particular ischemic process that portrayed in Electrocardiogram (ECG) changes bear similar depiction to different conditions, one of them is hypokalemia. On the other hand, Treadmill Test (TMT) has been used for decades for risk stratifying and diagnosing coronary artery disease as a non-invasive, safe and affordable screening test. However, using ECG changes as interpretation, TMT could have incidence of false positive results reported in various conditions, one of which is hypokalemia. The aim is to report a case of positive ischemic response resemblance in TMT of patient with severe hypokalemia. Case Illustration:A-43-years-old female with history of unstable angina pectoris with risk factors of diabetes mellitus and hypertension underwent several examinations. Computed Tomography Coronary Angiography (CTCA) showed a 60% stenosis lesion in Left Anterior Descending (LAD) coronary artery. Within 3 minutes of TMT the ECG showed ST-segment depression in lead II, III, aVF, V1-V6 and prominent elevation in lead aVR. Fear of left main coronary artery occlusion, the test was terminated and the patient was immediately planned for urgent Percutaneous Coronary Intervention (PCI). The result indicated non-significant coronary lesion. Potassium concentration of 1.87 mmol per liter and troponin levels were normal. Unbeknownst before, the patient had multiple episodes of vomiting for a whole day and felt dehydrated prior to the TMT. Patient then treated for potassium implementation and discharged uneventfully. Conclusion:Hypokalemia could induce widespread ST-Segment depression or ST-Segment elevation in right limb lead. Peculiarly in context of stress testing or accompanied with chest pain, it is difficult to differentiate ECG changes in hypokalemia with true myocardial ischemia. Hypokalemia should be considered when TMT result is not concordance with true myocardial ischemia. This article has a related Erratum.
Protokol STEMI yang dimodifikasi untuk PPCI selama Pandemi COVID-19: Apakah itu memperpanjang kinerja Door-To-Balloon Putranto, Astri Yuniarsih; Putra, Teuku Muhammad Haykal; Soedarsono, Wahyu Aditya
Jurnal Kardiologi Indonesia Vol 44 No 3 (2023): Indonesian Journal of Cardiology: July - September 2023
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1325

Abstract

Background COVID-19 became a main health problem and causes heavy impact, especially for healthcare system. Managing ST-Segment Elevation Myocardial Infarction (STEMI) patients before COVID-19 pandemic was already challenging enough for Healthcare Professionals (HCP) to pursue time-sensitive treatment. After COVID-19 pandemic, the time-sensitive treatment of pursuing door-to-balloon (DTB) time put a lot more burden to HCP. In this study, We sought to analyze how a change in protocol of PPCI in STEMI patients before and during the pandemic influence the performance of DTB in the hospital. Methods This is a single-centered retrospective observational study among STEMI patients which was treated by PPCI. Secondary data from the medical record were collected consecutively from April 2018 to January 2022 (46 months). We compared DTB performances before and during the pandemic. Result During 46 months period, the total population of this research was 880 patients. There were total 358 patients underwent PPCI before the pandemic and 522 patients after the pandemic. Modified protocol with the addition step to prevent the spread of COVID-19 had been implemented since April 2020. DTB increased significantly during the pandemic (90 (70-124) minutes vs 97 (76-135) minutes, p 0.002). The proportion of the patients who achieved DTB under 90 min was also significantly decreasing (56.4% vs 47.9%, p 0.0013). Conclusion It is necessary for PPCI center to modify PPCI workflow during the pandemic. A decent workflow should consider practicality and simplicity without compromising HCP and patient safety. Implementing modified PPCI workflow during the pandemic significantly increased DTB time but it is still within the limit of being reasonable and acceptable for the benefit of the patients.This article has a related Erratum.
Breaking Bad News to a Terminally-Diseased Physician in ICCU: A Case Study of Ethical and Cultural Dilemma Putra, Teuku Muhammad Haykal; Apriansyah, Fadhil Pratama; Putra, Bayushi Eka; Firmanda, Wibisono; Tedjasukmana, Firman; Juzar, Dafsah Arifa
Jurnal Kardiologi Indonesia Vol 46 No 4 (2025): October - December, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1871

Abstract

Background: Breaking bad news is one of the most problematic tasks for physician. Moreover, local guidelines or recommendations about this is not well established in Indonesia and its practice still varies between physicians.Case Illustration: This paper presents a case of a fellow physician admitted to ICCU with terminal cardiac condition whose family wished to keep the bad news away from the patient. The physician team were in a difficult situation when the patient asked about his condition, but they decided to respect and commit to the family’s decision to not giving information about his terminal state.Conclusions: In performing such problematic task, balancing non-maleficence and autonomy principle is the key. Cultural background differences should also be considered when dealing with such cases. Other important factor that can affect this practice is lack of legal support in Indonesia. Combination of all those factors should always be considered for the best interest of both parties.
Modified STEMI protocol for PPCI during COVID-19 Pandemic: Does it prolong Door-To-Balloon performance? Putranto, Astri Yuniarsih; Putra, Teuku Muhammad Haykal; Soedarsono, Wahyu Aditya
Jurnal Kardiologi Indonesia Vol 46 No 4 (2025): October - December, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.2023

Abstract

In “Modified STEMI protocol for PPCI during COVID-19 Pandemic: Does it prolong Door-To-Balloon performance?” (Indonesian Journal of Cardiology, 44(3), 103-10. https://doi.org/10.30701/ijc.1325), there is an error noted. An error has been found in the PDF version of this article. The DOI printed in the PDF is incorrect. The correct DOI is https://doi.org/10.30701/ijc.1325. The error occurs only in the PDF; the DOI listed in the article metadata is already correct.The publisher apologizes for any inconvenience caused by this error.DOI of original article: https://doi.org/10.30701/ijc.1325
Utility of Ischemic Signs from Initial ECG in Detecting Culprit Vessels in NSTE-ACS Patients Wijaya, Michael Asby; Putra, Teuku Muhammad Haykal; Widodo, Wishnu Aditya
Jurnal Kardiologi Indonesia Vol 46 No 4 (2025): October - December, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.2024

Abstract

In “Utility of Ischemic Signs from Initial ECG in Detecting Culprit Vessels in NSTE-ACS Patients” (Indonesian Journal of Cardiology, 44(3), 111-9. https://doi.org/10.30701/ijc.1321), there is an errorsnoted. An error has been found in the PDF version of this article. The DOI printed in the PDF is incorrect. The correct DOI is https://doi.org/10.30701/ijc.1321. The error occurs only in the PDF; the DOI listed in the article metadata is already correct.The publisher apologizes for any inconvenience caused by this error.DOI of original article: https://doi.org/10.30701/ijc.1321
When Positive Ischemic Response on Treadmill Test Implies Otherwise: One Overlooked Pitfall on TMT Rifanda, Dmitri Muhammad; Parama, M. A. L.; Putra, Teuku Muhammad Haykal; Widodo, Wishnu Aditya
Jurnal Kardiologi Indonesia Vol 46 No 4 (2025): October - December, 2025
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.2032

Abstract

In “When Positive Ischemic Response on Treadmill Test Implies Otherwise: One Overlooked Pitfall on TMT” (Indonesian Journal of Cardiology, 43(1), 30-6. https://doi.org/10.30701/ijc.1197), there is an error noted. An error has been found in the PDF version of this article. The DOI printed in the PDF is incorrect. The correct DOI is https://doi.org/10.30701/ijc.1197. The error occurs only in the PDF; the DOI listed in the article metadata is already correct. The publisher apologizes for any inconvenience caused by this error.DOI of original article: https://doi.org/10.30701/ijc.1197
Co-Authors Apriansyah, Fadhil Pratama Bayushi Eka Putra Firmanda, Wibisono Juzar, Dafsah Arifa Parama, M. A. L. putranto, astri yuniarsih Rifanda, Dmitri Muhammad Soedarsono, Wahyu Aditya Tedjasukmana, Firman Widodo, Wishnu Aditya Wijaya, Michael Asby