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The Importance of Hyperthyroid Screening in Acute Decompensated Heart Failure with Persistent Tachycardia Despite Optimal Decongestion: A Case Report Myrtha, Risalina; Wijayanto, Matthew Aldo; Prabowo, Nurhasan Agung
Jurnal Kardiologi Indonesia Vol 43 No 3 (2022): Indonesian Journal of Cardiology: July - September 2022
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1328

Abstract

Background: Hyperthyroid has various effects on the cardiovascular system. Cardiac arrhythmias ranging from sinus tachycardia to atrial fibrillation and low/high cardiac output state to congestive heart failure are observed in patients with hyperthyroidism. If hyperthyroidism is recognized and treated early, the cardiac dysfunction could be corrected. This case presentation will discuss the importance of thyroid function screening. Case Illustration and Discussion: A man was admitted to the emergency department with signs and symptoms of acute decompensated heart failure. Further examination was performed to confirm the diagnosis, namely ECG, laboratory examination including thyroid function test, and echocardiography. During hospitalization, heart failure medication was given and up titrated. The patient was still tachycardia until hyperthyroid was corrected with anti-thyroid medicines. Conclusion: Hyperthyroidism can cause or worsen left ventricular dysfunction, especially in individuals with a history of cardiovascular disease. Thus, thyroid function tests should be assessed during initial laboratory examination, especially on patients with acute decompensated heart failure.
ST-Depresi pada Infark Miokard Akut dengan Elevasi Segmen ST–Pentingnya Perubahan Resiprokal pada Elevasi Segmen ST yang Minimal Myrtha, Risalina; Wijayanto, Matthew Aldo; Putri, Desy Puspa; Hermawati, Berty Denny
Jurnal Biomedika dan Kesehatan Vol 7 No 3 (2024)
Publisher : Fakultas Kedokteran Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/JBiomedKes.2024.v7.339-344

Abstract

Coronary artery disease remains the leading cause of mortality globally. Management of ST-elevation myocardial infarction (STEMI) starts from the point of first medical contact. Time delay to treatment influences the mortality in STEMI patients. The aim of this study is to underline the importance of reciprocal ECG changes in helping diagnosis STEMI with subtle ST elevation. We present an obese and hypertensive male patient with atypical symptoms of MI and was diagnosed as peptic ulcer. The ECG showed subtle ST elevation in inferior ECG leads and reciprocal changes in I and aVL. Highly sensitive troponin was elevated. Serial ECG showed evolution, thus revealed acute inferior MI. Successful percutaneous coronary intervention was performed. ECG is one of the most important diagnosis tools in STEMI and a cornerstone to direct the decision to immediate reperfusion therapy. Minimal ST-elevation often leads to inappropriate diagnosis, thus delayed the time to reperfusion. A study shows that 11-23% of STEMI do not reach the cutoff for accepted ECG criteria. In a study of infarctions with minimal ST-elevation, reciprocal changes are reported in 58% of all cases. Reciprocal ECG changes is extremely useful to help identifying STEMI in the absence of obvious ST-elevation on ECG