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All Journal Heart Science Journal
Sekarsari, Calysta Citra
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Health Professions Immunology & microbiology Medicine & Pharmacology

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Navigating backward, healing forward: The impact of retrograde EVLT in venous ulcer management: A case report Sekarsari, Calysta Citra; Kurnianingsih, Novi; Kurniawan, Dea Arie
Heart Science Journal Vol. 6 No. 2 (2025): The Complexity in the Management of Heart Rhythm Disorder
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.02.19

Abstract

Background: Chronic venous insufficiency (CVI) is a condition caused by venous reflux (backward flow) or obstruction, leading to significant morbidity and negatively impacting patients' quality of life (QoL). One recognized treatment for CVI is Endovenous Laser Treatment (EVLT). The antegrade conventional approach of EVLT is typically straightforward, but distal vein access can sometimes be difficult to achieve. Case Illustration: A 50-year-old man presented with bilateral lower extremity swelling and a chronic ulcer on his left leg that had persisted for one year without improvement. Doppler ultrasonography confirmed CVI in both lower extremities, with a great saphenous vein (GSV) reflux time exceeding 1500 ms. The patient was diagnosed with CVI C6EpAsPr and underwent EVLT. However, the small diameter of the distal GSV and vasospasm made antegrade access challenging. A retrograde approach was employed for EVLT on his left lower extremity, resulting in a successful outcome. Conclusion: This case highlights the use of the retrograde approach in EVLT as a viable alternative for accessing distal lesions when antegrade access is difficult, leading to successful wound healing. The retrograde technique can be considered a valuable option for CVI patients facing such challenges.
Closing the gap in cardiomyopathy classification: A case report of the emerging non-dilated left ventricular phenotype Sekarsari, Calysta Citra; Handari, Saskia Dyah
Heart Science Journal Vol. 7 No. 3 (2026): Predicting Restenosis in Coronary Artery Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.03.12

Abstract

Background: In the latest ESC guidelines on cardiomyopathy management, the task force introduced several new concepts and recommendations, including a novel phenotype-based classification for cardiomyopathies, which refered Non-Dilated Left Ventricular Cardiomyopathy (NDLVC). This case underscores the critical importance of long-term follow up and adherence to the patient pathway approach, as emphasized in recently published clinical guidelines. Case Presentations: A young male patient was taken to the emergency room after he experienced a syncopal episode. An electrocardiogram (ECG) was performed, revealing multiple Premature Ventricular Contractions (PVC). Transthoracic echocardiography performed at the referral hospital revealed reduced systolic function, with a left ventricular ejection fraction (LVEF) of 37% and CT Angiography showed non-significant stenosis. A contrast-enhanced cardiac MRI was conducted, which identified hypokinesia and impaired systolic function. Neither fibrosis, sign of myocarditis nor other inflammatory diseases was detected. Based on these findings, a diagnosis of non dilated left ventricular cardiomyopathy is established. Importantly, despite the absence of a family history, genetic testing is needed to provide valuable insights for confirming the diagnosis and optimizing patient management through continuous monitoring and individualized treatment adjustments. Conclusions: In this case of a young patient with findings consistent with NDLVC, we highlight the importance of a cardiomyopathy-focused approach. This approach supports the selection of appropriate diagnostic tests, including genetic evaluation, to facilitate accurate risk stratification and phenotype-specific management.
Co-Authors Kurnianingsih, Novi Kurniawan, Dea Arie Saskia Dyah Handari