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All Journal The Avicenna Medical Journal Ibnu Sina: Jurnal Kedokteran dan Kesehatan - Fakultas Kedokteran Universitas Islam Sumatera Utara
Zheng, Tonni
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Humanities Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Distinguish Between Perforation or Coronary Cameral Fistula: A Rare Findings during Percutaneous Coronary Intervention Laksono, Sidhi; Angkasa, Irwan Surya; Zheng, Tonni; Hosana, Cliffian; Nurbaeti, Putri; Nokik Stujanna, Endin
The Avicenna Medical Journal Vol. 6 No. 1 (2025): The Avicenna Medical Journal
Publisher : Faculty of Medicine, UIN Syarif Hidayatullah Jakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15408/avicenna.v6i1.45801

Abstract

Introduction: Coronary cameral fistula (CCFs) is a connection between the coronary arteries and a chamber of the heart. Most of it is accidentally found on coronary angiography. This case report discusses a patient with symptoms in whom CCF was incidentally found on CAG. Case presentation: A 49-year-old male patient came to our hospital to undergo an elective standby coronary angiogram. No plaque was found in the LM and LCx; however, a chronic total occlusion (CTO) in the medial LAD was found, as well as 60% tubular stenosis in the proximal and 75% tubular stenosis in the distal RCA. Drug eluting stent was placed up to 20 atm in mid-distal LAD. However, we found contrast-dye extravasation that emptied directly into the heart chamber from the distal LAD. There’s no any signs of pericardial effusion from the bedside echo thus reinforcing the diagnosis of CCFs. Discussion: CCFs represent rare cardiovascular anomalies characterized by abnormal connections between coronary arteries and cardiac chambers or major vessels. Conclussion: Bedside echocardiography is a rapid modality to differentiate perforation from CCFs and can be performed intra-PCI. Management such as transcatheter closure or surgical ligation, can be performed with their own indications.
BREAKING THE CYCLE: HOW THROMBOCYTOSIS AMPLIFIES RISKS IN PERIPARTUM CARDIOMYOPATHY WITH SEVERE VALVE DYSFUNCTION: MEMUTUS SIKLUS: BAGAIMANA TROMBOSITOSIS MEMPERBESAR RISIKO PADA KARDIOMIOPATI PERIPARTUM DENGAN DISFUNGSI KATUP BERAT Laksono, Sidhi; Zheng, Tonni
Ibnu Sina: Jurnal Kedokteran dan Kesehatan - Fakultas Kedokteran Universitas Islam Sumatera Utara Vol. 25 No. 1 (2026): Januari 2026
Publisher : Faculty of Medicine Universitas Islam Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30743/ibnusina.v25i1.1068

Abstract

Peripartum cardiomyopathy (PPCM) is a rare but serious condition involving heart failure with reduced ejection fraction developing late in pregnancy or within five months postpartum. Thrombocytosis may increase thromboembolic risk, and severe functional mitral regurgitation (MR) from left-ventricular dilation further worsens clinical status. A 38-year-old woman, three months postpartum, presented with worsening dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and leg edema. She had hypertension and dyslipidemia. Examination revealed fluid overload and elevated jugular venous pressure. ECG showed sinus tachycardia with ST-T changes, and chest X-ray demonstrated cardiomegaly with pulmonary congestion. Laboratory testing identified thrombocytosis (platelets 627,000/µL). Echocardiography revealed severe LV dilation (LVEDD 63 mm), markedly reduced ejection fraction (21%), grade 3 diastolic dysfunction, severe functional MR, and spontaneous echo contrast. This case illustrates the interaction of PPCM, reactive thrombocytosis, and severe MR, emphasizing the need for thorough cardiac–hematologic evaluation and multidisciplinary management to optimize outcomes.
Co-Authors Angkasa, Irwan Surya Hosana, Cliffian Laksono, Sidhi Nokik Stujanna, Endin Nurbaeti, Putri