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All Journal Heart Science Journal Jurnal Klinik dan Riset Kesehatan
Gultom, Yosafat Hasiholan Marthin
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Sebuah Laporan Kasus Penurunan Fungsi Sistolik Ventrikel Kiri pada Pasien Hamil dengan Tetralogy of Fallot yang Telah Dikoreksi : Kardiomiopati Peripartum atau yang Lainnya? Gultom, Yosafat Hasiholan Marthin; Martini, Heny
Jurnal Klinik dan Riset Kesehatan Vol 5 No 1 (2025): Edisi Oktober 2025
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.05.1.8

Abstract

Background : Tetralogy of fallot (TOF) is the most common cyanotic congenital heart disease (CHD) worldwide. It is estimated that TOF occupies 5 to 8% of total CHD and twice as many among other CHD simple defect. By far, TOF can only be managed by surgical correction. In most cases, post corrected TOF patients may tolerate pregnancy well. The majority of post corrected TOF patients also have good LV function and just about 23% of them have moderate LV dysfunction. Meanwhile, peripartum cardiomyopathy is one of the cause of LV systolic dysfunction in pregnancy. Case Presentation : A 31-years-old 33 weeks pregnant woman was reffered with chief complain of shortness of breath since 1 month before and preceded with bilateral leg edema (NYHA functional class III). Patient with history of  TOF and was corrected surgically with residual tricuspid regurgitation. Patient with normal left ventricle (LV) systolic function by echocardiography at the second semester of pregnancy and deteriorated at the third semester of pregnancy. Due to the rapid deterioration of LV systolic function, the pregnancy was decided to be terminated by surgery. Patient was treated with bisoprolol, bromocriptine, captopril and warfarin. During the hospitalisation, patient didn’t develop any of arrhytmia or hemodynamic issue. After the termination, patient was with improvement of shortness of breath (NYHA functional class II) and improvement of LV systolic function. Conclusion : A pregnant, post corrected TOF, woman with rapid deterioration LV systolic function and clinical manifestation of heart failure underwent pregnancy termination by surgery. After the termination, patient still with shortness of breath and improvement of LV systolic function.
Atrial septal defect with pulmonary arterial hypertension in pregnancy : A case series Valerinna Yogibuana; Martini, Heny; Gultom, Yosafat Hasiholan Marthin
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.2026.007.03.14

Abstract

Background: Congenital heart disease (CHD) ranked among the most frequently encountered structural abnormalities in humans. Acyanotic congenital heart disease (CHD) persists as a global issue, with atrial septal defect (ASD) constituting the second most prevalent form, accounting for around 10% of all CHD cases and occurring more frequently in females than in males. Pregnancy physiologically modifies the cardiovascular system and may exacerbate the clinical condition of people with atrial septal defect and pulmonary hypertension, potentially resulting in heart failure. Case Presentations: We documented five examples of pregnant patients with ASD and pulmonary hypertension (PH).  Two patients had established medical records and attended regular follow-up, one of whom underwent ASD closure.  All patients had dilation of the right atrium and ventricle, with two individuals presenting right ventricular (RV) systolic dysfunction.  All patients exhibited normal left ventricular (LV) systolic function.  Notwithstanding the oversight of a multidisciplinary heart team and intensive care management, one of our patients succumbed following cesarean section delivery.  The patient exhibited diminished right ventricular systolic function, a bidirectional shunt lesion, a significant maximal pressure gradient, and lacked any documented cardiovascular or obstetric medical history, presenting with a poor mWHO classification.   She experienced unresolved postoperative shock and bleeding. Conclusions: Managing PH secondary to CHD among pregnant patients presents significant challenges for multidisciplinary teams. Intensive perioperative care is essential to minimize mortality and morbidity in pregnant women with PH. Careful planning of optimal medical therapy, timing and delivery method, and post-natal approach is vital to improve outcomes.
Co-Authors Martini, Heny Valerinna Yogibuana