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Raymond Pranata
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ijc@inaheart.org
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Editorial Office: Heart House, Jalan Katalia Raya No. 5, Kota Bambu Utara West Jakarta, 11430 - Indonesia Telephone: +62 21 5681149, Fax: +62 21 5684220 Email: ijc@inaheart.org
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INDONESIA
Indonesian Journal of Cardiology
Published by Indonesian Heart Association
ISSN : 28303105     EISSN : 29647304     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology
Indonesian Journal of Cardiology (IJC) is a peer-reviewed and open-access journal established by Indonesian Heart Association (IHA)/Perhimpunan Dokter Spesialis Kardiovaskular Indonesia (PERKI) [www.inaheart.org] on the year 1979. This journal is published to meet the needs of physicians and other health professionals for scientific articles in the cardiovascular field. All articles (research, case report, review article, and others) should be original and has never been published in any magazine/journal. Prior to publication, every manuscript will be subjected to double-blind review by peer-reviewers. We consider articles on all aspects of the cardiovascular system including clinical, translational, epidemiological, and basic studies. Subjects suitable for publication include but are not limited to the following fields: Acute Cardiovascular Care Arrhythmia / Cardiac Electrophysiology Cardiovascular Imaging Cardiovascular Pharmacotherapy Cardiovascular Public Health Policy Cardiovascular Rehabilitation Cardiovascular Research General Cardiology Heart Failure Hypertension Interventional Cardiology Pediatric Cardiology Preventive Cardiology Vascular Medicine
Arjuna Subject : Kedokteran - Cardiology and Cardiovascular Medicine
Articles 13 Documents
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Search results for , issue "online first" : 13 Documents clear
Myocarditis Mimicking STEMI Complicated by Complete Atrioventricular Block: Diagnostic and Therapeutic Insights Rido Mulawarman; Hiradipta Ardining; Celly Anantaria Atmadikoesoemah; Dony Yugo Hermanto; Bambang Widyantoro; Rarsari Soerarso
Jurnal Kardiologi Indonesia Online First
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1921

Abstract

Background: Myocarditis, or myocardial inflammation, may share similar characteristics to Acute Coronary Syndrome (ACS), particularly ST-Elevation Myocardial Infarction (STEMI). This condition is further augmented when a Complete Atrioventricular Block (CAVB) is present. Despite being rare, this condition may pose additional diagnostic and therapeutic challenges. Case Illustration: We report a 54-year-old woman with fatigue, dyspnea, fever, nausea, and watery diarrhea for three days. Upon admission, she experienced hypotension, pulmonary congestion, and a complete Atrioventricular (AV) block, with ST-segment elevation seen on the lateral leads. Initial laboratory results revealed markedly elevated high-sensitivity troponin T and C-reactive Protein (CRP). Bedside echocardiography showed a prominently reduced Ejection Fraction (EF) (40%) alongside the presence of regional wall motion abnormalities. Urgent coronary angiography revealed only non-obstructive coronary disease and no obstructive coronary disease. A temporary pacemaker and inotropic support were initiated. Given the presence of systemic prodromal symptoms and the absence of coronary obstruction, myocarditis was strongly suspected. High‑dose intravenous methylprednisolone was given as an anti‑inflammatory treatment in suspected fulminant myocarditis with cardiogenic shock and complete AV block. Recognizing that immunosuppressive therapy is not routinely recommended for all myocarditis cases, especially without biopsy confirmation. Cardiac magnetic resonance imaging subsequently confirmed myocarditis, demonstrating myocardial edema and subepicardial late gadolinium enhancement. The patient was discharged after receiving guideline-directed medical therapy and tapering corticosteroids, with preserved ventricular function on follow-up 1 month after discharge. Conclusions: This report illustrates the importance of a stepwise diagnostic approach to differentiate myocarditis from STEMI, particularly when complicated by conduction disturbances such as CAVB. Early recognition and timely initiation of immunosuppressive therapy can lead to favorable outcomes.
Cardiac Tamponade due to Purulent Pericarditis Jessica Anastasia Setiawan; Danayu Sanni Prahasti
Jurnal Kardiologi Indonesia Online First
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1963

Abstract

Background: Purulent pericarditis, though uncommon in the antibiotic era, remains highly fatal when diagnosis or drainage is delayed. Its presentation often mimics viral hepatitis, sepsis, or parasitic infections—particularly in endemic, low-resource regions—leading to underrecognition. This case reported the development of purulent pericarditis with initial equivocal signs and symptoms, followed by progressive hemodynamic deterioration. Case Illustration: A 40-year-old previously healthy man presented with fever, dyspnea, stabbing chest and abdominal pain, and dark urine. Examination revealed jaundice, pericardial friction rub, and hepatosplenomegaly. Laboratory tests showed leukocytosis, hyperbilirubinemia, and elevated liver enzymes. Initial echocardiography demonstrated a 2-cm circumferential effusion without signs of tamponade. Two days later, despite stable symptoms, he developed hypotension with new fibrinous effusion and right atrium collapse. Emergency pericardiocentesis drained 1.7 L of thick, purulent fluid. Hemodynamics improved rapidly after drainage. Prednisone and colchicine were initiated once infection control was achieved to limit fibro-inflammatory response and reduce the risk of constriction. Liver function normalized, and follow-up echocardiography showed minimal residual effusion. At follow-up, the patient remained asymptomatic. Conclusion: This case highlights that purulent pericarditis can occur in immunocompetent individuals without typical risk factors, possibly from overlooked infection in low-resource settings. Hemodynamic collapse may occur even with small increases in pericardial effusion volume, owing to fibrin-induced pericardial stiffness and reduced compliance. Serial echocardiography is therefore critical when symptoms appear stable. Early pericardiocentesis is both diagnostic and therapeutic, reducing bacterial and inflammatory load, while carefully selected adjunctive anti-inflammatory therapy may prevent chronic constrictive sequelae.
One-Year Outcomes of Major Adverse Cardiac Events in Patients with ST-Segment Elevation Myocardial Infarction Who Received Delayed PCI in a Type-B Hospital Nova Maryani; Gagah Buana Putra; Farhan Hanifati; Muhammad K. Abdillah
Jurnal Kardiologi Indonesia Online First
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.2038

Abstract

Background: Delayed Percutaneous Coronary Intervention (PCI) remains common in resource-limited hospitals due to system-related delays, often resulting in prolonged ischemic time. Although early reperfusion is the standard of care for ST-segment Elevation Myocardial Infarction (STEMI), delayed PCI may still be performed in selected, clinically stable patients. This study aimed to evaluate the one-year incidence of Major Adverse Cardiac Events (MACE) among STEMI patients undergoing PCI in a Type-B hospital, where delayed PCI was the predominant treatment pattern. Methods: This retrospective cohort study included adult STEMI patients who underwent PCI at PKU Muhammadiyah Gamping Hospital, Yogyakarta, Indonesia, between September 2018 and December 2020. Patients with incomplete medical records or loss to follow-up were excluded. Baseline clinical characteristics, comorbidities, infarct location, and door-to-wire-crossing time were collected. MACE included all-cause mortality, acute pulmonary edema, non-ST-segment elevation myocardial infarction, stroke, and rehospitalization due to reinfarction or acute heart failure within one year after PCI. Kaplan-Meier survival analysis and Mann-Whitney testing were applied. Results: Among 130 STEMI patients who underwent PCI, 123 (94.6%) received delayed PCI, with a median door-to-wire-crossing time of 10 hours 34 minutes. During one-year follow-up, MACE occurred in 10 patients (7.7%), corresponding to a 92.3% event-free survival rate. No significant association was observed between door-to-wire-crossing time and one-year MACE (p = 0.927). Conclusions: In this single-center study conducted at a Type-B hospital, one-year MACE occurred in 7.7% of STEMI patients undergoing PCI, most of whom received delayed PCI. No significant association was observed between door-to-wire-crossing time and MACE occurrence. Given the observational design and the limited number of events, these findings should be interpreted with caution. Delayed PCI appears feasible in selected patients, but should not be considered equivalent to guideline-recommended early PCI.

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