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All Journal Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya Indonesian Journal of Anesthesiology and Reanimation (IJAR) Majalah Biomorfologi (Biomorphology Journal) Cardiovascular and Cardiometabolic Journal (CCJ) Cerdika: Jurnal Ilmiah Indonesia
Agus Subagjo
Department Of Cardiology And Vascular Medicine, Faculty Of Medicine, Universitas Airlangga
Humanities Biochemistry, Genetics & Molecular Biology Economics, Econometrics & Finance Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Social Sciences

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Cardio-vocal Syndrome as a Complication Patient with Severe Mitral Regurgitation and Moderate Aortic Regurgitation with Pulmonary Hypertension Adityo Basworo; Agus Subagjo
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 5, No 1 (2021)
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v5i1.4775

Abstract

ABSTRACT  Hoarseness due to paralysis of vocal cord, as in Cardio-vocal syndrome, is caused by mechanical affection of left recurrent laryngeal nerve from enlarged cardiovascular structures. Mitral valve prolapse is rarely found to cause this syndrome. Case report presenting a 47 years old male visited the outpatient department with a clinical history of dyspnea and hoarseness since a year ago. Physical examination revealed late systolic murmur in apex and low-grade diastolic murmur in right second intercostal space. Echocardiography confirmed severe mitral regurgitation due to flail anterior mitral valve leaflet with severe left atrium dilatation (9.0 cm) and moderate aortic regurgitation due to mal-coaptation of aortic valves. Laryngoscopy revealed an immobile left vocal cord. He underwent successful double valve replacement after three months follow up the patient showed improvement of hoarseness. The incidence of Cardio-vocal syndrome in mitral valve disease varies from 0.6% to 5%. In cases diagnosed with thoracic disease, paralysis of the left vocal cord was reported 1.75 times more frequent than the right side. The aim of this case report is we have to aware that Cardio-vocal syndrome is a rare cause of vocal cord paralysis and should be considered as a differential diagnosis of hoarseness, particularly if the patient has a cardiac history. Comprehensive evaluation and prompt treatment may allow reversal of the damage to left recurrent laryngeal nerve. Permanent nerve damage can occur due to late diagnosis. Keywords             : Cardio-vocal syndrome, Mitral regurgitation, Aortic RegurgitationCorrespondence   : adityobasworo@gmail.com
EuroSCORE II as Predictor of Mortality and Morbidity in Post-CABG Patient in Dr. Soetomo General Academic Hospital Rama Azalix Rianda; Bambang Pujo Semedi; Agus Subagjo; Yoppie Prim Avidar
Indonesian Journal of Anesthesiology and Reanimation Vol. 4 No. 1 (2022): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (364.453 KB) | DOI: 10.20473/ijar.V4I12022.14-21

Abstract

Introduction: European System for Cardiac Operative Risk Evaluation (EuroSCORE) is a scoring system to predict mortality risk after cardiac surgery. EuroSCORE II was introduced to replace and show superiority over EuroSCORE I which tends to overestimate the risk of heart surgery procedures and have a low discrimination ability. Meanwhile, this is the first study to analyze EuroSCORE II as a predictor of mortality and morbidity in Indonesians. Objective: This study aims to analyze EuroSCORE II as a predictor of mortality and morbidity in Indonesians. Materials and Methods: This is a retrospective study using medical records of CABG patients in Dr. Soetomo General Academic Hospital from January 2016 to December 2017. Results and Discussion: Out of 39 Patients who have performed CABG surgery, most were male (89.7%) with the highest age range of 46-65 years (59%). Deceased patients had an average EuroSCORE II of 22.36% and SD±26.97%7%, while 27 patients who survived had an average EuroSCORE II of 6.78% and SD±6.4%. Based on morbidity assessment, EuroSCORE II only accurately predicted the risk of kidney failure and did not properly assess the length of inotropic use, vasopressors, hospitalization time, the risk of arrhythmias, low cardiac output syndrome, Durante-operative bleeding, and the need for blood transfusion. These inaccuracies occurred because the samples that were included varied based on their standard deviation and pattern-less graph. Conclusion: EuroSCORE II is inadequate to predict morbidity and mortality in postoperative patients, therefore, it is considered less effective.
THE PROFILE OF CORONARY HEART DISEASE PATIENTS IN DR. SOETOMO GENERAL ACADEMIC HOSPITAL, SURABAYA, INDONESIA Ogiska Chaherfa Nadasya; Johanes Nugroho Eko Putranto; I Ketut Sudiana; Agus Subagjo
Majalah Biomorfologi Vol. 31 No. 1 (2021): MAJALAH BIOMORFOLOGI
Publisher : Universitas Airlangga, Surabaya, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mbiom.v31i1.2021.6-10

Abstract

Background: Coronary heart disease is a deadly disease for human. The incidence of coronary heart disease is different, so that this research reported the profile of coronary heart disease patients in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Objective: To analyze the profile of CHD patients in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia from February to September 2018. Materials and Methods: A descriptive research based on the medical records. Results: There were 65 male patients and 20 female patients. There were 58% patients aged 50-60 years old, 24% patients aged more than 60 years old, and 18% patients are under 50 years old. The patients’ occupations were as follows: 42% civil servants, 36% private employees, 9% housewives, 5% retirees, 3% entrepreneurs, 1% for teacher, driver, fisherman, priest, and merchant. The complaints included chest pain (40%), shortness of breath (23.5%), PCI (4.6%), thump chest (1.2%), lower right abdominal pain (1.2%), right leg pain (1.2%), nausea (1.2%), vomitting (1.2%), cough (1.2%), dysentry (1.2%), and no complaint (23.5%). CHD patients in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia had the history of hypertension (30.6%), heart disease (22.6%), diabetes mellitus (21.9%), smoking (5.6%), COPD (0.8%), and no history of disease (12.9%). Sixty-one percent of the patients had blood sugar level of  ≥100 mg/dl, 19% patients had blood sugar level of <100 mg/dl, 20% patients did not have data. Conclusion: There were 85 patients, predominantly males of 50-60 years old. The most common occupation of the patients was civil servant and they came with major complaint of chest pain with the history of hypertension.
Difficult Atrial Fibrillation Rate-Control and Digitalis Toxicity in Mitral-Valve Prolapse Patient with Hyperthyroidism Suryo Ardi Hutomo; Agus Subagjo
Cardiovascular and Cardiometabolic Journal Vol. 1 No. 2 (2020): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v1i2.2020.57-68

Abstract

Rate-control is important management in patient with atrial fibrillation. The optimum rate control provides a decrease of symptoms, improves hemodynamics and prevents tachycardia-induced cardiomyopathy. Rate-control could be difficult to achieve because of  patient's comorbidities and special treatment strategy is needed to resolve it. A-46-yo. male, came to ER with palpitation. Holosystolic murmur was heard at apex, radiating to axilla. ECG showed atrial fibrillation, with rapid ventricular response 180 bpm. Echocardiography showed dilated LA and LV, false-normal LV function with EF 59% and anterior mitral-valve prolapse with moderate mitral regurgitation. Acute treatment was administration of digoxin and beta blockers, but ventricular rate wasn’t controlled, until 1.5 mg doses of digoxin was administered. Then patient develops acute digitalis intoxication. After toxicity management, rapid ventricular rate recurs. Patient reevaluation showed hyperthyroidism with low TSH and high T4. Methimazole and propranolol was given and rate-control was achieved shortly after euthyroid state, in 2 months treatment. This patient suffered difficult rate-control despite guidelines-based management. Digitalis intoxication was developed after administration of several therapeutic doses. The diagnosis of hyperthyroidism is central in management of this case. Coexistent of hyperthyroidism and mitral-valve prolapse may be explained by genetic, autoimmune, and thyroid hormone effects in myocardium.
Infective Endocarditis: A Case with Prolonged Fever Maulia Prismadani; Agus Subagjo
Cardiovascular and Cardiometabolic Journal Vol. 2 No. 2 (2021): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v2i2.2021.84-89

Abstract

Infective endocarditis (IE) is associated with a high rate of mortality and morbidity in patients with anomalies of heart valves. We present a case of a 23-year-old male known to have severe mitral regurgitation (MR) with a history of prolonged fever for 5 months. According to The Modified Duke Criteria, clinical sign and symptoms fulfilled one major criterion (echocardiography finding of vegetation on mitral valve) and three minor (fever of at least 380 Celsius, valvular heart disease as a predisposing heart condition, and positive blood culture for Lactococcus sp. and Pediococcus sp.) considered as definite IE. Fever is one of the most common symptoms of IE (>90% of cases). Patient with prolonged fever and structural abnormality of heart valve should be considered for acute or subacute of IE. Establishing an diagnosis of IE and appropriate antibiotic therapy will improve the patient's clinical condition, and reduce morbidity and mortality. Keywords: Infective endocarditis (IE), Prolonged fever
Profile of Major Risk Factors in Acute Coronary Syndrome (ACS) at Pusat Pelayanan Jantung Terpadu (PPJT) Dr. Soetomo Public Hospital Surabaya Between the Period of January-December 2019 Ikhsanuddin Qothi; Muhamad Robi’ul Fuadi; Agus Subagjo
Cardiovascular and Cardiometabolic Journal Vol. 2 No. 2 (2021): Cardiovascular and Cardiometabolic Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v2i2.2021.59-72

Abstract

Background: Coronary heart disease (CHD) is a leading cause of death worldwide. One type of CHD that most often causes clinical manifestations and death is Acute Coronary Syndrome (ACS). In 2013 the prevalence of SKA in Indonesia reached 1.5% and it is estimated that it will continue to increase every year. Objective: This study aims to determine the profile of major risk factors for ACS sufferers in the Pusat Pelayanan Jantung Terpadu (PPJT) Dr. Soetomo Public Hospital Surabaya in the period January-December 2019. Methods: This study used a retrospective descriptive method to analyze the patient's electronic medical record (e-MR). Results: Out of 623 patients diagnosed with ACS, 429 were excluded from the research. 194 patients who met the inclusion criteria were studied with the following details: 19 APTS patients, 43 N-STEMI patients, and 132 STEMI patients. It was found that 73% of ACS patients were male, with the 55-64 years’ age group dominating by 46%. Based on blood pressure and serum cholesterol examination data, it was found that 51% of patients had hypertension and 77% of patients had dyslipidemia (40% hypercholesterolemia, 42% hypertriglyceridemia, 40% low HDL-C levels, and 34% high LDL-C levels). 60% patients had type-2 diabetes mellitus and 52% of patients had a history of smoking. Conclusion: 73% of ACS patients in this study were men. Most common age groups were 55-64 years old (46%), had hypertension by 51%, had dyslipidemia by 77% (40% hypercholesterolemia, 42% hypertriglyceridemia, 40% low HDL-C levels, 34% high LDL-C), had type-2 diabetes mellitus by 60%, and had a smoking history by 52%.
Faktor Risiko Pasien Acute Limb Ischemia Fhahira Rizkhika Admadiani; J Nugroho Ekoputranto; Heroe Soebroto; Agus Subagjo
Cerdika: Jurnal Ilmiah Indonesia Vol. 2 No. 4 (2022): Cerdika: Jurnal Ilmiah Indonesia
Publisher : Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (3930.874 KB) | DOI: 10.59141/cerdika.v2i4.376

Abstract

Acute Limb Ischemia (ALI) is a classification of peripheral arterial disease that causes decreased blood flow to the extremities, with onset within 2 weeks and characterized by 6 'P's, namely pallor, pain, perishing cold, pulseless, paralysis, and paresthesia. This can be identified through several risk factors, including: diabetes, smoking, gender, high blood pressure, age,hyperlipidemia, atrial fibrillation (AF) and diabetes. This study aims to identify risk factors in ALI patients. Hospital identification. Soetomo Surabaya Period January 2016 – March 2019. This study uses a total sampling technique. This study uses a descriptive cross sectional method with medical record instruments and direct interviews with patients. Twenty-five (25) patients were known to have ALI (14 males and 11 females), and the age of the patients ranged from 65 to 69 years (20%). The causes of risk included a history of smoking obtained from 10 subjects (40%), a history of hypertension in 7 subjects (28%), a history of stage 1 hypertension, a history of diabetes mellitus with the highest blood glucose test value > 126 mg/dl up to 10 people. . (62.5%), with a history of hyperlipidemia, with total cholesterol within normal limits of up to 4 (66.7%), LDL in the normal range of not more than 3 (60%), and HDL with 2 with low HDL values (40%). ), and the highest triglyceride levels were within the normal range. Electrocardiographic examination revealed 7 patients (28%) with atrial fibrillation. Most of the ALI patients in this study were aged between 65 and 69 years and were male. Most ALI patients in this study were 65-69 years old and males. The most common risk factors for ALI patients were hypertension, diabetes mellitus, and hypercholesterolemia.
Co-Authors Adityo Basworo Avidar, Yoppie Prim Fhahira Rizkhika Admadiani Heroe Soebroto I Ketut Sudiana Ikhsanuddin Qothi Maulia Prismadani Muhamad Robi’ul Fuadi Ogiska Chaherfa Nadasya Okky Wahyu Firmansyah Paulus Budiono Notopuro Putranto, J. Nugroho Eko Rama Azalix Rianda Semedi, Bambang Pujo Suryo Ardi Hutomo