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All Journal Heart Science Journal Pediatric Sciences Journal Journal of Community Health and Preventive Medicine (JOCHAPM)
Heny Martini
Department Of Cardiology And Vascular Medicine
– Faculty Of Medicine, Universitas Brawijaya
Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Peripartum Cardiomyopathy (PPCM): How to Diagnose and Deal with? Monika Sitio; Cholid Tri Tjahjono; Heny Martini; Novi Kurnianingsih
Heart Science Journal Vol 2, No 1 (2021): How to Diagnose Heart Failure and Deal with The Treatment Complexity
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2021.002.01.08

Abstract

Peripartum cardiomyopathy (PPCM) is a diagnosis of exclusion, where patients present with heart failure (HF) secondary to left ventricular (LV) systolic dysfunction without any other cause of HF identified in the last month of pregnancy or within first five months after delivery, abortion, or miscarriage. PPCM is a life-threatening condition which frequently under diagnosed and inadequately treated, whereas the morbidity and mortality rate ranges between 7% and 50%. Early diagnosis is important to decrease morbidity and mortality. Therefore, it is necessary to report the case related to this condition.A 34-year-old woman was referred to RSSA with worsening shortness of breath (SOB). She has given birth about 2.5 months prior to admission. History taking and supporting findings form this case were supported to diagnosis of PPCM. She was treated with diuretic, aldosterone antagonist, ACE-I, beta blocker, anticoagulant, and bromocriptine. The symptoms were improved in the following days. She was discharged with better condition and educated to comply with medication.
The Nightmare in Defect Occlusion by Transcatheter: A Case Report Iskandar Iskandar; Seprian Widasmara; Ratna Pancasari; Heny Martini
Heart Science Journal Vol 3, No 3 (2022): Cardiovascular Disease in Young Adulthood: Who, When, and How to Screen?
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2022.003.03.7

Abstract

Background : ASD closure ASD closure with a transcatheter is the first choice in patients who meet the criteria for insertion. Closure using this method is relatively safe, and has low complications. Several factors must be considered so that this closure action can be optimal. Case illustrations:A 24-year-old woman with complaints of shortness of breath during strenuous activities since 3 years ago. Transthroracal echocardiography showed a gap in the IAS of 1.7-1.9 cm. The patient then underwent TEE and DXRL. The patient was planned for percutaneous ASD closure with zero fluoroscopy. The patient was punctured on the right femoral, and entered into the occluder memopart no 24 mm. Do a wriggle test, the occlude tool is installed properly. When the device was pulled out, the patient's blood pressure dropped to 75/52. On TEE examination, pericardial effusion was found and pericardiocentesis was performed, obtained 600 cc of fluid. The patient was then observed in the ICVCU, and there was no additional free fluid in the pericardial cavity. Discussions:ASD closure can be done through percutaneous and surgery. Closure via percutaneous is the main option. Complications and treatment period is shorter than surgery. Preparation and timing of appropriate action is closely related to clinical outcomes. Observation and knowledge of the risks of the procedure are very important to be able to detect complications and optimize clinical outcomes.  
The importance of correct management in a 15-year-old boy with severe pulmonary arterial hypertension associated with patent ductus arteriosus Dyahris Koentartiwi; Devi Albaiti Jannati; Ardhanis Ramadhanti; Heny Martini
Pediatric Sciences Journal Vol. 3 No. 2 (2022): Available online : 1 December 2022
Publisher : Medical Faculty of Brawijaya University, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/pedscij.v3i2.44

Abstract

Background: Pulmonary arterial hypertension (PAH) is a condition in which pulmonary vascular pressure increases and is associated with diverse diseases or aetiologies. In children, 50% of PAH cases are caused by congenital heart disease (CHD), especially due to large left-to-right shunts. Large systemic to pulmonary shunts may develop in PAH if left untreated or repaired late. PAH, when present, markedly increases morbidity and mortality in patients with CHD. Case presentation: We present a 15-year-old boy with a large patent ductus arteriosus (PDA) and severe pulmonary arterial hypertension. Catheterization under general anaesthesia was performed at the age of 16 years. We performed an acute vasoreactivity test (AVT), with the AVT result showing pulmonary arterial hypertension with high flow and low resistance. Transcatheter closure (TCC) of PDA was performed, resulting in no residual PDA. Meanwhile, the echocardiographic finding showed that there was still class II pulmonary arterial hypertension. We then gave heart failure medication and selective pulmonary vasodilator for 6 months. Post-treatment, pulmonary artery systolic pressure was significantly lower (TR Vmax 2.31 m/s, TR Max PG 21 mmHg, estimated PAP 24 mmHg). In this case, clinical evaluation, CXR, ECG, echocardiography, and cardiac catheterization data were presented with a review of the current guidelines regarding the management of paediatric patients with PAH associated with PDA. Summary: TCC of PDA is an option to treat pulmonary hypertension in PDA patients. Combined use of drugs and TCC PDA proves beneficially synergistic effect with better outcomes and may reduce mortality.
CARDIOVASCULAR DISEASE AMONG ADOLESCENCE IN SMPN 5 MALANG: A CROSS-SECTIONAL SURVEY STUDY Cholid Tri Tjahjono; Fandy Hazzi Alfata; Heny Martini; Indra Prasetya; sawitri satwikajati
Journal of Community Health and Preventive Medicine Vol. 1 No. 1 (2021): JOCHAPM Vol. 1 No. 1 2021
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (243.636 KB) | DOI: 10.21776/ub.jochapm.2021.001.01.5

Abstract

Cardiovascular disease (CVD) is the leading cause of death in Asia-Pacific, although highly preventable, CVD was the cause of an estimated 9.4 million deaths. It accounted for one-third of all deaths in 2016. Hypertension is one of cardiovascular disease risk factors. Early detection of cardiovascular disease is the main issues to reduce the prevalence of the cardiovascular disease. Adolescence was the population in which the modifiable cardiovascular risk factor firstly developed. In the year 2018, Indonesian Health Ministry discovered that the prevalence of the cardiovascular disease in East Java was 0.2 % higher than national prevalence and Malang as one of the biggest cities in East Java with high population growth, hence early detection of cardiovascular disease become highlight issue. This cross-sectional survey was held in September 2019 at SMPN 5 Malang, which participated by 123 students (75 females and 48 males). Bivariate analysis was done to examine the correlation between each variable, and logistic regression was done to the most influential variable. Seventy-eight per cent of students were sedentary lifestyle with physical activities < 300 minutes/week, 16.2 % of students were an active smoker, and all were male. Among 123 students, 0.8 % with no cardiovascular risk factor, 29.2 % had 1 risk factor, 30.8 % had 2 risk factors, 27.6 % had 3 risk factors, and 11.3 % had 4 risk factors. The most prevalent risk factors were sedentary life (80 %), increase waist circumference (50 %), passive smoker  (48.5 %), overweight & obesity (15 %), and active smoker (14,6 %). Waist circumference above normal was more prevalent in female (65 %) than male (31%). Hypertension had been found in 14.6 % of students and had a significant correlation with heart rate (p 0.011)
Aortic Intramural Hematoma Mimicking Acute Coronary Syndrome Zainal Fathurohim; Novi Kurnianingsih; Djanggan Sargowo; Heny Martini
Heart Science Journal Vol 4, No 2 (2023): Dealing with the Complexity of the Wide Spectrum of Cardiovascular Disease
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.02.5

Abstract

Abstract :Type A Aortic intramural haematoma (IMH), a variant form of classic aortic dissection, has been accepted as an increasingly recognised and potentially fatal entity of acute aortic syndrome.It is a very dangerous, fatal, and emergency condition. It is very important to recognize the symptoms of acute aortic syndrome related to appropriate management Case IllustrationA 52 year old man patient  suffered from chest pain with moderate intensity while he was working at home. It was sharp , tear-like sensation, in the middle of the chest radiated to the back, accompanied with cold sweating, and did not relieve by rest. Because of this condition he brought to hospital. From examination at Emergency room, he had cardiomegaly, aortic dilatation. From the Electrocardiography an st elevation at V1-V2 and T inverted V4-V6 precordial lead,I aVL extremities lead  and slightly elevated cardiac enzymes with risk factors for active smoking and uncontrolled hypertension. Initially he was suspected of having acute coronary syndrome with differential diagnose acute aortic syndrome. To exclude the diagnose he had underwent cardiac catheterization, the cardiologist in charge suspicious this patient with aortic dissection because of trapping contrast durante procedure and coronary minor disease. For a better diagnosis, transtransthoracic echocardiography and Aortic Computed Tomography angiography was performed on the patient which confirmed the evidence of dissection. After being diagnosed, we treat the patient as an acute aortic syndrome and we stabilize the patient's condition. The patient was planned for cardiac surgery DiscussionAcute aortic syndrome, which includes Acute Aortic Dissection, Intramural Hematoma and penetrating aortic ulcer, is difficult to diagnosed. Aortic intramural hematoma, which is one of the acute aortic syndromes, is characterized by the presence of a hematoma in the medial layer of the aortic wall without the appearance of an intimal tear. The incidence of intramural hematoma differs slightly from that of aortic dissection syndrome. Patients with intramural hematomas often occur in older patients, more often with aortic aneurysmsThe patient  receive treatment aggressively to control blood pressure by administering a non-dihydropyridine calcium channel blocker intravenously and then beta blocker, angiotensin II receptor blockers, was also needed. Acute aortic syndrome, where an intramural aortic hematoma can present with varying symptoms of varying severity, which can lead to misdiagnosis and delay in cases of life-threatening disease. In the case of our patient, who had strong cardiac risk factors, His initial presentation described an acute myocardial infarction; the diagnosis was made after CT scan was performed and the patient remained stable  ConclussionComplaints of chest pain due to symptoms of acute aortic syndrome are very important to be recognized immediately because they need proper management. Complaints in this syndrome have similarities with complaints in acute coronary syndrome, pulmonary embolism and others. Patients with aortic intramural hematoma are at high risk for developing periaortic hematoma and hemorrhagic pericardial effusion. In patients with an intramural aortic hematoma, Stanford A, the most appropriate management is surgical technique. Initial management of blood pressure control, heart rate and anti-pain can be given. In this case, the choice of a combination of surgery with endovascular may be a logical choice of therapyKeywordAortic Intramural Hematoma, Acute aortic syndrome
Effect Of Combination Decafeinated Green Tea and Green Coffee In Reducing Cholesterol Levels In Patients With Metabolic Syndrome Fandy Hazzy Alfata; Mohammad Saifur Rohman; Tri Astiawati; Cholid Tri Tjahjono; Heny Martini
Heart Science Journal Vol 4, No 3 (2023): The Essensial Role of the Metabolic Syndrome in the Development of Cardiovascula
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2023.004.03.4

Abstract

Background: Green tea and green coffee are natural ingredients that improve cholesterol levels. Combining the two in experimental animal studies provides more significant benefits when compared to single administration in reducing cholesterol levels.Objective: This study aimed to determine the effect of decaffeinated green tea and green coffee as adjuvant treatments in reducing blood cholesterol levels.Methods: This randomized controlled trial included 90 metabolic syndrome patients determined according to the IDF criteria for Asian people aged 50–70. All subjects received atorvastatin 20 mg and were divided into three groups. Participants in Group 1 received decaffeinated green tea and green coffee 2.5 grams twice daily, Group 2 received 5 grams daily, and Group 3 received a placebo. The total cholesterol, low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), and triglyceride levels were measured at the beginning and the end of the study.Results: At 90 days, after administration of the extract of decaffeinated green tea and green coffee, we found that the concentration of total cholesterol in Group 1 and Group 2 was significantly reduced compared to the placebo (-50 ± 6.1 vs. -62.8 ± 5.9 vs. -22.5 ± 5.8 mg/dL; p= <0.05). But there was no significant difference in reduction of total cholesterol levels between the first and second groups. The other parameters also decreased, but not significantly compared to the placebo group.Conclusion: Administration of a combination of decaffeinated green tea extract and green coffee as an adjunctive therapy can reduce the average total  cholesterol, LDL, HDL, and triglyceride levels more than placebo, but only total cholesterol has a significant difference compared to other cholesterol  components.
Co-Authors Ardhanis Ramadhanti Cholid Tri Tjahjono Devi Albaiti Jannati Djanggan Sargowo Dyahris Koentartiwi Fandy Hazzi Alfata Fandy Hazzy Alfata Indra Prasetya Iskandar Iskandar Mohammad Saifur Rohman Monika Sitio Novi Kurnianingsih Ratna Pancasari sawitri satwikajati Seprian Widasmara Tri Astiawati Zainal Fathurohim