ACUTE DECOMPENSATED HEART FAILURE PADA RHEUMATIC HEART DISEASE ANAK
DOI:
https://doi.org/10.31004/prepotif.v9i1.43134Keywords:
Penyakit Jantung Rematik, Gagal Jantung Akut, Demam Rematik Akut, AnakAbstract
Gagal jantung akut dekompensata adalah komplikasi umum dari Rheumatic Heart Disease (RHD) pada anak-anak, terutama pada negara dengan penghasilan rendah-menengah. RHD adalah kondisi kronis akibat acute rheumatic fever (ARF) suatu respons autoimun terhadap infeksi Streptococcus Grup A (GAS) yang tidak diobati. Secara global, prevalensi RHD diperkirakan mempengaruhi > 40 juta orang, dengan sekitar 300 ribu kematian tiap tahunnya, utamanya pada anak. Beberapa faktor berkontribusi terhadap perkembangan gagal jantung pada RHD anak, termasuk keterlambatan diagnosis, profilaksis sekunder yang tidak memadai, episode ARF yang berulang, dan faktor sosial ekonomi. Pentingnya pencegahan dan penanganan sedini mungkin pada ARF dan RHD untuk mencegah terjadinya gagal jantung. Dilaporkan anak laki-laki usia 11 tahun mengeluhkan sesak napas disertai batuk berdahak warna putih dan nyeri tenggorokan sejak 1 bulan terakhir memberat 1 jam terakhir. Riwayat pingsan, sering mudah lelah dan sesak napas terutama ketika beraktivitas (seperti berolahraga) ataupun saat berbaring. Tanda vital didapatkan takikardi. Pada auskultasi paru didapatkan ronki dikedua lapang paru. Pada pemeriksaan jantung kesan terdapat pembesaran jantung, murmur (+). Hasil laboratorium dilaporkan ASTO negatif. EKG disimpulkan sinus takikardia disertai dengan LAD. Hasil rontgen thorax didapatkan kardiomegali disertai corakan bronkovaskular kasar. Ekokardiografi memberikan kesan EF 61%, terdapat regurgitasi mitral berat, stenosis mitral berat, regurgitasi trikuspid berat dan regurgitasi aorta ringan-sedang.References
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