VISUAL HALLUCINATION POST CORONARY ARTERY BYPASS GRAFTING : A CASE REPORT

Authors

  • IGB Adi Dharmawan Anesthesiology and Intensive Care Department, Prof. Dr. dr. IGNG Ngoerah General Hospital, Denpasar, Bali, Indonesia
  • Pontisomaya Parami Anesthesiology and Intensive Care Department, Udayana University General Hospital, Denpasar, Bali, Indonesia
  • Cynthia Dewi Sinardja Anesthesiology and Intensive Care Department, Udayana University General Hospital, Denpasar, Bali, Indonesia

DOI:

https://doi.org/10.31004/prepotif.v9i2.45518

Keywords:

coronary artery bypass grafting, delirium, halusinasi visual

Abstract

Halusinasi visual merupakan komplikasi neuropsikiatri yang jarang namun penting setelah tindakan Coronary Artery Bypass Grafting (CABG). Halusinasi ini sering dikaitkan dengan delirium, namun beberapa pasien mengalaminya secara mandiri, sehingga menimbulkan tantangan dalam diagnosis dan penanganan. Kami melaporkan kasus seorang pria berusia 63 tahun dengan penyakit arteri koroner multipembuluh dan syok kardiogenik yang menjalani CABG mendesak tanpa penggunaan mesin jantung-paru (off-pump). Setelah operasi, dalam kondisi hemodinamik stabil dan tanpa gangguan metabolik, pasien mengalami halusinasi visual kompleks yang muncul hanya saat mata tertutup. Halusinasi yang dialaminya berupa bayangan seekor anjing, bayangan hitam besar, dan pemandangan kampung halaman yang familiar. Tidak ditemukan tanda-tanda delirium berdasarkan penilaian menggunakan Delirium Symptom Interview (DSI) dan Confusion Assessment Method (CAM). Penanganan suportif serta pemberian haloperidol dosis rendah berhasil meredakan gejala dalam waktu 24 jam tanpa kekambuhan. Kasus ini menyoroti bentuk halusinasi visual yang jarang, yakni halusinasi saat mata tertutup, setelah CABG off-pump, yang berbeda dari halusinasi dengan mata terbuka yang lebih umum dilaporkan. Tinjauan literatur menunjukkan bahwa insiden halusinasi visual pascaoperasi jantung berkisar antara 11% hingga 58%, dengan sirkulasi ekstrakorporeal (penggunaan mesin jantung-paru) diduga sebagai faktor risiko. Namun, kasus ini menantang anggapan tersebut. Fenomena ini memiliki kemiripan dengan Charles Bonnet Syndrome, yaitu kondisi di mana deprivasi visual memicu munculnya halusinasi spontan di korteks asosiasi visual. Halusinasi visual ternyata dapat terjadi bahkan pada pasien CABG off-pump tanpa delirium atau defisit neurologis. Mengenali fenomena ini sangat penting untuk mencegah misdiagnosis dan intervensi yang tidak perlu. Penelitian lebih lanjut diperlukan untuk memahami patofisiologi dan faktor risiko yang mendasarinya.

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Published

2025-06-17

How to Cite

Dharmawan, I. A., Parami, P., & Sinardja, C. D. (2025). VISUAL HALLUCINATION POST CORONARY ARTERY BYPASS GRAFTING : A CASE REPORT. PREPOTIF : JURNAL KESEHATAN MASYARAKAT, 9(2), 3280–3285. https://doi.org/10.31004/prepotif.v9i2.45518

Issue

Vol. 9 No. 2 (2025): AGUSTUS 2025

Section

Articles

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Copyright (c) 2025 IGB Adi Dharmawan, Pontisomaya Parami, Cynthia Dewi Sinardja

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