EKLAMPSIA POSTPARTUM DENGAN VENTRICULAR BIGEMINI DAN VT RUN PASCA SEKSIO SESAREA : SEBUAH LAPORAN KASUS LANGKA
DOI:
https://doi.org/10.31004/prepotif.v10i1.55991Keywords:
aritmia ventrikel, eklampsia postpartum, hipertensi kehamilan, seksio sesarea, ventricular extrasystoleAbstract
Eklampsia postpartum merupakan komplikasi obstetri berat yang dapat menyebabkan keterlibatan multiorgan, termasuk sistem kardiovaskular. Laporan kasus ini menyajikan seorang perempuan P1A0 pasca seksio sesarea yang mengalami eklampsia postpartum disertai aritmia ventrikel berupa ventricular extrasystole (VES) dengan pola bigemini dan episode ventricular tachycardia non-sustained. Pasien datang dengan kejang yang didahului gejala neurologis prodromal, tanpa ditemukan kelainan struktural otak pada pemeriksaan pencitraan. Evaluasi elektrokardiografi serial menunjukkan adanya progresivitas iritabilitas miokard, yang kemudian membaik setelah pemberian amiodaron intravena. Pemeriksaan ekokardiografi mengungkapkan hipertrofi ventrikel kiri konsentrik dengan disfungsi diastolik, tanpa gangguan fungsi sistolik yang bermakna. Temuan ini menunjukkan adanya keterlibatan kardiovaskular yang signifikan pada kondisi eklampsia postpartum. Mekanisme terjadinya aritmia ventrikel pada kasus ini diduga bersifat multifaktorial, meliputi disfungsi endotel sistemik, perubahan hemodinamik yang abrupt pada periode postpartum, peningkatan aktivitas simpatis, serta gangguan elektrolit seperti hipokalemia dan hipokalsemia relatif. Kombinasi faktor-faktor tersebut menciptakan kondisi proaritmogenik yang meningkatkan risiko terjadinya aktivitas ektopik ventrikel dan takiaritmia. Kasus ini menekankan pentingnya pemantauan komprehensif, termasuk evaluasi kardiovaskular dan pemantauan irama jantung secara kontinu, pada pasien eklampsia postpartum. Deteksi dini dan penatalaksanaan yang tepat sangat krusial untuk mencegah komplikasi yang berpotensi mengancam nyawa.References
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