Page 117 - Abstract Book KONIKA 18

Cardiology

P-CAR-001
The Treatment Challenge of Covid-19 in Teenage Patient with Rheumatic Heart
Disease in Limited Resource: A Rare Case Report

Phebe Anggita Gultom, Lianda Tamara
Rumah Sakit Umum Bethesda Serukam, West Borneo, Indonesia

Abstract
Background We describe a case of Rheumatic Heart Disease (RHD) with concurrent Covid-19, presents as
one of the cardiovascular comorbidities in Covid-19. Objective To show treatment challenges in a Covid-19
patient with RHD in a limited healthcare facility. Case A 17-year-old girl came into the ER with sudden left-
sided hemiparesis with onset 22 hours before admission. The patient also had a fever, headache, difficulty
speaking, and shortness of breath since the night before. There was no history of cough, loss of consciousness,
and seizure. She was beforehand diagnosed with RHD and routinely controlled. Physical examination
showed increased jugular venous pressure, apical holosystolic murmur, gallop on cardiac auscultation, no
rales, crackles, or wheezing. Neurological examination showed one-sided hemiparesis with motoric strength
+1 on the left side and +5 on the right side. Laboratory results showed slight anemia, leukocytosis, severe
thrombocytopenia, elevated ESR, positive for rapid test SARS Cov-2 Antigen. Electrolyte and blood sugar
within the normal level. Chest x-ray showed pneumonia. In this case, the administration of anticoagulant
drugs becomes a dilemma due to severe thrombocytopenia, and no hemostasis parameters were available.
Head CT examination was delayed because of the lack of facility, so the patient must be referred to another
city. The CT examination showed ischemic lesions due to vasculitis in the right temporoparietal. Finally,
the patient got appropriate treatments but still has hemiparesis. Conclusion Treatment of Covid-19 patients
with RHD in limited health facilities requires careful clinical assessment, which can affect the prognosis.
Keywords: Covid-19; cerebral infarction; rheumatic heart disease

P-CAR-002
Risk Factors of Congenital Heart Disease which Diagnosed in Prenatal Period in
a Tertiary Hospital in Indonesia: A Seven Years Observational Study

Syarif Rohimi, Setya Dewi Lucyati, Winda Azwani, Suprohaita R. Thalib
Women and Children Harapan Kita Hospital, Jakarta, Indonesia

Abstract
Background Finding causative non hereditary factors will enable to plan intervention strategies and mitigate
consequences associated with CHDs. Objective To evaluate mothers, fetal characteristic, newborns outcome
and hereditary factors. Methods This observational study done from 2013 to 2020 to pregnant mothers
and foetals who consulted to pediatric cardiology clinic. All foetals were delivered in Women and Children
Harapan Kita and followed to 7 days of age. We evaluated mother’s age, pregnancy status and newborn
characteristic (birth weight, apgar score, CHD type, heart rhythm and mortality). Results There were 218
mothers consist of 214 single gestation, 3 duplet gestations and 221 foetals. Mother’s age 29 (20-45) years,
7 (3,5%) were grand multipara. We found no history of smoking, drinking wine in pregnancy period, 32
(15%) mother showed non hereditary risk factors. We examined 221 foetals: gestation age 34 (20-40) weeks,
birth weight 2854.05±478.88 g, 23 (11.5%) born with severe asphyxia. The diagnosis of CHD was confirm
with trans thoracal echocardiography and revealed 121 (57.9%) CHD: 73 (34.92%) non cyanotic, 48 (23%)
cyanotic, 17 (14%%) CCHD and 5 (2%) CAVB. Extracardiac anomalies found in 22 (18%). There were
significant correlation between non hereditary risk factors, grand multipara, IUGR and CHD. Conclusion
The correlation between non hereditary risk factors, grand multipara, IUGR and CHD can be applied to
identify perinatal CHD on health services to increase management in perinatal period.
Keywords: non hereditary factors; CHD; perinatal outcome

KONIKA XVIII Abstract Book 69