Page 122 - Abstract Book KONIKA 18

Cardiology

P-CAR-011
Sydenham Chorea as a Manifestation of Acute Rheumatic Fever: A Case Report

Sari Yunita Sukmawati, Teddy Ontoseno. Mahrus A. Rahman, Alit Utamayasa, Taufiq Hidayat
Department of Child Health, Faculty of Medicine Universitas Airlangga/Dr.Soetomo General Academic Hospital,
Surabaya, East Java, Indonesia
Abstract
Background Sydenham Chorea is the neurological manifestation of acute rheumatic fever, and the most
common acquired chorea of childhood. The incidence has been markedly decreased but in the last two decades,
this disease has reappeared and should be taken into account in the evaluation of children with movement
disorders. Early diagnosis and prompt treatment may lead to better prognosis. Objective To determine
early diagnosis for a patient with sydenham chorea. Case A 11-year-old girl was admitted to Dr. Soetomo
hospital due to intermittent involuntary movement in her extremities and face within a week and impaired
walking, speech and eating ability. Before admitted, she had fever and sore throat. Patient did not have any
history of allergies, drug intake and no family history of a similar disease. The results from laboratory the
antistreptolysin O (ASO) titer was 505,91 IU. Echocardiography showed severe mitral regurgitation. Brain
CT scan was normal. Patient are treated with penicillin propyhylaxis and haloperidol. Within 4 days, her
symptoms started to improve and after 1-month she had fully recovered. Conclusion Sydenham Chorea is
a clinical diagnosis made after a careful assessment. Therefore it is important to screen a patient for early
diagnosis, treatment to improve the quality of life.
Keywords: Sydenham chorea; acute rheumatic fever, child; movement disorder

P-CAR-012
Persistent Foramen Ovale as a Risk Factor of Embolic Ischaemic Stroke:
A Case Report

Suprohaita R. Talib, Winda Azwani, Syarif Rohimi
Department of Child Health, Cardiology Division, PKIAN RSAB Harapan Kita, Jakarta, Indonesia

Background Embolic ischaemic stroke occurred after the occlusion of the cerebral artery causes decreased
blood flow and ischaemic. Etiology of this stroke mostly atrial fibrillation in elder patient. Atrial septal defect
and persistent foramen ovale were reported as rare risk factor of stroke in younger patient. Objective To
demonstrate risk factor of persistent foramen ovale in younger patient with embolic ischaemic stroke. Case
A 13 yo male patient was referred to our hospital for evaluating structural heart defect after stroke. Patient
was hospitalized and managed well as acute stroke in primary hospital. We found normal electrocardiogram,
no dysrhythmia and ischemic event. Vegetation and thrombus were not found in echocardiography. Atrial
septal defect was not found obviously, but suspected persistent foramen ovale. Microbubble injection by using
contrast was performed to opacified right atrium. This procedure was guided by echocardiography. Findings
was large amount microbubble crossing from the right atrium into the left atrium. Patient discharged well
with oral anticoagulant and planned to observed for recurrent ischemic stroke and physiotherapy regularly.
Conclusion Persistent foramen ovale is a rare risk factor of embolic ischaemic stroke in younger patient. Early
detection of stroke symptoms and management of acute stroke play important role to improve post-stroke
outcome. Echocardiography was done for evaluating structural heart defect combined with microbubble
injection to prove persistent foramen ovale.

Keywords: persistent foramen ovale; risk factor; embolic ischaemic stroke

74 KONIKA XVIII Abstract Book