Page 124 - Abstract Book KONIKA 18

Cardiology

P-CAR-015
Clinically Outcome of Covid-19 in Children with Heart Disease

Ni Putu Veny Kartika Yantie, Sang Ayu Praba Amandari Sutyandi, Eka Gunawijaya
Department of Child Health, Faculty of Medicine Universitas Udayana/Sanglah Hospital, Denpasar, Bali, Indonesia
Abstract
Background Patients with heart disease are a potentially vulnerable patient cohort in case of Covid-19. Some
cardiac defects may be associated with a poor Covid-19 outcome. Objective To collect clinical outcome data
and to identify risk factors for a complicated course of Covid-19 in patients with heart disease. Methods
Patients with heart disease such as acyanotic and cyanotic congenital heart defect (CHD), acquired heart
disease diagnosed with Covid-19 presenting centres between March 2020 and August 2021 were included.
Demographic data, symptoms, type of CHD, and outcomes were analysed. A complicated disease course
was defined as hospitalisation for Covid-19 requiring non-invasive or invasive ventilation and/or inotropic
support, or a fatal outcome. Results There were 15 patients confirm with Covid-19. Range of age was 0-221
months old, most of the patients were female (10 from 15), 9 patients had hospitalization of whom 1 died.
The disease severity found were asymptomatic to mild in 8, moderate in 2, severe in 5. Fever, respiratory
distress, cough, and nausea were the most symptoms recorded. Complicated disease found in 5 patients.
Proportion of acyanotic and cyanotic heart defect were equal (each 7 patients) and acquired in 1 patients.
In descriptive analysis, age < 1 year old, type of CHD, and malnutrition were similar in complicated and
uncomplicated disease course. Conclusion We observed most were mild Covid-19 clinical course in our
cohort of CHD patients. General risk factors (age, malnutrition and type of CHD) of complicated Covid-19
course were similar. Although these results should be confirmed in larger cohorts.
Keywords: Covid-19; heart disease

P-CAR-016
Congenital Complete Heart Block in Infant with Patent Ductus Arteriosus
and Secundum Atrial Septal Defect

Audylia Hartono, Teddy Ontoseno, Mahrus A. Rachman, Alit Utamayasa, Taufiq Hidayat
Department of Child Health, Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Academic Hospital,
Surabaya, East Java, Indonesia
Abstract
Background Congenital heart block (CHB) is a rare disorder that affects one in every 15,000–20,000 live
births. Left untreated, congenital heart block is associated with a fetal and neonatal mortality ranging between
14-34%. Atropine and other pharmacotherapies are usually ineffective in newborns and children with CHB.
The most common treatment for CHB is the implantation of a pacemaker to prevent sudden cardiac death.
Objective To present a case of infant with congenital CHB. Case A four-month-old baby girl was referred to
emergency department Dr. Soetomo General Hospital with chief complaint of lethargy and a slow heartbeat.
The patient was frequently appeared breathless during the feeding. The physical examination revealed
that she was underweight and severely wasted, heart rate was 52 beats per minute. Continuous murmurs
were present on the left subclavian region. The electrocardiography revealed third degree heart block, with
regular R-R interval 53 beats/minute. The echocardiography revealed a moderate PDA left to right shunt, a
moderate Secundum ASD left to right shunt, and a mild tricuspid regurgitation. The patient was diagnosed
with congenital complete heart block + moderate PDA + moderate Secundum ASD + underweight + severely
wasted, and an urgent temporary pacemaker insertion was planned. The patient underwent a sternotomy
seven days after the temporary pacemaker implantation for PDA ligation and permanent pacemaker insertion.
Conclusion Early detection and more aggressive approach toward pacemaker are the most important
prognostic factor in infant with bradycardia.
Keywords: congenital heart block; bradycardia; temporary pacemaker; permanent pacemaker

76 KONIKA XVIII Abstract Book