Page 129 - Abstract Book KONIKA 18

Cardiology

P-CAR-025
Different Nutritional Status in Tet Spell Tetralogy of Fallot: Report of Two Cases

Metta Maulida Rizqia Haq, Zul Febrianti
Banten Province General Hospital, Serang, Banten, West Java, Indonesia
Abstract
Background Nutritional status of congenital heart disease (CHD) is mostly malnutrition due to chronic
hypoxia and metabolic stress, lead to low IGF-1 level which important for growth and development. Tetralogy
of Fallot (TOF) is the most common cyanotic CHD that also affects in growth impairment, while tet spell was
contributed by severity of right ventricle outflow obstruction. Objective To describe clinical presentation of
TOF with different nutritional status. Case Two 6-months-old patients, were managed in our PICU room for
their frequent spells which SpO levels were 30-70% and looked lethargy. The spell was worsening particularly
2
while crying followed by fast and deep breathing pattern. The first case was female, with good nutritional
status, -2 SD Z score WHO growth chart. Second case was male, with severely wasted nutritional status,
<-3 SD. They were diagnosed as TOF at 3 months of age. Both was born at full term with uncomplicated
pregnancy. There was no recall diet disorder. Physical examination recorded ejection systolic murmur IV/6
at 3 intercostal left upper sternal border. Chest X-Ray showed cardiomegaly, boot shape with oligemic
rd
lung. Echocardiography revealed TOF morphology with small and confluent pulmonary artery branches and
pulmonary valve annulus was 5.3 mm, and 5.6 mm, respectively. Blalock Tausig shunt were performed to
overcome their cyanotic spells. Conclusion Children with CHD are likely have a nutritional status disorder
due to chronic hypoxia and hypermetabolism which increased metabolic demands as result of cardiac defect.

Keywords: tetralogy of Fallot; malnutrition; chronic hypoxia; spell
P-CAR-026
Infective Endocarditis in Children with Cardiac Diseases
at Dr. Mohammad Hoesin Hospital Palembang

Esti Febriyanti Sihotang, Ria Nova, Deny Salverra Yosy
Department of Child Health, Faculty of Medicine Universitas Sriwijaya/Dr. Mohammad Hoesin General Hospital,
Palembang, South Sumatera, Indonesia

Abstract
Background Infective endocarditis (IE) is one of the complications in children with cardiac diseases. It is
associated with high mortality and morbidity. Early detection will improve the outcome. Objective To report
prevalence, clinical features and outcome of IE in children with cardiac diseases. Methods We reviewed
medical records of children with cardiac diseases who were admitted at hospital between May 2016 and June
2021. Data of age, gender, nutritional status, clinical signs and symptoms, blood culture results, and type of
cardiac diseases were collected. Results There were 1681 pediatric patients with cardiac diseases, 42 (2.50%)
patients fulfilled the diagnostic criteria for IE. Of patients with IE, 25 (59.5%) patients had congenital heart
diseases consist of 22 (52.4%) acyanotic, 3 (7.1%) cyanotic, and 17 (40.5%) had rheumatic heart disease.
Prolonged low-grade fever was found in 39(92.85%) patients, while no signs of vascular and immunologic
phenomena. Blood cultures were positive in 23(53.46%) patients. S. haemolyticus, S. hominis, and S. aureus
represented 5 (11.9%), 5 (11.9%), and 4 (9.5%), respectively. Echocardiography revealed vegetations in
all patients. The overall mortality was eight patients (19%). Conclusion In this study, the prevalence of IE
in children with cardiac diseases is low, and prolonged low-grade fever is found in almost all patients. The
most frequently isolated organisms were Staphylococcus spp. The mortality rate is relatively high. Clinicians
should have a high suspicion of IE in children with cardiac disease and prolonged low-grade fever.

Keywords: infective endocarditis; congenital heart disease; rheumatic heart disease; characteristic;
outcome

KONIKA XVIII Abstract Book 81