Background: Ventricular septal rupture (VSR) is a fatal mechanical complication following acute myocardial infarction (AMI). The definitive treatment remains surgical repair, however several aspects are still debatable, including the timing of surgery. Patient’s refusal of treatment and lack of medical facilities put other challenges in management of VSR. Case presentation: A-48-year-old male with a history of diabetes mellitus and hypertension came with a late-presentation anterior AMI, and refused the reperfusion therapy. By the third day, he developed VSR and cardiogenic shock. The patient was also against any referral plan for further therapy. Hemodynamic status was optimally controlled with vasopressor and inotropic agents. The patient was discharged with a grade II-III New York Heart Association (NYHA) on the tenth day. In follow up evaluation a week later, the patient presented limb swelling and functional NYHA class III-IV. The patient agreed to received percutaneous coronary intervention (PCI). Drug eluting stent (DES) in left anterior descending (LAD) coronary artery was implanted successfully without defect closure. Follow-up after 12-months revealed no signs or symptoms of decompensated heart failure.
Keywords: ventricular septal rupture; percutaneous coronary intervention; acute myocardial infarction
Pekerja pabrik tembakau dikelilingi oleh berbagai bahaya kesehatan kerja. Debu tembakau yang terhirup terus menerus menyebabkan akumulasi di saluran pernapasan yang menyebabkan peradangan dan menghasilkan jaringan fibrotik yang dapat mengurangi ekspansi paru-paru (restriction). Forced Vital Capacity (FVC) dalam hasil spirometri digunakan sebagai parameter untuk pola gangguan restriksi paru-paru. Penelitian ini bertujuan untuk mengetahui perbedaan FVC pada wanita menopause dan wanita pekerja pabrik tembakau usia subur. Jenis penelitian ini adalah observasional analitik dengan rancangan studi cross-sectional. Sampel penelitian ini adalah pekerja wanita menopause dan wanita usia subur yang bekerja di produksi pabrik tembakau. Pengumpulan data dilakukan wawancara dengan kuesioner, dan data FVC diperoleh dari hasil pemeriksaan spirometri. Penelitian ini menggunakan desain penelitian observasional analitik cross-sectional dan Unpaired T-test. Pengumpulan data tentang karakteristik individu dilakukan dengan kuesioner, sedangkan data FVC diperoleh dari spirometri. Hasil penelitian menunjukkan bahwa mayoritas pekerja pabrik tembakau perempuan mengalami penurunan nilai FVC dalam bentuk pembatasan paru-paru dan ada perbedaan nilai FVC yang signifikan antara wanita menopause dan wanita usia subur pada pekerja pabrik tembakau.
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