Medicine and Health Sciences Commons^™

Assessment And Intervention For Health Behavior Change In Primary Care Across The Lifespan: A Guide For Residents In Primary Care Specialties, Stacy A. Ogbeide, Alexis Ramos, Bridget Murphy, Angel Ogbeide

HCA Healthcare Journal of Medicine

More than 45% of Americans have at least 1 chronic disease, with chronic disease also being a leading cause of death in the United States. In primary care settings, about 75% of visits are for management of multiple chronic diseases. Due to the increasing medical complexity of patients who present to primary care, these numbers make it more challenging for Primary Care Clinicians (PCCs) to manage these conditions alone and point to the need for innovative solutions to chronic disease care. One evidence-based innovation is team-based care to improve the treatment of these conditions. Clinicians such as clinical pharmacists, registered …

Autoimmune Hemolytic Anemia Associated With Leptospirosis: A Rare Complication, Anum Waqar, Furqan Mazhar, Mahrukh Afzal, Sadia Razzaq, Sana Ijaz

HCA Healthcare Journal of Medicine

Introduction

Autoimmune hemolytic anemia (AIHA) is rare but potentially life-threatening complication of leptospirosis, a zoonotic infection caused by the Leptospira species. Autoimmune hemolytic anemia occurs when the immune system targets red blood cells, resulting in hemolysis and anemia. The relationship between leptospirosis and AIHA is uncommon and often under-recognized, which can delay diagnosis and management. This case highlights the importance of considering hematologic complications in leptospirosis.

Case Presentation

A 23-year-old male presented with low-grade fever, productive cough, shortness of breath, jaundice, and pallor for 15 days. On examination, he was pale and icteric with bilateral chest crepitations. Laboratory studies showed …

A Case Report Of Mesalazine-Induced Pulmonary Injury In A Patient With Ulcerative Colitis, Vasileios Paraschou, Vasileios Papavasileiou, Ilektra Voulgareli, Vasilios Tzilas

HCA Healthcare Journal of Medicine

Introduction

Mesalazine (5-aminosalicylic acid) is widely used as a first-line therapy for ulcerative colitis (UC) due to its efficacy and safety profile. Rarely, it can cause pulmonary toxicity with variable clinical and radiologic manifestations, making diagnosis challenging.

Case Presentation

We report the case of a 52-year-old woman with UC who developed persistent fever and progressive exertional dyspnea following escalation of mesalazine dosage. Imaging revealed diffuse bilateral ground-glass opacities, while infectious and UC-related pulmonary causes were excluded. Pulmonary function testing demonstrated restriction and markedly reduced diffusing capacity. Following mesalazine discontinuation and initiation of corticosteroid therapy, the patient experienced rapid symptomatic, functional, …

An Unusual Case Of Bilateral Upper And Lower Oral Cavity Cysts In A Newborn, Frances Rodriguez Lara, Jillian L. Chen, Jennifer N. Shehan, Jessica R. Levi

HCA Healthcare Journal of Medicine

Background

Oral mucosal lesions in newborns have a broad differential diagnosis, ranging from benign, transient conditions to potential early signs of systemic disease. Most of these lesions are resolved without intervention, but delayed recognition can lead to complications, such as airway obstruction. Early identification is crucial for appropriate management. This case report discusses an unusual presentation of multiple oral mucosal cysts in a newborn, emphasizing the challenges of diagnosis and management.

Case Presentation

A 1-day-old male was evaluated at Boston Medical Center for cystic oral lesions identified during newborn screening. The infant was born at 36 weeks and 2 days’ …

Navigating Complex Esophageal Perforations: A Case-Specific Approach To Successful Outcomes, Harsimran Kalsi, Anushree Rai, Kobina Essilfie-Quaye, Neeka Akhavan, Yaseen Perbtani, Tony S. Brar

HCA Healthcare Journal of Medicine

Esophageal perforation is a life-threatening condition requiring prompt diagnosis and effective management. While self-expanding metal stents (SEMS) are a first-line treatment, persistent leaks often necessitate adjunctive endoscopic interventions. A structured, multimodal approach is critical for optimizing outcomes and avoiding surgical intervention. A 44-year-old man developed an iatrogenic esophageal perforation following surgical leiomyoma enucleation. Initial treatment with overlapping fully covered self-expanding metal stents (FC-SEMS) failed to achieve closure, necessitating endoscopic suturing for defect reinforcement. Despite suturing, persistent leakage required placement of a larger-diameter FC-SEMS, secured with an endoscopic fixation system to prevent migration. Serial imaging confirmed successful defect closure, allowing the …

Using Mohs Micrographic Surgery To Treat A Large, Pedunculated Trichoblastoma On The Upper Cutaneous Lip, Richard G. Bindernagel Jr., Addie Walker, Richard Miller

HCA Healthcare Journal of Medicine

Trichoblastomas are uncommon adnexal tumors that usually occur on the face. We report a case of a 62-year-old White man with a large, asymptomatic, slow-growing lesion that had been on his right upper cutaneous lip for 15 years. A 2 cm pink, pedunculated nodule with telangiectasia was seen on examination. A shave biopsy was consistent with trichoblastoma: a circumscribed-appearing dermal tumor of basaloid cells arranged in cords and islands within a cellular stroma, focal epidermal connection, and papillary mesenchymal bodies. The patient elected for treatment with Mohs micrographic surgery (MMS) given the length of time that the tumor had been …

Impact Of Pre-Existing Psychiatric Conditions On Trauma Outcomes: A National Analysis, Kelly Mckenney, Marie Ugo, Sindhura Kompella, Clara Alvarez, Ilko Luque

HCA Healthcare Journal of Medicine

Background

Understanding the impact of psychiatric pre-existing conditions (PsyPECs) on trauma outcomes is crucial, as trauma is the leading cause of mortality for Americans aged 1-45. Although previous regional studies have shown higher mortality rates and longer hospital length of stay (H-LOS) for injured patients with PsyPECs, this has not been studied at the national level. The purpose of this study is to identify the PsyPECs associated with mechanism of injury and other outcomes in adult patients admitted for trauma in the United States’ trauma centers.

Methods

Data were extracted from the National Trauma Data Bank (NTDB). There were 5301 …

Time For A New Whole-Person Care Pathway For Chest Pain Admissions, Dana Kajan, Sabbir Mirza, Alexander M. Ruiz, Anthony Degennaro, Mohamad S. Saad

HCA Healthcare Journal of Medicine

Background

Emergency department (ED) visits for chest pain are common and costly, and ED workup often shows no clear cardiac etiology in low-risk patients. Emerging evidence suggests that social determinants of health (SDOH) such as loneliness, social isolation, and food insecurity contribute to cardiovascular outcomes and chest pain presentations.

Methods

We interviewed 114 patients (>18 years) presenting with chest pain and a thrombolysis in myocardial infarction (TIMI) score less than 4 at our community teaching hospital ED. Structured questionnaires assessed the SDOH triad of loneliness, social isolation, and food insecurity. Dependent variables included systolic blood pressure (SBP) at admission, …

Does Staff Education Increase Sequential Compression Device Utilization: A Retrospective Study, Devin Q. John, Vincent Lee, Akshay V. Daji, Hans Lapica, Connor Donley, Matthew J. Mccrosson, Nino Coutelle, Carlos Fernandez, Diego Lima

HCA Healthcare Journal of Medicine

Background

Venous thromboembolism (VTE) is a significant perioperative safety concern among orthopedic patients, with an incidence of 0.4%-1.0% and a substantial risk of chronic complications. Sequential compression devices (SCDs) are recommended for VTE prophylaxis, yet compliance remains suboptimal due to staff misconceptions. This study evaluates the impact of a resident-led educational intervention on SCD utilization among nursing staff in orthopedic postoperative care.

Methods

This retrospective study was conducted at 2 hospitals (HCA Florida JFK Hospital and HCA Florida Palms West Hospital). Nursing staff participated in a single educational session addressing SCD benefits, application techniques, and operational protocols. Data on SCD …

Trends In Emergency Department Utilization After Metabolic And Bariatric Surgery In The United States, Andrew Sanders, Isabella Moncada, Sabrina Avanzato, Michelle Fakler, Michael Dombek, R. Wesley Vosburg

HCA Healthcare Journal of Medicine

Background

In this article, we sought to understand the factors associated with emergency department (ED) utilization by patients after metabolic and bariatric surgery (MBS). The hopes were that modifiable risk factors could be identified to reduce ED visits after MBS.

Methods

We analyzed data from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database (MBSAQIP) which is comprised of data from all nationally accredited bariatric centers in the United States. For our study, we included a population of 681 743 patients having undergone the 2 most common MBS procedures: sleeve gastrectomy (SG) and gastric bypass (GBP). Using logistic …

Are Combat Athletes Different Sleepers? A Pittsburgh Sleep Quality Index-Based Comparative Survey Across Athletic Populations, Zofia Tkocz, Małgorzata Hołda Dr, Michał Spieszny, Adam Zając, Robert Trybulski, Aleksandra Filip-Stachnik

Baltic Journal of Health and Physical Activity

Background: Sleep plays an important role in athletic performance, recovery, and cognitive function. The aim of this study was to compare sleep quality and selected sleep-related  variables in combat sports athletes and athletes from other sport disciplines . Materials and Methods: Ninety-eight competitive athletes participated in the study, including 52 combat sports athletes and 46 athletes  representing other sport disciplines. Sleep quality was assessed using the modified Pittsburgh Sleep Quality Index (PSQI) with a weekly recall period, global PSQI score and additional  variables, such as sleep duration, sleep latency, and habitual sleep-wake times, were analyzed using general linear models adjusted …

Detection And Diagnostic Screening Of Breast Cancer: A Systematic Review And Future Frontiers, Lama Yassine, Amira J. Zaylaa

BAU Journal - Science and Technology

A comprehensive evaluation of current and novel diagnostic techniques is necessary since the diagnosis of breast cancer is essential for improving treatment efficacy and raising long-term survival. Evidence from conventional imaging methods including mammography, ultrasonography, and magnetic resonance imaging is combined in this systematic review with advancements in liquid biopsies and current AI-based diagnostic tools. Using specific keywords related to breast cancer, early detection, imaging, biomarkers, and artificial intelligence, a thorough search was conducted in PubMed, Scopus, Web of Science, and IEEE Xplore. Reviews, case reports, and studies unrelated to breast cancer were excluded; only clinical, experimental, and computational research …

Can Gingival Crevicular Fluid Help In Diagnosing Pulp Inflammation? A Systematic Review, Wael Kassamany, Roula Abiad

BAU Journal - Science and Technology

This review aims to find if there’s a positive correlation between biological markers detected in human gingival crevicular fluid and pulp inflammation.

An electronic search of three databases; PubMed, EBSCOhost and Google Scholar was conducted using the keywords “tooth or teeth or pulp” AND “gingival crevice fluid or gingival crevicular fluid” for English articles published between the year 1990 and 2026. Information regarding study design, patients age range and gender distribution, sampling method used, types of biomarkers studied, assay test used, and key findings of each article were extracted and analyzed.

Biomarkers studied were substance P “SP”, neurokinin A “NKA”, …

Gambaran Penyebab Klaim Bpjs Rawat Inap Berstatus Pending Di Rumah Sakit Ciremai Kota Cirebon Tahun 2025, Jazim Shebrina Kharisma Sendy, Lina Khasanah, Bambang Karmanto, Maula Ismail Mohammad

Jurnal Ekonomi Kesehatan Indonesia

Pending claims involving BPJS Kesehatan remain a challenge in the healthcare financing system in Indonesia. This condition hinders the receipt of JKN funds by healthcare facilities. In general, pending claims arise due to inconsistencies in files, disease and/or action codes, or the determination of medical measures. The same problem also occurred at Tk. III Hospital 03.06.01 Ciremai, Cirebon City, with the continued discovery of pending inpatient BPJS claims in 2025. Based on these conditions, this study aims to describe the causes of pending inpatient BPJS claims based on administrative, coding, and medical aspects. This study aims to describe the causes …

Pendekatan Time-Driven Activity-Based Costing Dan Theoretical Framework Of Acceptability Untuk Estimasi Anggaran Layanan Home-Based Palliative Care Di Yogyakarta, Tatik Hariyanti, Firdaus Hafidz, Arif Budiarto

Jurnal Ekonomi Kesehatan Indonesia

Palliative care services delivered through a home care scheme in Indonesia are not yet included in the National Health Insurance (JKN) benefit package. Through a bridging guarantee scheme, since 2020 the Regional Government of the Special Region of Yogyakarta (DIY) has provided this service to the local population in accordance with applicable regulations. Therefore, a basis for budget allocation that considers the regional conditions of DIY is required. This study employed a mixed-methods approach with an explanatory sequential design, beginning with a quantitative study to estimate the prevalence of the population requiring palliative care services as well as the unit …

Analisis Pengelolaan Persediaan Obat Menggunakan Integrasi Abc–Fsn Dan Economic Order Quantity (Eoq) Di Rsud Haji Provinsi Jawa Timur, Rina Kartika Sari, Irwan Syahrir, Musa Gufron

Jurnal Ekonomi Kesehatan Indonesia

This study aims to analyze the performance of pharmaceutical inventory at RSUD Haji, East Java Province using an integrated ABC–FSN and Economic Order Quantity (EOQ) approach. A quantitative descriptive method was employed using secondary data from 560 drug items during January–December 2025. ABC analysis was used to identify the concentration of investment value, while FSN analysis was applied to evaluate drug movement patterns. Furthermore, EOQ was utilized to determine the optimal order quantity to minimize total inventory costs. The results show that the majority of inventory value is concentrated in category A (70.08%) and is dominated by fast-moving items (89.15%). …

Analisis Implementasi Clinical Pathway Terhadap Length Of Stay (Los) Dan Biaya Perawatan Pasien Anak Dengan Demam Berdarah Dengue (Dbd) Di Rsi Nu Demak, Akhmad Safi’I, Muhammad Zulfikar Asumta, Abdul Aziz

Jurnal Ekonomi Kesehatan Indonesia

Clinical pathway (CP) is a quality and cost control instrument in hospitals designed to ensure service standardization, efficiency of Length of Stay (LOS), and control of healthcare costs. Dengue Haemorrhagic Fever (DHF) in children is an infectious disease that often requires hospitalization, with considerable variation in LOS and treatment costs. This study aimed to assess the effectiveness of CP implementation on LOS and cost of care among pediatric DHF patients at Rumah Sakit Islam Nahdlatul Ulama (RSI NU) Demak. This research applied a quantitative approach using a retrospective descriptive-analytic design. Data were obtained from medical records of 34 pediatric DHF …

Analisis Pending Claim Pasien Rawat Inap Di Rumah Sakit Dharma Kerti Tabanan, Gusti Ayu Putu Putri Maha Dewi, Made Karma Maha Wirajaya, Putu Ayu Laksmini, Putu Ika Farmani

Jurnal Ekonomi Kesehatan Indonesia

In the BPJS health claim submission process, not all documents submitted by the hospital can be accepted immediately. Claims are declared ineligible or pending if the submitted files are incomplete or do not meet BPJS Kesehatan requirements. At Dharma Kerti Hospital, Tabanan, from August to October 2024, 16.7% or 130 of 779 inpatient claim files were recorded as pending. This study aims to analyze the factors that influence pending claims for inpatients in the period November 2024 to January 2025 by reviewing coding, medical, and administrative aspects. The study used a mixed methods approach, namely quantitative analysis of the claim …

Determinan Kepuasan Peserta Jkn Terhadap Sistem Rujukan Berjenjang Di Provinsi Bali, Made Karma Maha Wirajaya, I Ketut Tunas, Putu Ika Farmani, Putu Ayu Laksmini

Jurnal Ekonomi Kesehatan Indonesia

The Indonesian government, through the National Health Insurance (JKN) Program, is committed to achieving Universal Health Coverage (UHC) by ensuring equitable, high-quality, and sustainable healthcare services. One key element in JKN implementation is a tiered referral system designed to improve the effectiveness and efficiency of healthcare services. However, in practice, the tiered referral system still faces various obstacles that may reduce the level of satisfaction of JKN participants with health services. This study aims to examine factors related to JKN participant satisfaction with the implementation of a tiered referral system in Bali Province. This study used an analytical cross-sectional design …

Analisis Biaya Perawatan Ulkus Diabetes Dan Implementasi Clinical Pathway Serta Cost Recovery Rate Di Rumah Sakit Xyz, Jawa Tengah, Nur Alaydrus, Chriswardani Suryawati, Puji Harto

Jurnal Ekonomi Kesehatan Indonesia

The INA-CBGs payment system in the National Health Insurance (JKN) program requires hospitals to improve cost efficiency through quality and cost containment. This study aims to analyze the implementation of the Clinical Pathway (CP) for diabetic ulcers, calculate the unit cost of care, and evaluate the Cost Recovery Rate (CRR) at XYZ Hospital, Central Java, using the Activity-Based Costing (ABC) method. A descriptive quantitative study with a cross-sectional design was conducted on all inpatients with a single diagnosis of diabetic ulcer without comorbidities from October to December 2024. Data were collected through activity-based CP observation, medical record review, and hospital …

Analisis Biaya Standar Pelayanan Minimal (Spm) Kesehatan Menggunakan Aplikasi Siscobikes Di Tingkat Kabupaten/Kota Di Indonesia, Purwa K. Sucahya, Resi Natalia Turnip, Lemi Kurniawan, Bondan Wicaksono Adhi, Iwan Supriyadi, Ni’Matun Nurlaela

Jurnal Ekonomi Kesehatan Indonesia

This research investigates the capacity of the Siscobikes (Health Costing System) application to forecast the financial requirements for the execution of Minimum Service Standards (SPM) within Indonesia’s health sector at the district and city levels.. The study utilized cross-sectional data from 166 districts/cities to ascertain the projected health financing requirements and juxtaposed these estimates with the actual budgetary allocations. The results show that each district/city requires approximately IDR 16 billion annually for SPM. Districts require around IDR 17 billion annually, while cities require approximately IDR 13 billion. Substantial regional disparities are observed: Eastern Indonesia has the highest per capita needs …

Hubungan Kadar Malondialdehida (Mda) Serum Dan Fraksi Ejeksi Ventrikel Kiri Pada Pasien Hemodialisis Reguler, Teguh Setiadi Amir, Taufik Indrajaya, Zulkhair Ali

Jurnal Penyakit Dalam Indonesia

Introduction. Malondialdehyde (MDA) is a marker of oxidative stress that is elevated in chronic kidney disease (CKD) patients undergoing regular hemodialysis. Oxidative stress can affect cardiac function especially left ventricular function. This study aimed to evaluate the relationship between serum MDA levels with left ventricular function in regular hemodialysis patients at Dr. Mohammad Hoesin Genaral Hospital, Palembang.

Methods. This study was an analytic observational study with a cross-sectional design conducted on regular hemodialysis patients in the Hemodialysis Installation of Dr. Mohammad Hoesin Genaral Hospital, Palembang. The MDA levels were examined from the serum of post-hemodialysis patients using ELISA …

Takikardia Ventrikel Berulang Pasca Coronary Artery Bypass Grafting (Cabg): Laporan Kasus Berbasis Bukti, Ika Prasetya Wijaya, Simon Salim, Audina Dhiya Nabila

Jurnal Penyakit Dalam Indonesia

Coronary artery bypass grafting (CABG) remains the treatment of choice for patients with complex multivessel coronary artery disease but carries a risk of serious perioperative complications, including ventricular arrhythmias such as ventricular tachycardia (VT). Although VT following CABG is rare, it is potentially life-threatening and often results from multiple interrelated factors. This report presents a case of recurrent ventricular tachycardia after CABG and to highlight the underlying mechanisms, risk factors, and evidence-based management strategies aimed at preventing adverse outcomes.We report a 54-year-old woman with diabetes, hypertension, prior myocardial infarction, and severe left ventricular dysfunction who underwent urgent CABG for three-vessel …

Variabel Dan Model Prediktor Perdarahan Varises Esofagus Berulang Pada Pasien Sirosis Hati Di Rsupn Dr. Cipto Mangunkusumo, Ifani Media Sari, Juferdy Kurniawan, Kemal Fariz Kalista, Aulia Rizka, Eka Ginanjar, Sally Aman Nasution, Leonard Nainggolan Md. Internal Medicine, Tropic-Infection Spesialist, Sukamto Koesnoe

Jurnal Penyakit Dalam Indonesia

Introduction. Liver cirrhosis is a chronic condition associated with severe complications, including esophageal variceal bleeding, which carries high morbidity and mortality rates. Approximately 60% of patients with cirrhosis experience recurrent bleeding within one year, with a mortality rate of 20–60% within six weeks after the initial bleeding episode. Therefore, identifying predictors of recurrent bleeding is essential for improving preventive strategies. This study aimed to identify predictors of recurrent esophageal variceal bleeding in patients with liver cirrhosis and to develop a predictive model.

Methods. This retrospective study included 220 patients with liver cirrhosis and a history of esophageal variceal …

Kontinuitas Terapi Lupus: Kesenjangan Antara Evidence-Based Medicine Dan Real-World Practice, Abirianty P. Araminta

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Hubungan Penggantian Imunosupresan Tidak Terencana Dengan Aktivitas Penyakit Lupus Eritematosus Sistemik: Studi Kohort Retrospektif Di Rsupn Dr. Cipto Mangunkusumo, Jakarta, Rosvitha Amanda, Sukamto Koesnoe, Alvina Widhani, Ikhwan Rinaldi, Adityo Susilo, Juferdy Kurniawan, Rudi Putranto, Birry Karim

Jurnal Penyakit Dalam Indonesia

Introduction. Systemic lupus erythematosus (SLE) is a complex chronic autoimmune disease with diverse clinical manifestations. Treatment stabilization is crucial for optimal disease control, but the consistency of immunosuppressive therapy may be affected by non-ideal conditions, including drug unavailability or adverse effects. This study aimed to assess the association between unplanned immunosuppressant switching and increased disease activity in SLE patients.

Methods. A retrospective cohort study of SLE patients meeting the inclusion criteria, whose disease activity was evaluated using the MEX-SLEDAI score during immunosuppressant substitution. Participants were grouped into an exposed group undergoing unplanned immunosuppressant switching due to drug unavailability …

Efektivitas Penambahan Suplementasi Vitamin C Terhadap Penurunan Malondialdehid Dan Perbaikan Derajat Aktivitas Penyakit Lupus Eritematosus Sistemik: Uji Klinis Acak Tersamar Ganda, Yuniza Yuniza, Nova Kurniati, Theodorus Theodorus, Eddy M. Salim, Kristian S. Hartanto

Jurnal Penyakit Dalam Indonesia

Introduction. Vitamin C is an antioxidant that exerts its effects at multiple cellular levels. However, evidence regarding its effects in systemic lupus erythematosus (SLE) remain inconclusive. This study aimed to evaluate the potential of vitamin as an adjunctive antioxidant therapy in patients with SLE by assessing its effects on serum malondialdehyde (MDA) levels and disease activity using the Mexical Systemic Lupus Erythematosus Disease Activity Index (MEX-SLEDAI) score.

Methods. This pilot double-blind, randomized controlled trial was conducted at Dr. Mohammad Hoesin General Hospital, Palembang. Participants were patients with mild-to-moderate SLE diagnosed according to the 2019 European Alliance of Association …

Profil Biomarker Apolipoprotein B Dan Lipid Terhadap Skor Syntax Pada Pasien Sindrom Koroner Kronik, Muhammad Novran Chalik, Erwin Sukandi, Taufik Indrajaya, Ferry Usnizar, Syamsu Indra, Imran Saleh, Rukiah Chodilawati, Irfannuddin Irfannuddin

Jurnal Penyakit Dalam Indonesia

Introduction. Apolipoproteins are structural components of plasma lipoproteins that are involved in lipoprotein metabolism and lipid transport, reflecting the number of circulating atherogenic particles. The degree of coronary artery stenosis can be assessed by calculating the Synergy between PCI with TAXUS/paclitaxel-eluting stent and Cardiac Surgery (SYNTAX) score, which is an angiographic scoring system used to evaluate the complexity of coronary artery lesions. This study aimed to investigate the profile of apolipoprotein B and lipids, as well as their correlation with the SYNTAX score in patients with chronic coronary syndrome.

Methods. An observational analytic study with a cross-sectional design …

Gagal Jantung Kanan Pada Hipertiroid Tidak Terkontrol: Laporan Kasus, Kevin Lazuardy, Leonard Nainggolan, Nadim Marchian Tedyanto

Jurnal Penyakit Dalam Indonesia

Right heart failure is a clinical syndrome that is influenced by various factors. The incidence of heart failure reaches 5/1,000 population, while the prevalence of heart failure reaches 1-2% of the adult population. Management of the main etiology of heart failure is the main therapy. In some cases, hyperthyroidism is an indirect cause of heart failure, especially in right heart failure. Hyperthyroidism can cause reversible pulmonary hypertension which causes right heart failure, although the underlying mechanism is uncertain at the moment. This study reports a 46-year-old woman who was diagnosed with right heart failure and also had hyperthyroidism. In this …

Miopati Atrium, Fibrilasi Atrium, Dan Stroke: Mengungkap Hubungan Tersembunyi, Muhammad Yamin, Mohamad Syahrir Azizi, Anneira Amanda Putri

Jurnal Penyakit Dalam Indonesia

Atrial fibrillation (AF) is the most common arrhythmia and has been long recognized as a cause for atrial thrombus formation leading to cardioembolic stroke. However, recent studies reveal that the relationship between atrial fibrillation and stroke is an association rather than a temporal relationship. Left atrial thrombus formation is associated with vascular risk factor, atrial remodeling, and thrombogenesis. Various atrial electrical and structural markers of atrial myopathy have been linked to ischaemic stroke, even in the absence of AF. In addition to the CHA2DS2-VASc score as a consideration for anticoagulant administration, accurate atrial myopathy markers are needed to allow early …