Case Parade

Pembimbing dr. Valerinna Yogibuana, Sp. JP(K)

No Date Patient Identity Diagnose Management Problem
Admission
1 15/10/2023 – Ny. Sumarmi/77 TAVB pro PPM Post Post PPM
18/10/2023 th/11279553 HF St. C FC. III IVFD NaCL 0.9% 0.7cc/kgbb/jam
DM type 2 on OAD Oral intake 800cc/24jam
Menopause BC seimbang
DJ IV 1500kkal/hari

PO:
candesartan 0-0-16 mg
spironolactone 0-25 mg-0
Furosemide 40 mg-0-0
Glimepirid 2 mg 1-0-0
metformin 2x500 mg
No Date Patient Identity Diagnose Management Problem
Admission
3 17/10/2023 – Ny, Sutati / 35 th / 1. HF FC C St III Susp dt PPCM PTx Follow up Hasil Echo
Hari ini 11593576 O2 NC 2lpm
IVFD NaCl 0.9% 1000cc/24jam
Oral intake 800cc/24jam
BC -500 s/d seimbang
DJ III 1800kkal/hari
Inj. Furosemide 1 amp iv k/p

PO:
Captopril 3x25mg
Bisoprolol inisiasi 1.25mg-0-0
Atorvastatin 0-0-20mg
Diazepam 0-0-2mg
Laxadyn 0-0-CI
No Date Patient Identity Diagnose Management Problem
Admission
4 16/10/2023 Nn. SINDU 1. VSD subaortic besar L to R shunt PDx: Post RHC
– PRAMESTI/18 pro RHC EKG serial
18/10/2023 th/11593077 2. Double Chamber RV
3. PS valvar-subvalvar PTx:
IVFD NaCl 0.9% 1 cc/kg/jam
Oral intake 600 cc/24jam
Target BC seimbang
DJ IV 1500 kcal/hari
No Date Patient Identity Diagnose Management Problem
Admission
5 16/10/2023 – Tn. NURHIDAJAT/65 1. APS CCS III Post Staging PCI PDx:
18/10/2023 th/11320392 Implantasi 1 DES di RCA pada CAD3VD EKG/24 jam
2. HFpEF stage C FC II dt. CAD (EF 62%) Ur/Cr pre dan post tindakan
3. DM type II on OAD
4. Family history of PCAD PTx:
IVFD NaCl 0.9% 1.0 cc/kgBB/jam ~ 72
cc/jam
Oral intake 1000 cc/24jam
BC seimbang
DJ IV 1800 kkal/hari

PO
ASA loading 320 mg -> 0-0-80 mg
Clopidogrel 300 mg -> 75 mg-0-0mg
Atorvastatin 0-0-40 mg
Bisoprolol 5mg-0-0
Lisinopril 0-0-2.5 mg
ISDN 5 tab prn
Glimepirid 2 mg-0-0
Metformin 3x500 mg (tunda)
Acarbose 3x100 mg
Allopurinol 100mg-0-0
No Date Patient Identity Diagnose Management Problem
Admission
6 15/10/2023 – Ny. Teni Trisyani/ 59 1. HF st C Fc III dt HHD PTx: Hyperglycemia
Sekarang th/ 10647683 2. Shock Condition dt Septic dd Total Cairan 2000cc/24 jam Pneumonia
Hipovolemic (resolved) IVFD NS 1000cc/24 jam
3. Hyperglicemia in criticilly ill dt DM Oral Intake 1000cc/24 jam
type II (perbaikan) Inj. Moxifloxacin 1x400 mg (H3)
4. Pneumonia CAP INJ. Lantus 0-0-10 iu
5. UTI Nebu Combivent Pulmicort/12 jam
6. AKI st II
7. GEA (resolved) PO:
Candesartan 0-0-16 mg
Bisoprolol 1.25mg-0-0
Adalat Oros (TUNDA)
Sucralfat 3xCI
Attapulgite 2tab/diare
Gabapentin 1x300mg
Nabic 1x1
Lansoprazole 1x30 mg
No Date Patient Identity Diagnose Management Problem
Admission
7 15/10/2023 – Tn. Andhik Anto/ 44 1. APS CCS III pro DCA Adhoc ECG/24jam Pro DCA Ad hoc
17/10/23 tahun/ 11333733 2. HFrEF st C fc II dt CAD (EF 30%) Lab HbA1c, GD1,GD2, Profile lipid, As Urat
3. LV Thrombus Evaluasi SE
4. Mild Hiperkalemia (K 5,42) Ur/Cr post tindakan
5. Bilateral Pyelum Stone
PTx
IVFD NaCl 0.9% 1 cc/kgbb/jam ~ 58 cc/jam
Oral intake 1000 cc/24jam
BC seimbang
DJ IV 1800 kkal/hari
P.O.:
Aspirin 0-0-80mg
Clopidogrel 75mg-0-0
Atorvastatin 0-0-40mg
Bisoprolol 2,5mg-0-0
Ramipril 0-0-5mg
Spironolacton 0-25mg-0
Warfarin 0-0-2mg
Kalitake 3x1
No Date Patient Identity Diagnose Management Problem
Admission
8 15/10/2023 – Tn. Alexander 1. APS CCS III pro Staging PCI PDx: Pro Staging PCI
17/10/23 Nanlohy/ 65tahun/ 2. HFrEF St. C Fc II dt CAD (EF 16%) EKG/24jam
11588099 3. Azotemia Pre renal dd renal Echocardiography
4. History of smoker Ur/Cr pre (evaluasi post hidrasi) dan
post tindakan

PTx:
IVFD NaCl 0.9% 1.5 cc/kgbb/jam ~
110 cc/jam
Oral intake 1000 cc/24jam
BC seimbang
DJ IV 1800 kkal/hari

P.O.:
Aspilet 0-0-80mg
Ticagrelor 2 x90mg
Atorvastatin 0-0-40mg
Ramipril 0-0-10mg
Bisoprolol 2.5mg-0-0
Spironolactone 0-25mg-0
Amlodipin 10mg-0-0
ISDN 3x5mg
No Date Patient Identity Diagnose Management Problem
Admission
9 16/10/2023 Tn.Tursimin/52/ 1. APS CCS III Pro Staging PCI Total cairan 2250 cc/24jam Pro Staging PCI
–18/10/23 111578825 2. HF Stage C FC II dt CAD IVFD NS 0,9% 1 cc/kg/jam ~ 75 cc/jam
3.DM type II on Insulin Oral Intake 500 cc/24jam
4.History of Smoker DJ II 2000 kkal/24 jam
Lantus 0-0-16 iu sc
Novorapid 3x4 iu sc 15`ac

PO :
Aspilet 0-0-80mg
Ticagrelor 2x90 mg
Atorvastatin 0-0-40mg
Ramipril 0-0-10mg
Bisoprolol 2.5 mg-0-0
No Date Patient Identity Diagnose Management Problem
Admission
10 16/10/2023 Nn. PUTRI AMALIA 1. PDA type A kecil L to R shunt post PDx: Post closure by device
– sekarang KARTIKA/18 closure by device ECG/24 jam
th/11438343 2. VSD Perimembran besar L to R shunt PTx:
3. Pulmonary hypertension PDA closure by device
IVFD NS 1 cc/kgbb/jam
Target BC seimbang
PO:
Revatio 3x20mg
Bisoprolol 2,5mg-0-0
Ramipril 0-0-2,5mg
No Date Patient Identity Diagnose Management Problem
Admission
11 18/10/2023 Ny. Sri Wilujeng / 62 1. UAP Kilip I GRACE 88 CRUSADE 29 Planning Evaluasi symptoms dan
– sekarang th / 11591278 2. CAD three vessel disease post PDx/ cardiac enzyme
implantasi 1 DES di proksimal-mid EKG/24 jam
LAD Serial cardiac enzyme
3. HFpEF stage C FC II dt CAD
4. Menopause PTx:
IVFD NaCl 0.9% 1000cc/24 jam
Oral intake 800cc/24 jam
Target BC seimbang
DJ III 1800 kcal/24 jam

PO:
ASA 0-0-80mg
Clopidogrel 75mg-0-0
Atorvastatin 0-0-40mg
Ramipril 0-0-5mg
Bisoprolol 1.25mg-0-0
Nitrocaf retard 2x2.5mg
ISDN 3x5mg k/p
Laxadine syr 0-0-C1
Diazepam 0-0-2mg
No Date Patient Identity Diagnose Management Problem
Admission
12 15/10/2023 – Ny. Haniah/ 60 1. APS CCS III pro staging PCI PDx: Pro Staging PCI
17/10/2023 thn/11083456 2. HFpEF stage C FC II dt CAD (EF 55%) EKG/24jam
3. DM type II on OAD Ur/Cr pre, post tindakan, post Hidrasi,
4. AKI DD ACKD HbA1C, Profil lipid, As. Urat, GDS,
5. Anemia Normokromik-normositik dt GD2PP, SE Post Koreksi.
renal dd Chronic disease (Hb 9.5)
6. Mild Hyperkalemia (K: 5.71) PTx:
7. Menopause IVFD NaCl 0.9% 1,5 cc/kgbb/jam ~ 130
cc/jam
Oral intake 1000cc/24jam
BC seimbang
DJ IV 1800kkal/hari
Usul Koreksi Hiperkalemia dengan IV
Insulin 10 IU D40% 2 fl, IV Ca Gluconas 1
gr, Furosemide 20mg IV (2 siklus).

PO
Miniaspi 0-0-80mg
Brilinta 2 x 90
Atorvastatin 0-0-40mg
Valsartan 0-0-80mg
Bisoprolol 2,5mg-0-0
Adalat Oros 1x30mg
Nitrokaf 2x2.5mg
Lansoprazole 1x30mg
Metformin 3x500mg (Tunda)
No Date Patient Identity Diagnose Management Problem
Admission
13 15/10/2023 – Tn. Pudjianto/ 68 th/ 1. APS CCS III pro staging PCI PDx: Pro Staging PCI
17/10/2023 11580629 2. HF St. C Fc. II dt CAD EKG/24jam
3. BPH Ur/Cr post tindakan, Lipid profil, HbA1c,
4. History of smoker GD I/II, AU

PTx:
IVFD NS 0,9% 1 cc/kgbb/jam ~ 58 cc/jam
Oral intake 1000cc/24jam
Balance cairan seimbang
DJ IV 1800kkal/24 jam

PO:
Miniaspi 0-0-80mg
Clopidogrel 75mg-0-0
Atorvastatin 0-0-40mg
Bisoprolol 2,5mg-0-0
Valsartan 0-0-160mg
Adalat OROS 30mg-0-0
Tamsulosin 0.4 mg 1x1 tab
1 Date Patient Identity Diagnose Management Problem
Admission
14 10/10/2023 – Tn. Hariyono/ 74 th/ 1. ADHF wet and warm pf infection --> PDx Pasien dengan COPD dan
17/10/2023 10938158 HF stage C FC III dt CAD ECG/24jam HF. Pasien oksigen
2. AF RVR C3H2 → AF NVR C3H2 Echo FS dependen
3. Pneumonia CAP PSI 134 RC V FH evaluasi/3hari
4. Susp PPOK stable Populasi B
PTx
O2 NC 4-5 lpm
IVFD NaCl 0.9% 0.7cc/kgbb/jam
Oral intake 800cc/24jam
BC seimbang
DJ III 1800kkal/hari
Ini. Levofloxacin 1x750mg (H5)

PO
Digoxin 0.25mg-0-0
Ramipril 0-0-5mg
Spironolacton 0-25mg-0
Warfarin 0-0-2mg
Furosemide 40mg-0-0
NAC 3x200mg
Diazepam 0-0-2mg
Laxadyn 0-0-C1

Nebulisasi combivent 1 respule/8jam

No Date Patient Identity Diagnose Management Problem
Admission
15 16/10/2023 – Tn. Ida Bagus Made 1. APS CCS III Pro Staging PCI PDx/ Pro Staging PCI
17/10/2023 Suriana/72 thn/ 2. HFmrEF stage C FC II dt CAD (EF 50% EKG/24 jam
11583159 BP Ur/Cr post rehidrasi
3.Mild Hiperkalemia (K 5.14) Ur/Cr post Tindakan, Lipid Profile,
4. COPD GDP/2PP, AU
5. DM type II on OAD
PTx/
IVFD NaCl 0.9% 1cc/kgBB/jam -
55cc/jam
Oral intake 1000cc/24jam
Target balance cairan seimbang
DJ II 1800 kcal/hari

PO.
Aspilet 0-0-80 mg
Clopidogrel 75 mg-0-0
Atorvastatin 0-0-40 mg
Candesartan 0-0-16 mg
Acarbose 3x100 mg
Vildagliptin 2x50 mg
Glimepirid 1 mg -0-0
Theobron kapsul 2 x 130 mg
Symbicort 2x1 puff
Spiriva 1x2 puff
No Date Patient Identity Diagnose Management Problem
Admission
16 14/10/2023 – Ny. Siti Nurjannah/ 73 1. STEMI inferior Killip 1 onset 4 Jam PDx: Pasiien pindahan CVCU
17/10/2023 thn/ 10183872 TIMI 4/7 GRACE 113 CRUSSADE 45 post ECG/24jam dalam kondisi stabil
implantasi 1 DES di proksimal-mid RCA Echocardiography Full Study
pada CAD 3VD
2. HF Stage C FC II dt CAD PTx:
3. DM type II on insulin O2 NC 3lpm
4. History of CVA (2020) IVFD NaCl 0.9% hidrasi 1 cc/kgBB/jam ~
5. Menopause 68 cc/jam
Oral intake 800 cc/jam
BC seimbang
DJ III 1800 kcal/hari
Inj. Levemir 0-0-10IU (s.c)

PO:
ASA 0-0-80 mg
Clopidogel 75 mg-0-0
Atorvastatin 0-0-40 mg
Bisoprolol 2.5mg-0-0
Captopril 3x50 mg
Amlodipin 10mg-0-0
Lansoprazole 30 mg-0-0
Diazepam 0-0-2 mg
Laxadyn 0-0-C1
No Date Patient Identity Diagnose Management Problem
Admission
17 12/10/2023 - Tn. Salam Ashari/66 1. AF RVR C2H2 --> NVR PDx_ Pasien BC + 480
sekarang th/ 11563287 2. HF St C Fc IV dt CAD - EKG/24 jam Creatini ada perbaikan
3.CCS Post PCI (2021 dan 2022 dengan - Echocardiography FS 2.13  1.65  1.35
ISR)
3. Respiratory Failure type I (perbaikan) -Cek DL, Ur/Cr
4. Riwayat VT post kardioversi
5. AKI dd aCKD (Cr 2.13) *Planning Therapy:*
7. Susp Pneumonia - Total Cairan 1800cc/24jam
9. Mild Hyperkalemia perbaikan - IVFD NS 0.9% 1000 cc/jam
- Oral intake 800 cc/24 jam
- Target BC -250 s/d seimbang
- DJ II 1800 Kkal/24 jam
- Inj. Moxifloxacin 1x 400 mg (H 5)

PO
- Aspilet 0-0-80 mg
- Atorvastatin 0-0-40mg
- Warfarin 0-0-2 mg
- NAC 3X200mg
- Lansoprazol 30 mg-0-0
- Bisoprolol 2.5-0-0
- Captopril 3X6.25
No Date Patient Identity Diagnose Management Problem
Admission
18 17/10/2023 – Ny. Dian Yunitasari/42 1.Obs. Palpitasi PDx Pro Holter
18/10/2023 th/ 11462340 2.Riwayat CVA Holter Monitoring

PTx
Oral intake 2500 cc/24 jam
Target BC seimbang
DJ IV 1800 kkal/hari
PO:
Bisoprolol 1x2.5mg (TUNDA)
CPG 75mg-0-0
No. Date Admission Patient Diagnose Management Problem
Identity

19 MRS 15/10/23  Tn. Soetrisno/ 1. APS CCS III Pro Staging PCI PDx: - Stabil, Pro Staging PCI
H1 67th/ 2. HFmrEF stage C FC II dt CAD (EF EKG/24 jam
11584085/ 5B 42%) HBA1C, GDI/GDII, Profil lipid, As. - Implantasi 1 DES
2.4/ dr. Wella 3. History of CVA (2013) Urat prox LCx dan 1 DES
Karolina, 4. History of LV Thrombus Ur/Cr post tindakan OM1 pada CAD3VD
Sp.JP(K) (Resolved)
5. History of smoker PTx:
IVFD NaCl 0.9% 1.0 cc/kgBB/jam ~
52 cc/jam
Oral intake 1000 cc/24jam
BC seimbang
DJ IV 1800 kkal/hari
PO
Aspilet 0-0-80mg
Clopidogrel 75mg-0-0
Atorvastatin 0-0-20 mg
Ramipril 0-0-5 mg
Bisoprolol 2.5 mg-0-0
ISDN 3x5mg
Spironolacton 0-25mg-0
*Maksimal kontras 208 cc*
No. Date Admission Patient Identity Diagnose Management Problem

20 MRS 09/10/23  H8 Tn. Zainul Arifin/ 67th/ 1. ADHF wet and warm pf infection dt CAD --> HF P : PDx/ Stabil, Sesak nafas (+)  Pneumonia CAP, efusi
11592717/ 5B, 2.2/ dr. st C FC III dt CAD EKG/24 jam pleura bilateral, HF, CAD
Anna Fuji Rahimah, 2. CAD 3VD post implantation 1 DES at distal LCX Echo FS
(post rescue PCI a/i STEMI anterior failed P : PDx/
Sp.JP(K)
fibrinolytic) EKG/24 jam Rehab Fase 1, mobilisasi
3. Pneumonia CAP PSI 117 RC IV Pro: DL, SE (16/10/23)
4. Susp. Efusi Pleura bilateral PTx/ bertahap, perbaikan KU  KRS
5. DM type II on OAD Total bedrest
6. Azotemia Renal Semifowler position
O2 2-4 lpm.
Total cairan 1800cc/24 jam
Target BC -500 s/d -1000cc/24 jam
Inj. Furosemide 3x20mg
Inf. Paracetamol 3x1 gram (k/p demam)
PO:
ASA 0-0-80mg
Ticagrelor 2x90mg
Atorvastatin 0-0-40mg
Uperio 2x50 mg
Bisoprolol 2.5 mg-0-0
Spironolacton 0-25mg-0
ISDN 3x5mg
Laxadin 0-0-CII
Diazepam 0-0-2mg
Lansoprazole 1x30mg
Glimepirid 1x1
Domperidone 1x10mg (k/p)

PTx Paru :
- IVFD ~ leader
- IV Levofloxacin 1x 750mg (H7)
- PO NAC 3x 200 mg
- Thoracocentesis jika marker (+)
- lain - lain ~ TS Leader
PMo:
Subj, VS, UOP, BC, bleeding sign
Pro: DL, SE (16/10/23)
No. Date Admission Patient Identity Diagnose Management Problem

21 Ny. Heni Kusumawati/ MRS 15/10/23  1. APS CCS III pro staging PCI
65th/ 11588791/ 5B, 1.2/
dr. Novi Kurnianingsih,
Sp.JP(K)
PDx: Stabil, Pro Staging PCI
H1 2. HFpEF st C FC II dt CAD, HHD (62%) EKG/24 jam
3. Chronic Asthma Ur/Cr post tindakan Implantasi 2DES prox-
4. Familiy history of PCAD GDP/2PP, HbA1c, lipid profile, asam
5. Menopause urat, Albumin
distal LAD (overlapped)
pada CAD3VD
PTx:
IVFD NaCl 0.9% 1 cc/kgBB/jam ~ 73 Susp. Stenosis a.
cc/jam Femoralis, dan a Illiaca
Oral intake 1000 cc/24jam
BC seimbang  ABI  DUS Vaskular hasil
DJ IV 1800 kkal/hari Normal

PO:
Aspilet 0-0-80 mg
Clopidogrel 75 mg-0-0
Atorvastatin 0-0-40 mg
*Usul Amlodipin 5 mg-0-0*
*Ramipril 0-0-5mg -> usul 0-0-10
mg*
Bisoprolol 5 mg-0-0
ISDN 3x5 mg
Meloxicam 2x1 tab
Vit BC 1x1 tab
Paracetamol + Diazepam 1 mg prn
Gabapentin 300 mg prn
Theophylline 1x1 tab prn

*Max kontras 389 cc*1

No. Date Admission Patient Identity Diagnose Management Problem

22 MRS 161023  Tn. Noordinsyah/ 65th/ 1. APS CCS III pro staging PCI Planning Stabil, Pro Staging PCI
Hari ke 2 11582119/ MRS 161023/ 2. HFpEF st C FC II dt CAD, PDx:
5B 1.4/ dr. Anna Fuji HHD (EF biplane 31 %; Teich EKG/24 jam
Rahimah, Sp.JP(K) 53%) Echo FS
3. History of Smoker Ur/Cr pre-post tindakan
GDP/2PP, HbA1c, lipid profile, asam
urat, Albumin

PTx:
IVFD NaCl 0.9% 1 cc/kgBB/jam ~ 67
cc/jam
Oral intake 1000 cc/24jam
BC seimbang
DJ IV 1800 kkal/hari

PO:
Aspilet 0-0-80 mg
Clopidogrel 75 mg-0-0
Atorvastatin 0-0-40 mg
Vbloc 6.25mg-0-0
Candesartan 0-0-8mg
Spironolacton 0-25mg-0
ISDN 3x5mg
No. Date Admission Patient Diagnose Management Problem
Identity
23 MRS 16102023 Ny. Rina 1. ASD sekundum L to Pdx: Stabil, Pro RHC
H2 Yuli/34th/ R shunt pro RHC Pro RHC
11490764 2. PH ECG/24 jam
/ 5B 1.3/
dr. Heny Ptx:
Martini, Total cairan 1500cc/24jam
Sp.JP(K) IVFD NS 0,9%
1000cc/24jam
Oral intak 500cc/24jam
DJ III 1500kkal/24jam
P.O
- Revatio 3x20mg
No. Date Admission Patient Identity Diagnose Management Problem

24 17/10/23  MRS H2 Tn. Moh Haeru 1. APS CCS III Pro Staging PCI PDx: Stabil
Anwar/71 tahun/21-06- 2. HF Stage C FC II dt CAD EKG/24 jam Pro Staging PCI
1952/11593611/23319 3. History of Smoker Cek HbA1c, Profil lipid, UA, GDP, GD 2PP
046/BB 63 kg /TB 165 Ur/Cr post tindakan
cm/ BPJS Kelas I/ 5B
2.1/ Prof. dr. M. Saifur PTx:
Rohman, Sp.JP(K), PhD Total cairan 2000 cc/24jam
IVFD NS 0,9% 1 cc/kg/jam ~ 63 cc/jam
Oral Intake 500 cc/24jam
DJ III 1800 kkal/24 jam
BC seimbang

PO :
Miniaspi 0-0-80mg
CPG 75mg-0-0
Atorvastatin 0-0-40 mg
Herbesser 0-0-200mg
Spironolactone 25mg-0-0
Nitrokaf 2 x 2.5 mg

Max Kontras 286 cc