Echocardiografi di bidang Endokrinologi, Nefrologi, Hematologi

(Fokus pada beberapa kasus)

Yogi P. Rachmawan

Pembimbing :

dr. Susi Herminingsih SpJP(K)

Pokok Bahasan

• Endokrinologi– Gangguan fungsi tiroid– Diabetes

• Nefrologi– Gagal ginjal kronis

• Hematologi– Anemia kronis– Hemochromatosis– Hipereosinofilia

Endokrinologi

Penyakit Tiroid• Hipertiroid

• Sinus takikardia• Atrial Fibrilasi• Hipertrofi• Kardiomiopati

reversibel• Gagal jantung

Toft AD, Boon NA. Thyroid Disease and The Heart. Heart 2000;84:455–460

• Gambaran Echocardiogram Hipertiroid– FS ↑– LVEF ↑– IVRT ↓– Early filling deceleration time ↓– LV dilatasi dan hipertrofi– MVP

Yusoff Rahal. Echocardiography in Endocrinopathies.:http://www.malaysianheart.org/article.php?aid=517

Parasternal Long Axis Echocardiogram : Pasien dgn tirotoxicosis yang mengalami kardiomiopati, dgn LVIDD 52 mm (normal)

Feigenbaum's Echocardiography, 6th Edition. 2005. p738-772

• Hipotiroid

Hiperlipidemia, penyakit jantung koroner : angina pectoris, infark miokard

Dillmann, W H. Cardiac function in thyroid disease: Clinical features and management considerations. Ann Thorac Surg 1993;56:9-15

• Gambaran Echocardiogram Hipotiroid– FS ↓– LVEF ↓– IVRT ↑– Efusi perikardial (30-80% pada keadaan lebih lanjut)

Yusoff Rahal. Echocardiography in Endocrinopathies.:http://www.malaysianheart.org/article.php?aid=517

Parasternal Short Axis Echocardiogram : Pasien hipotiroid dengan penyakit jantung koroner

Feigenbaum's Echocardiography, 6th Edition. 2005. p738-772

Dzuvo AH et al. Echocardiographic Evaluation of Cardiac Function in Female Patients with Thyroid Disorders. Bosnian Journal of Basic Medical Sciences 2010; 10 (2): 112-115

Endokrinologi

Diabetes Melitus

Bauters C et al. Influence of Diabetes Mellitus on Heart Failure Risk and Outcome. Cardiovascular Diabetology 2003, 2 :1

Fang et al. Echocardiographic Detection of Early Diabetic Myocardial Disease. JACC Vol. 41, No. 4, 2003

Apical 4 chamber view : menunjukan gambaran kesan dilatasi semua ruang jantung dan global hipokinetik pada pasien dgn diabetic kardiomiopati

Feigenbaum's Echocardiography, 6th Edition. 2005. p738-772

Nefrologi

Gagal Ginjal Kronis

Hung MJ et al. Three-dimensional echocardiographic assessment of left ventricular remodeling in predialysis

chronic kidney disease patients. Jnephrol 2012; : 01) 96- 106 25

Parasternal long axis echocardiogram pd pasien dgn GGK : menunjukan kalsifikasi annulus mitral (tanda panah) dan efusi perikardial

Feigenbaum's Echocardiography, 6th Edition. 2005. p738-772

a. Parasternal long axis view : menunjukan gambaran LVH konsentrik b. Parasternal short axis c. Gambaran klasik gangguan relaksasi d. Tanda panah menunjukan kalsifikasi annulus mitral

Filho RP, Barberato FH. Echocardiography in Chronic Kidney Disease: Diagnostic and Prognostic Implications. Nephron Clin Pract 2010;114:c242–c247

Feigenbaum's Echocardiography, 6th Edition. 2005. p738-772

Hung MJ et al. Three-dimensional echocardiographic assessment of left ventricular remodeling in predialysis

chronic kidney disease patients. Jnephrol 2012; : 01) 96- 106 25

Hayashi et al. Left ventricular Function in Patients with Chronic Kidney Disease Evaluated by Colour Tissue Doppler Velocity Imaging. Nephrol Dial Transplant (2006) 21: 125–132

Hematologi

Anemia Kronis

Mehta PA, Dubrey SW. Review : High output heart failure. Q J Med 2009; 102 :235–241

Kim Yoo Ri, et al. Relation of AAnemia to Echocardiographically Estimated Left Ventricular Filling Pressure in Hypertensive Patients Over 50 Year-Old. J Cardiovasc Ultrasound 2010;18(3):86-90

Apical 4 chamber echocardiogram : wanita 19 th dgn anemia kronis – sickle cell anemia (Hb 6 g/dl), tampak kesan dilatasi LV dgn global hipokinetik LV, yg terjadi akibat kombinasi mikroinfark & high-output state

Feigenbaum's Echocardiography, 6th Edition. 2005. p738-772

Hematologi

Hemochromatosis

Downloaded from http://echealthinsurance.com/health-insurance-advisor/hemochromatosis/

Parasternal short axis echocardiogram : Pasien dgn cardiac hemochromatosis, didapatkan penebalan dinding ventrikel & abnormalitas tekstur myocardial dgn fungsi sistolik ↓

Feigenbaum's Echocardiography, 6th Edition. 2005. p738-772

Hematologi

Hipereosinofilia

Rodig SJ, Kutok JL. Bone Marrow Disorders with Associated Eosinophilia. http://dx.doi.org/10.1016/j.mpdhp.2009.01.012

Leiferman KM, Gleich GJ. Hypereosinophilic Syndrome: Case presentation and update. http://dx.doi.org/10.1016/j.jaci.2003.01.051

Feigenbaum's Echocardiography, 6th Edition. 2005. p738-772

Apical 4 chamber echocardiogram : Pasien dgn hipereosinofilia, didapatkan massa dgn tekstur abnormal yg secara homogen mengisi apex LV