Lanjut Usia dengan Infark Miokard Akut yang Diduga Dicetuskan oleh Hospital-Acquired Pneumonia - Laporan Kasus
Laporan Kasus
DOI:
https://doi.org/10.55175/cdk.v53i04.1866Kata Kunci:
Infark miokard akut, lanjut usia, laporan kasus, pneumonia, STEMIAbstrak
Pendahuluan: Pneumonia diduga dapat mencetuskan kejadian kardiovaskular baru pada lanjut usia (lansia). Risiko komplikasi kardiovaskular dapat meningkat hingga beberapa tahun setelah pneumonia. Kasus: Laki-laki berusia 75 tahun dirawat di rumah sakit dengan keluhan utama buang air besar (BAB) cair. Selama perawatan, pasien mengeluh BAB hitam, batuk berdahak, demam, dan sesak napas. Setelah pasien ditetapkan mengalami hospital-acquired pneumonia (HAP), ia juga terdiagnosis dengan angina atipikal. Gambaran elektrokardiografi (EKG) mengalami evolusi menjadi elevasi segmen ST pada lead II, III, dan aVF, dengan peningkatan biomarker jantung. Pasien didiagnosis dengan ST elevation myocardial infarction (STEMI) inferior Killip III, amebiasis intestinal, melena karena kecurigaan ulkus peptikum dd/ kolitis amebiasis, anemia normositik normokromik derajat sedang, late-onset hospital-acquired pneumonia (HAP), dan acute kidney injury (AKI) stage II dd/ acute on chronic kidney disease (ACKD) prerenal diduga akibat pielonefritis kronik dd/ nefrosklerosis. Pembahasan: Kecurigaan pneumonia sebagai pencetus STEMI dapat dilihat dari gambaran klinis infeksi yang dominan serta adanya peningkatan leukosit yang signifikan sebagai salah satu marker infeksi. Setelah dirawat selama beberapa hari di unit pelayanan intensif jantung dengan terapi antiplatelet dan anti-angina, kondisi klinis pasien membaik. Simpulan: Mekanisme kejadian kardiovaskular yang dicetuskan oleh pneumonia masih belum jelas. Terapi adekuat memegang peranan penting dalam penanganan pneumonia.
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Referensi
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