Coronavirus disease 2019 (COVID-19) has already stated as a pandemic by the World Health Organization (WHO). Until now, Indonesia has also infected with this severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. All medical staffs join hand by hand to overcome this pandemic, not only pulmonologist but also cardiologist. Early reports from China showed that cardiovascular comorbidities add more mortality than without comorbid. Cardiac implication of this infection is cardiac injury. Viral pathology and pathophysiology that induced cardiac injury is still debatable and not well understood. Angiotensin-converting enzyme 2 (ACE2) has emerged as a key regulator of renin-angiotensin system in cardiovascular disease. ACE2 has been postulated as one of the pathophysiology of COVID-19 and cardiac injury. ABSTRAK Coronavirus disease 2019(COVID-19) telah dinyatakan sebagai pandemi olehOrganisasi Kesehatan Dunia (WHO). Saat ini, Indonesia juga telah terinfeksi dengan infeksi coronavirus 2 (SARS-CoV-2) yang parah. Semua staf medis bergandengan tangan untuk mengatasi pandemi ini, tidak hanya dokter paru tetapi juga ahli jantung. Laporan awal dari Cina menunjukkan bahwa komorbiditas kardiovaskular menambah lebih banyak kematian daripada tanpa komorbiditas. Implikasi jantung dari infeksi ini adalah cedera jantung. Patologi virus dan patofisiologi yang menyebabkan cedera jantung masih bisa diperdebatkan dan tidak dipahami dengan baik. Angiotensin-converting enzyme 2 (ACE2) telah muncul sebagai pengatur utama sistem reninangiotensin pada penyakit kardiovaskular. ACE2 telah disimpulkan sebagai salah satu patofisiologi COVID-19 dan cedera jantung.

Background Coronary artery disease is one of the major issues in the medical world around the globe. The prevalence tends to increase. The use of coronary intervention is one of the ways often used in the management of coronary artery disease due to its satisfying result from earlier studies. Nowadays, there are several different techniques in coronary intervention: balloon vs stent. Main body The stent-based vascular interventions are increasingly being used over balloon-based coronary intervention. However, revascularization intervention using stent often have undesirable long-term effects compared to balloon. Besides, stent-based interventions are also considered more expensive, use more complicated techniques, and use more drug regimens. On the other hand, percutaneous coronary intervention techniques using balloons coated by anti-proliferation drugs have begun to be glimpsed by many interventionists. Studies have found many benefits that cannot be given by stent-based intervention therapy. Conclusions Angioplasty using percutaneous coronary intervention techniques reveals satisfying result compared to conservative medical treatment. The indication and technique of percutaneous coronary intervention is still evolving until now. Currently, percutaneous coronary intervention using stent, either bare-metal stent or drug-eluting stent, is preferred by interventionist. Nevertheless, recent clinical trial favors the using of drug-eluting balloon for percutaneous coronary intervention in terms of both clinical outcome and complication in several scenarios.

Background COVID-19 was a trending topic all year long in 2020. Currently, it is not only a problem for a pulmonologist since it could cause complications to many other organs, including the cardiovascular system. Recent acute COVID-19 infection state has been associated with hypercoagulation and causing microthrombi called immunothrombus. Acute limb ischemia is one of the rare complications but organ-threatening. Unfortunately, unlike coronary artery disease, there is no recent guideline for cardiologists to diagnose and manage acute limb ischemia in pandemic situations Case presentation This case series presented two patients with acute limb injury (ALI)-complicating COVID-19, with chief complaints of pain at their lower extremity. The first patient was an 80-year-old woman who was just dismissed from the hospital due to COVID-19. The distal part of her toe was cyanosed, and her motoric and sensory functions were partially reduced. She was treated with oral drug therapy due to unwillingness to be hospitalized. Interestingly, she had recovered by using oral drug therapy. The second case was a 54-years-old female with several comorbidities such as obesity, type 2 diabetes mellitus, hypertension, dyslipidemia, and chronic obstructive pulmonary disease. She had cyanosed foot and weak arterial pulsation. Unfortunately, she passed away due to acute respiratory distress syndrome. Conclusion Several internal and external factors cause ALI treatment to be more challenging in the pandemic COVID-19 situation. The diagnosis and management of ALI in COVID-19 patients may not fully comply with the current guideline and are likely to be affected by local hospital regulations. Clinical follow-up might be an essential feature in treating ALI in COVID-19 patients.

Heart failure is the terminal stage of all the heart pathological conditions. The common understanding in heart failure is always preceded by left ventricular dysfunction. There are several clinical studies that indicate heart failure might occur without prior left ventricular dysfunction. Left atrial dysfunction may have more important roles than we previously thought in the context of heart failure. The atrium has a unique and different anatomical structure and function compared to the ventricles. Left atrial failure can occur independently of left ventricular dysfunction or mitral valve abnormalities. Atrial failure, similar to ventricular failure, could also cause or initiate global heart failure. The mechanism of atrial failure can be caused by fibrosis, electrical and mechanical dysfunction. Through this article, we would emphasize that atrial failure also has clinical significance and may explain heart failure with the condition of the sustained ejection fraction. Gagal jantung adalah hasil akhir dari semua kondisi patologi di jantung. Terminologi umum dalam gagal jantung selalu didahului oleh disfungsi ventrikel kiri. Ada beberapa studi klinis yang menunjukkan gagal jantung mungkin terjadi tanpa disfungsi ventrikel kiri sebelumnya. Disfungsi atrium kiri mungkin memiliki peran penting lebih dari pada yang kita pikirkan sebelumnya pada kondisi gagal jantung. Berbeda dengan ventrikel, atrium memiliki struktur anatomis dan fungsi yang unik dan berbeda.  Gagal atrium kiri dapat terjadi secara independen terhadap disfungsi ventrikel kiri dan kelainan katup mitral. Seperti halnya ventrikel kiri, gagal atrium dapat menyebabkan gagal jantung secara global. Mekanisme gagal ventrikel dapat disebabkan dari fibrosis, disfungsi elektrik dan mekanik. Melalui artikel ini, kami akan menjelaskan bahwa kegagalan fungsi atrium juga memiliki signifikansi klinis dan mungkin menjelaskan gagal jantung dengan kondisi fraksi ejeksi yang dipertahankan.

Background: Currently, hypertension becomes one of the leading issues not only for medical community but also to the broader societies. Even though hypertension could be symptomatic, in most case it didn’t until the devastating complications shows up. Functional capacity is a simple tool based on our daily activity. The six-minute walk test could be one of the simplest ways in measuring functional capacity. Six-minute distance as the outcome of this test could be potentially a marker for functional capacity in hypertensive group compare to non-hypertensive group.Methods: This is a case control study with 34 female participants in six-minute walking test.Result: There are no significant different of age, height, weight, and body max index between those groups. The six-minute walking distance drastically difference between hypertensive and non-hypertensive group, 306m and 367m respectively with p-value < 0,01. Heart rate pre-test also statistically different between control group and case group. (75 bpm and 94 bpm, p-value = 0,027) Post-test blood pressure is notably distinctive between two groups. Additionally, systolic blood pressure post-test lower than initial value. Hypertension alters human functional capacity ominously.Conclusion : The six-minute walk test could be applied as simple functional capacity marker in hypertension subject.