Right Heart Failure (RHF) as a rapidly progressive syndrome with systemic congestion in the setting of impaired RV filling and/or decreased RV outflow output. A 28-year-old male patient, a photographer, lived in North Aceh was admitted to the ED of Cut Meutia Hospital. He was admitted with worsening dyspnea since 2 days before, initiated after a periode of fever. He also complained of fatigue, palpitations in ordinary activities and chest pain occasionally. He had history of presyncope and syncope. He denied any history of hypertension, type 2 diabetes, allergies, and active smoking. He had no congenital or family history of heart disease. Physical examination revealed full of conciousness with slightly abnormal vital sign. He had malar rash, dilated jugular vein. The apex of the heart shifts to the axilla anterior line, S1>S2 with systolic murmur (+). ECG showed complete RBBB with RAD and chest x-ray showed cardiomegaly. The transthoracic echocardiogram revealed severe TR (Tricuspid Regurgitation), dilatation of RARV (Right Atrium Right Ventricle), with severe PH (Pulmonary Hypertension). The patient was diagnosed with RHF (Right Heart Failure) caused by primary PH. The patient was placed on intravenous furosemide, spironolacton, digoxin, and sildenafil. Treatment and lifestyle modification were expected to improve the quality of life.

Rheumatic heart disease (RHD) is damage of the heart valves due to acute rheumatic fever (ARF) which results from the body’s autoimmune response to Streptococcus pyogenes (group A Streptococcus bacteria) infection which is a throat infection. Acute rheumatic fever is one of the most important causes of cardiovascular morbidity and mortality in the developing countries. A 25-years-old male patient, domiciled in Alue Dalam, Darul Aman, East Aceh, admitted to emergency department of Cut Mutia hospital, the patient was brought to the hospital by his family at 05.0o pm on January 27th, 2022. Patient referred from Graha Bunda hospital. Patient was admitted to the hospital with complaints shortness of breath. Shortness of breath is felt during activity and worsens at night. Shortness of breath since yesterday. The patient also complained of pounding. The pounding has been felt for five days before arriving at the hospital. The patient also has chest pain, and tired easily. Past medical history such hypertension and diabetes mellitus are denied. Physical examination before treatment was obtained: the patient looked restless, weakness, and akker. Echocardiography examination showed the MR Severe, MS moderate, AR moderate, TR moderate, PH mild, AML calsification, all chamber dilatation, and thrombus LV. The patient was given initial treatment in Cut Mutia General Hospital.

Background: Deep vein thrombosis (DVT) is frequently observed in patients with chronic heart failure (CHF), increasing the risk of pulmonary embolism (PE). Clinical evaluation of CHF patients with suspected acute PE is challenging since these diseases share several symptoms and signs such as dyspnea.   Objective: The aim of this study was to analyze whether heart failure increases the risk of DVT.   Method: This study uses a qualitative approach with a case study model that analyzes and identifies venous thromboembolism in hospital patients with heart failure, does heart failure increase the risk of DVT?   Result: DVT (Deep Vein Thrombosis) is the formation of a thrombus or blood clot that often attacks the deep veins of the lower extremities (such as the calf, femoral and popliteal veins) or deep veins in the pelvic area, more frequent in proximal than distal DVT. This condition is potentially dangerous, leading to morbidity and mortality that can essentially lead to disease. This happens all over the world. In general these diagnoses are combined in VTE (Venous Thromboembolism). In patients with DVT without PE, short-term mortality rates of 2–5% were reported. Recurrence risk is high, especially within first 6 months.   Conclusion: From the results obtained we can know that Symptomatic patients with proximal DVT may present with lower extremity pain, calf tenderness, and lower extremity swelling (Kesieme et al., 2011) Same with this case, Patient was admitted to the hospital with complaints swelling of the whole body, especially the legs accompanied by pain, redness, feel warmed a few hours before the patient going to hospital.

Sudden cardiac death (SCD) is a vital public health issue, accountable for almost 50% of all cardiovascular deaths. In the last three decades, SCD was the leading cause for almost 230000 to 350000 deaths per annum in the United States. Ventricular arrhythmias account for 25% to 36% of witnessed sudden cardiac arrests (SCA) at home and 38% to 79% of witnessed SCA in public. The goals of ventricular arrhythmia management include symptom relief, improving quality of life, reducing implantable cardioverter defibrillator shocks, preventing deterioration of left ventricular function, reducing risk of arrhythmic death, and potentially improving overall survival. Based on the ACLS guideline, each tachyarrythmia with a pulse should be given synchronized cardioversion, however, when such action could not be performed for various reasons, and showed wide QRS 0,12, intravenous or antiarrthytmia might serve as a possible treatment. If intravena antiarrhytmics are given, amiodarone may be considered. Amiodarone is also effective in preventing recurrence of monomorphic VT. Lidocaine is less effective in terminating VT than procainamide, sotalol and amiodarone. Lidocaine may be considered second-line antiarrthythmic therapy for monomorphic VT.

Rheumatic heart disease (rheumatic heart disease) is an acquired heart disease which is a heart valve disorder that persists due to previous acute rheumatic fever, mainly affecting the mitral valve (75%), the aorta (25%), rarely affecting the tricuspid valve, and never affecting the valves lungs. A 52-year-old male patient, domiciled in Mutiara (Alue Awe) Lhokseumawe City, Indonesia. Come for outpatient treatment at Polyclinic of Cut Meutia Hospital. Patients are who routinely go to the polyclinic every month to take medicine. The patient complains of left chest pain, shortness of breath, heart palpitations, cough, tired easily during activities, especially during strenuous activities. History of Diabetes Mellitus is denied, history of hypertension (+). The patient admitted that he was diagnosed with rheumatic heart disease at the age of 19 years. The patient has been undergoing treatment for 33 years by routinely complete checks related to his heart every year and regularly taking medication at the polyclinic every month. The patient admitted at junior high school age he often experienced attacks of fever that went up and down accompanied by pain in the throat. Physical examination found: Compos Mentis (E4V5M6), BP:140/40 mmHg, HR : 92x/i, RR: 23x/i, T; 37.1°C, SpO2 : 95%. Chest examination showed vesicular breath sounds, Rhonki (-), Wheezing (-), Diastolic murmur (+).Echocardiography showed an EF of 70%. AR Severe, MR Moderate. AML Prolapse, Calcification (+), LV Dilatation, LVH Eccentric