Mengatasi Fibrilasi Atrium Rapid Response Dengan Bisoprolol

Abstract

We reported a 77-year old female, admitted to the Prof dr RD Kandou General Hospital due to dyspnea. Physical examination revealed hypertension, rales and wheezing in both lungs, heart enlargement, and an auscultation heart rate of 140 beats per minute. ECG showed a rapid response atrial fibrillation. Besides that, chest X ray examination showed cardiomegaly with CTR>50%. A working diagnosis revealed lung edema (pneumonia as a differential diagnosis), and functional heart failure class II-III due to hypertensive heart disease, associated with a rapid response atrial fibrillation. Bisoprolol 5 mg once daily was given immediately along with oxygen, a NaCL 0.9% infusion, and furosemide 40 mg intravenously. In addition to this, was added ceftriaxon 1g twice daily, captopril 6.25 mg three times daily, furosemide 40mg, thiazide 25 mg, and aspirin 80 mg once daily, coenzyme Q10 100 mg twice daily, and trimetazidine 35 mg two tablets daily. The ECG result after approximately 10 hours was a normal respone atrial fibrillation. The patient left the hospital at the fifth day with the same ECG result. Key words: atrial fibrillation, bisoprolol, congestive heart failure. Abstrak: Telah dilaporkan seorang perempuan berusia 77 tahun, dirawat di RSU Prof dr RD Kandou dengan keluhan sesak napas. Pada pemeriksaan fisik ditemukan hipertensi, adanya ronki dan wheezing, pada perkusi pembesaran jantung, auskultasi frekuensi denyut jantung 140 kali per menit. EKG memperlihatkan fibrilasi atrium rapid response. Selain itu pada foto dada tampak kardiomegali dengan CTR>50%. Diagnosis kerja adalah suspek pneumonia, gagal jantung kongestif fungsional kelas I-III karena penyakit jantung hipertensi, disertai fibrilasi atrium rapid response. Pemberian bisoprolol 5 mg sekali sehari telah dimulai sejak saat masuk, disertai pemberian oksigen, infus cairan Nacl 0,9%, dan furosemid 40 mg intra venous. Kemudian ditambahkan ceftriaxon 1g dua kali sehari, captopril 6,25 mg tiga kali sehari, tiazid 25 mg sekali sehari, furosemid 40 mg sekali sehari, coenzim Q10 100 mg dua kali sehari, trimetazidine 35 mg dua tablet sehari, dan aspirin 80 mg sekali per hari. Pada hari kedua EKG telah memperlihatkan gambaran fibrilasi atrium normal response. Pasien dipulangkan pada hari ke lima dengan diagnosis gagal jantung kongestif fungsional I-II karena penyakit jantung hipertensi, hipertensi terkontrol, dan fibrilasi atrium normal response. Kata kunci: fibrilasi atrium, bisoprolol, gagal jantung kongestif.