The screening of congenital heart disease by cardiac auscultation and 12-lead electrocardiogram among Indonesian elementary school students

Dinarti, Lucia Kris; Murni, Indah K; Anggrahini, Dyah Wulan; Dewanto, Vera Christina; Pritazahra, Armalya; Hadwiono, Muhammad Reyhan; Fajarwati, Prahesti; Hartopo, Anggoro Budi

doi:10.1017/s1047951120003881

Cited by 8 publications

(9 citation statements)

References 35 publications

(40 reference statements)

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“…Cost burden and limited drug coverage under the National Health Insurance are key issues that must be addressed by the government to improve PAH outcomes in Indonesia [29,32,33]. Annual screening for elementary school children and pregnant women, by cardiac auscultation and 12-lead electrocardiography, can help improve PAH outcomes in Indonesia since it can detect asymptomatic CHD [34]. A recent study published by Dinarti LK, et al, used these methods for screening CHD among Indonesian elementary school students [34].…”

Section: Addressing Challenges and Unmet Needs In Pah Management In Indonesiamentioning

confidence: 99%

“…Annual screening for elementary school children and pregnant women, by cardiac auscultation and 12-lead electrocardiography, can help improve PAH outcomes in Indonesia since it can detect asymptomatic CHD [34]. A recent study published by Dinarti LK, et al, used these methods for screening CHD among Indonesian elementary school students [34]. The study indicated the cardiac abnormality prevalence of 2.9 per-1000 school-age children [34].…”

Section: Addressing Challenges and Unmet Needs In Pah Management In Indonesiamentioning

confidence: 99%

“…A recent study published by Dinarti LK, et al, used these methods for screening CHD among Indonesian elementary school students [34]. The study indicated the cardiac abnormality prevalence of 2.9 per-1000 school-age children [34]. Implementing these simple, reliable CHD screening methods in schoolage children can provide early referral and appropriate management and reduce mortality associated with undetected CHD later in adulthood.…”

Section: Addressing Challenges and Unmet Needs In Pah Management In Indonesiamentioning

confidence: 99%

“…Such a nationwide registry may hold great prominence in the future for designing and promoting standards of care in PAH. In Indonesia, nationwide screenings in the prenatal and postnatal periods have not yet been implemented [34]. • Secondly, PAH care is still centralized in Indonesia, with patients being referred to tertiary health facilities for comprehensive evaluation and management which leads to later diagnosis.…”

Section: Recommendations and Future Directionsmentioning

confidence: 99%

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Pulmonary Arterial Hypertension in Indonesia: Current Status and Local Application of International Guidelines

et al. 2021

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Recent advances in the diagnosis and management of pulmonary arterial hypertension (PAH) have led to a significant improvement in the outcomes for patients with PAH. However, prompt and accurate diagnosis of PAH remains an unmet challenge due to lack of awareness and lack of meticulous data to profile the etiology and pathophysiology of this rare progressive disease, especially in low- and middle-income country. In Indonesia, the true prevalence and incidence of different subtypes of PAH in general population is still unknown. The Congenital HeARt Disease in adult and Pulmonary Hypertension (COHARD-PH) registry was the first single-center prospective registry in Indonesia, which indicated that almost 80% of adult patients with congenital heart disease (CHD) had experienced PAH and even Eisenmenger syndrome due to delayed diagnosis. Screening for early detection of asymptomatic CHD in children is yet to be systematically established in Indonesia, leading to undiagnosed and uncorrected CHD in adulthood. There are no specific national guidelines focusing on diagnostic workup and treatment of PAH in Indonesia. Furthermore, the lack of adequate diagnostic facilities, limited treatment availability, and limited drug coverage under the National Health Insurance Scheme are key issues that remain unaddressed. This review focuses on the diagnosis, treatment, and management of PAH associated with CHD in Indonesia as per international guidelines. We have proposed recommendations to effectively control and prevent PAH associated with CHD in Indonesia. The paper should be of interest to readers in the area of medical management and policy makers especially in low- and middle-income countries. Key Highlights: Pulmonary arterial hypertension (PAH) is a rare progressive subtype of pulmonary hypertension with poor overall prognosis and outcomes. Prompt and accurate diagnosis of PAH remains an unmet challenge in low- and middle-income countries due to poor knowledge about the etiology and pathophysiology of this syndrome. Also, the symptoms and signs of early-stage PAH are usually nonspecific or undetectable in newborn and infants, thus presenting a challenge for physicians to establish early diagnoses of PAH. The challenging factors in low- and middle-income countries, especially Indonesia archipelago are limitations of healthcare infrastructure, limited expertise, lack of awareness, lack of timely PAH screening strategies, poor antenatal care and unpredictable availability of PAH medications. There are no specific national guidelines focusing on diagnostic workup and treatment of PAH in Indonesia. Under-utilization of treatment guidelines and lack of adequate diagnostic treatment facilities have resulted in sub-optimal management of PAH patients in Indonesia. Adherence to international guidelines is an important aspect of PAH management in Indonesia. Updated disease and functional classifications of PAH as per internati...

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Section: Addressing Challenges and Unmet Needs In Pah Management In Indonesiamentioning

confidence: 99%

Section: Addressing Challenges and Unmet Needs In Pah Management In Indonesiamentioning

confidence: 99%

Section: Addressing Challenges and Unmet Needs In Pah Management In Indonesiamentioning

confidence: 99%

Section: Recommendations and Future Directionsmentioning

confidence: 99%

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Pulmonary Arterial Hypertension in Indonesia: Current Status and Local Application of International Guidelines

et al. 2021

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“…Several studies on cardiovascular abnormality screening methods have been performed by combining cardiac auscultation, 12 lead electrocardiogram (ECG) and echocardiography. 7,10 The ECG examination is a simple, effective, and easy to perform method for diagnosing CVD. Based on our previous study, this program has been proven effective as a screening method of CVD in children.…”

Section: Introductionmentioning

confidence: 99%

The screening of heart disease by cardiac auscultation and electrocardiography examination in pregnant women in Puskesmas Tegalrejo, Yogyakarta, Indonesia

Dinarti

Nurdiati

Hartopo

et al. 2021

J Community Empowerment for Health

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Women adapt to pregnancy through multi-organ system physiologic changes, including cardiovascular adaptations. These changes affect those with pre-existing cardiovascular problems differently, and subsequently lead to higher probability of death caused by cardiovascular diseases during pregnancy. Therefore, detection of cardiovascular disease early in pregnancy is important to lower maternal morbidity and mortality by providing prompt and adequate management. This study aimed to evaluate and test the feasibility of integrating 12-lead electrocardiogram (ECG) examination and antenatal care (ANC) screening as a simple and effective method for early detection of heart abnormality in pregnant woman. Pregnant women were recruited in this study in any trimester who attended ANC for a routine pregnancy examination in Puskesmas Tegalrejo Yogyakarta. The subjects underwent primary screening which focused on cardiac auscultation and 12-lead ECG examinations, and those who had abnormal findings were further followed-up in secondary screening by using trans-thoracic echocardiography to confirm heart abnormality. A total of 523 pregnant women from Puskesmas Tegalrejo were included in this study. 15 (2.8%) pregnant woman were suspected to have heart abnormalities; from those, 3 (0.5%) were found with heart murmurs with abnormal ECG readings, 1 (0.19%) had heart murmurs with normal ECG results, and 11 (2.1%) had abnormal ECG readings only. The secondary screening of those patients resulted in 1 (0.19%) pregnant woman who was diagnosed with Atrial Septal Defect. Our study found that among 15 patients identified with suspected ECG abnormalities, one mother who underwent ANC was newly diagnosed with a pre-existing cardiac abnormality. Our study concluded this screening method is a simple and feasible integrated heart screening program that can be implemented widely. We hope this integrated heart screening program may benefit pregnant women who may have cardiac abnormalities to be detected as early as possible, thus reducing maternal morbidity and mortality.

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Unrecognized congenital heart disease in rural school-age children: getting to the root of the problem

Zhao

Huang

2022

World J Pediatr

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The screening of congenital heart disease by cardiac auscultation and 12-lead electrocardiogram among Indonesian elementary school students

Cited by 8 publications

References 35 publications

Pulmonary Arterial Hypertension in Indonesia: Current Status and Local Application of International Guidelines

Pulmonary Arterial Hypertension in Indonesia: Current Status and Local Application of International Guidelines

The screening of heart disease by cardiac auscultation and electrocardiography examination in pregnant women in Puskesmas Tegalrejo, Yogyakarta, Indonesia

Unrecognized congenital heart disease in rural school-age children: getting to the root of the problem

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