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Background Hypertension is a significant mortality risk factor. The knowledge and practice among physicians of hypertension management and home blood pressure monitoring (HBPM) in blood pressure control is important. We aimed to investigate the awareness and practice of HBPM among physicians in Indonesia after publishing of the local 2019 HBPM guidelines. Methods This was a cross-sectional study involving 611 physicians in Indonesia that was conducted between February and October 2020. The questionnaire covered awareness, knowledge, and practice of HBPM. Results A total of 330 male physicians (54.0%) aged 20-49 years participated in the survey. More than half were specialists (51.6%) and recommended HBPM to their patients with hypertension (89.0%). The awareness of HBPM benefits was substantial among the physicians; however, the knowledge of the home blood pressure (HBP) reference values of was low (7.9%). Around 54% of the respondents thought that the barriers to low recognition of HBPM are lack of HBPM guidelines or lack of understanding of HBPM among physicians. A considerable percentage provided instruction on HBPM that aligned with the local guidelines, but between 7.5-29.5% gave no instruction on HBPM. Conclusion Most physicians recommend HBPM, but there is still a lack of knowledge and attitude toward HBPM. In Indonesia, local HBPM guidelines were published in 2019, but have not yet sufficiently penetrated the country, therefore robust dissemination of the published HBPM guidelines is still needed. For efficient utilization of HBPM by physicians in clinical practice, developing user-friendly educational tools such as physicians’ pocket guide on HBPM instructions is essential.

Background: Iron deficiency anemia (IDA) in heart failure (HF) is associated with poor functional capacity. Several studies reported the benefit of iron therapy in HF with IDA on improving functional capacity. Therefore, we attempt to investigate the effect of oral iron supplementation on functional capacity in HF patients with IDA. Results: Double blind randomized controlled trial was conducted in National Cardiovascular Center Harapan Kita Hospital Universitas Indonesia. A total 54 HFREF patients with IDA were enrolled and randomized to either oral Ferrous Sulphate (FS) 200mg 3 times a day or placebo with 1:1 ratio for 12 weeks. Primary outcome was functional capacity measured by 6-minute walk test. There were 41 participants completed the study (FS n=22, placebo n=19). Ferrous sulphate significantly improved functional capacity changes (46.23+35m vs -13.7+46m, p

Background: Percutaneous mitral valve repair (PMVR) with MitraClip is considered as an optional treatment for patients with significant MR who are high risk for having surgery. This novel therapy is less invasive, safe, and effective for MR reduction, and hence improve symptoms of heart failure, as well as reverse left ventricle remodeling. The purpose of this study was to report the early experience of Mitraclip procedure for treating significant MR at the National Cardiovascular Center Harapan Kita. Methods: This retrospective study was conducted at National Cardiovascular Center Harapan Kita Hospital, Jakarta. The data was retrieved from computerized database and medical records from February 2014 to January 2015, and then analyzed with SPSS. Results: A total of 6 patients with age 51 - 75 years old, underwent MitraClip procedure. Of all patients, the MR were severe in 5 patients and moderate in 1 patient. One was female and 5 were male. Among these patients, 2 were degenerative MR and 6 were functional MR. Two patients were treated with single MitraClip and 4 patients required double MitraClip. Post proccedure, there was reduction of MR to mild was achieved in 2 patients and to moderate in 4 patients. The left ventricular end diastolic dimension decreased from 66 6.5 mm at baseline to 59 7.3 mm (p=0.04) and end systolic dimensions decreased from 50 10.6 mm at baseline to 48 10.0 mm before discharge (p=0.27) as evaluated from predischarge echocardiography. At one month after procedure, 2 patients were in New York Heart Association (NYHA) functional class I and 4 patients were in class II. In-hospital mortality was 0%. Only 1 patient was re-hospitalized after procedure due to heart failure. Conclusion: From our early experience, MitraClip was considered an effective and safe option for patients with functional and degenerative MR who are at high risk for open-heart surgery. Left ventricle dimension, NYHA functional class, MR reduction, and re-hospitalization rate were improved after procedure.

Cardiac myxomas are the most common primary cardiac tumors. Myxoma are more common in women. Clinical manifestations can mimic many cardiac and noncardiac conditions. Transthoracic echocardiography (TTE) is the gold standard method in the diagnosis of cardiac myxoma. The management of cardiac myxoma are medical therapy for the treatment of associated conditions and surgical removal as the definitive treatment.

Primary tumors of the heart are rare where myxomas predominate as the most common type of primary cardiac tumors in all age groups. Even rarer, the incidence of myxomas during pregnancy is reported extremely low in the medical literature. The hemodynamic changes during pregnancy play an important role in influencing the clinical manifestation. The management is vary, depending on the week of gestation and risk assessment for both the mother and baby. We report a case of left atrial myxoma in 33-34 weeks of pregnancy. After judicious consideration, the patient was planned to have caesarian section at the full term pregnancy that will be followed one week after by tumor resection.

Trombosis pada katup prostetik jarang terjadi, namun dapat mengancam jiwa pasien dengan penggantian katup. Komplikasi ini lebih sering terjadi pada katup prostesis mekanik, meskipun kejadiannya hanya 0,3-4,3 % pertahun. Trombosis katup prostetik ditandai dengan adanya trombus, tanpa disertai infeksi, yang melekat pada atau dekat katup, yang menyumbat aliran darah atau mengganggu fungsi katup. Hal ini tergantung pada jenis katup (katup plat berdiri atau katup bola), struktur (katup mekanik), lokasi (mitral) dan kepatuhan pasien terhadap penggunaan obat anti koagulan.