Skrining Kardiovaskular pada Pasien dengan Sindroma Marfan: Suatu Laporan Kasus dan Tinjauan Singkat

Sidhi Laksono Purwowiyoto, Rismarini Asanti

Abstract


Sindroma Marfan (SM) merupakan penyakit jaringan ikat herediter yang diturunkan secara autosomal dominant yang melibatkan multiorgan, salah satunya adalah sistem kardiovaskular. Tidak ada terapi kuratif, namun diagnosis dini, skrining dan pemantauan berkala, serta perubahan gaya hidup dapat memperbaiki prognosis pada penderita SM. Penegakan diagnosis SM dapat dikonfirmasi dengan revised Ghent criteria. Sebagai penyebab morbiditas dan mortalitas yang utama pada pasien dengan SM, perlu dilakukan penapisan dan follow-up rutin untuk mendeteksi terjadinya komplikasi pada sistem kardiovaskular utamanya pada aorta dan katup mitral. Dipaparkan kasus laki- laki, usia 25 tahun, rujukan dari sejawat ortopedi dengan kecurigaan SM. Keluhan utama pasien hanya nyeri pada tulang ekor. Riwayat keluhan nyeri dada, sesak, dan berdebar disangkal oleh pasien. Hasil EKG menunjukkan adanya right atrial enlargement dan LVH. Pada pasien dikerjakan pemeriksaan transtorakal ekokardiografi sebagai bagian dari skrining kardiovaskular. Tidak dijumpai adanya dilatasi root aorta, katup- katup masih dalam batas normal, serta fungsi sistolik ventrikel kanan dan kiri baik. Follow up minimal 1 tahun sekali perlu dikerjakan untuk pemantauan serta pencegahan komplikasi kardiovaskular di masa mendatang.


Keywords


Aortic root, Ekokardiografi, Sindroma marfan, Skrining kardiovaskular

Full Text:

PDF

References


Isekame Y, Gati S, Aragon-Martin JA, Bastiaenen R, Kondapally Seshasai SR, Child A. Cardiovascular Management of Adults with Marfan Syndrome. European Cardiology Review. 2016;11(2):102.

Vanem TT, Geiran OR, Krohg‐Sørensen K, Røe C, Paus B, Rand‐Hendriksen S. Survival, causes of death, and cardiovascular events in patients with Marfan syndrome. Mol Genet Genomic Med. 2018 Nov 4;6(6):1114–23.

de Beaufort HWL, Trimarchi S, Korach A, Di Eusanio M, Gilon D, Montgomery DG, et al. Aortic dissection in patients with Marfan syndrome based on the IRAD data. Ann Cardiothorac Surg. 2017 Nov;6(6):633–41.

Mahavira A, Siswanto BB. Diagnosis and Management of Marfan Syndrome. Indonesian Journal of Cardiology. 2014 Mar 4;105–12.

Crosas-Molist E, Meirelles T, López-Luque J, Serra-Peinado C, Selva J, Caja L, et al. Vascular Smooth Muscle Cell Phenotypic Changes in Patients With Marfan Syndrome. Arterioscler Thromb Vasc Biol. 2015 Apr;35(4):960–72.

Franken R, Radonic T, den Hartog AW, Groenink M, Pals G, van Eijk M, et al. The revised role of TGF-β in aortic aneurysms in Marfan syndrome. Netherlands Heart Journal. 2015 Feb 24;23(2):116–21.

Hagerty T, Geraghty P, Braverman AC. Abdominal Aortic Aneurysm in Marfan Syndrome. Ann Vasc Surg. 2017 Apr;40:294.e1-294.e6.

Gu X, He Y, Li Z, Han J, Chen J, Nixon JV (Ian). Echocardiographic versus Histologic Findings in Marfan Syndrome. Tex Heart Inst J. 2015 Feb 1;42(1):30–4.

Nyktari E, Drakopoulou M, Rozos P, Loukopoulou S, Vrachliotis T, Kourtidou S, et al. Marfan Syndrome beyond Aortic Root—Phenotyping Using Cardiovascular Magnetic Resonance Imaging and Clinical Implications. Medicina (B Aires). 2023 May 14;59(5):942.

Guala A, Pons M, Ruiz-Munoz A, Dux-Santoy L, Madrenas L, Valente F, et al. Aortic root longitudinal strain by speckle-tracking echocardiography predicts progressive aortic root dilation in Marfan syndrome patients. Eur Heart J Cardiovasc Imaging. 2021 Feb 8;22(Supplement_1).

Ramlingam G. Ghent Criteria an Aid to Diagnose Latent Systemic Diseases in Marfan Syndrome. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH. 2015;

Isekame Y, Gati S, Aragon-Martin JA, Bastiaenen R, Kondapally Seshasai SR, Child A. Cardiovascular Management of Adults with Marfan Syndrome. European Cardiology Review. 2016;11(2):102.

Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ, et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2017 Sep 21;38(36):2739–91.

Isselbacher EM, Preventza O, Hamilton Black J, Augoustides JG, Beck AW, Bolen MA, et al. 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation. 2022 Dec 13;146(24).

Radke RM, Baumgartner H. Diagnosis and treatment of Marfan syndrome: an update. Heart. 2014 Sep;100(17):1382–91.

Freeman LA, Young PM, Foley TA, Williamson EE, Bruce CJ, Greason KL. CT and MRI Assessment of the Aortic Root and Ascending Aorta. American Journal of Roentgenology. 2013 Jun;200(6):W581–92.

Sutarjono B, Ahmed AJ, Ivanova A, Buchel B, Rauscher J, O’Connell A, et al. Diagnostic accuracy of transthoracic echocardiography for the identification of proximal aortic dissection: a systematic review and meta-analysis. Sci Rep. 2023 Apr 11;13(1):5886.

Dormand H, Mohiaddin RH. Cardiovascular Magnetic Resonance in Marfan syndrome. Journal of Cardiovascular Magnetic Resonance. 2013 Dec 15;15(1):33.




DOI: https://doi.org/10.33854/heme.v6i2.1485

Refbacks

  • There are currently no refbacks.


Creative Commons License   Health and Medical Journal This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.