Rizky Adriansyah

Rizky AdriansyahLangsa, 19 Mei 1979

PendidikanS1 FK USU : lulus tahun 2001Pendidikan Profesi Dokter FK USU: lulus tahun 2002S2 Ilmu Kesehatan Anak FK USU: lulus tahun 2010Pendidikan Dokter Spesialis Anak FK USU: lulus tahun 2011

PekerjaanDokter PTTT / Kepala Puskesmas Nusajaya, Kabupaten Halmahera Timur, Provinsi Maluku Utara, 2003 - 2005Staf Dinas Kesehatan Provinsi SumateraStaf Divisi Kardiologi, Departemen Ilmu Kesehatan AnakHeart Diseases in Children:An IntroductionRizky AdriansyahApproach to Heart Diseases in ChildrenBasic Tools in Routine Evaluation

History Taking and Physical ExaminationCardiac Interpretation of Pediatric Chest X-RayPediatric Electrocardiography

Special ToolsPediatric EchocardiographyPediatric Cardiac CatheterizationPediatric Heart DiseasesCongenital Heart Diseases

Acyanotic CHDs (Left to Right Shunt)Ventricular Septal Defect (VSD)Atrial Septal Defects (ASD)Patent Ductus Arteriosus (PDA)Atrioventricular Septal Defect (AVSD)Pulmonary Stenosis (PS)Aortic Stenosis (AS)Coarctation Aorta (CoA), etc

Cyanotic CHDs (Right to Left Shunt)Tetralogy of Fallot (TOF)Transposition of the Great Arteries (TGA), etcPediatric Heart DiseasesAcquired Heart Diseases

Rheumatic Fever and Rheumatic Heart Disease (RHD)Kawasaki DiseaseCardiovascular infectionsCardiomyopathyCardiac ArrhythmiasCardiac Involvement in Systemic Diseases, etc

Special Problems

Pediatric Heart FailurePediatric Hypertension, etcSelected Aspects of History TakingGESTATIONAL AND NATAL HISTORY Infections, medications, excessive smoking or alcohol intake during pregnancy; Birth weight

POSTNATAL, PAST AND PRESENT HISTORY Weight gain, development, and feeding patternCyanosis, cyanotic spells, and squattingTachypnea, dyspnea, puffy eyelidsFrequency of respiratory infectionExercise intolerance; Heart murmurChest pain; Syncope; Palpitations; Joint symptoms; Neurologic symptoms; Medications

FAMILY HISTORY Hereditary disease; Congenital heart defect; Rheumatic fever; Sudden unexpected death; Diabetes mellitus, arteriosclerotic heart disease, hypertension, and so onDisordersCV Abnormalities: Frequency and TypesMajor FeaturesEtiologyDown syndrome (trisomy 21)Frequent (40%50%); ECD, VSDHypotonic, flat facies, slanted palpebral fissure, small eyes, mental deficiency, simian creaseTrisomy 21Fetal alcohol syndromeOccasional (25%30%); VSD, PDA, ASD, TOFPrenatal growth retardation, microcephaly, short palpebral fissure, mental deficiency, irritable infant or hyperactive childEthanol or its byproductsInfant of diabetic motherCHDs (3%5%); TGA, VSD, COA; cardiomyopathy (10%20%); PPHNMacrosomia, hypoglycemia and hypocalcemia, polycythemia, hyperbilirubinemia, other congenital anomaliesFetal exposure to high glucose levelsMajor Syndromes Associated with Cardiovascular AbnormalitiesDisordersCV Abnormalities: Frequency and TypesMajor FeaturesEtiologyLong QT syndrome:Very common; long QT interval onCongenital deafness (not in Romano-Ward syndrome), syncope resulting from ventricular arrhythmias, family history of sudden death ()Marfan syndromeFrequent; aortic aneurysm, aortic and/or mitral regurgitationArachnodactyly with hyperextensibility, subluxation of lensADNoonan's syndrome (Turner-like syndrome)Frequent; PS (dystrophic pulmonary valve), LVH (or anterior septal hypertrophy)Similar to Turner's syndrome but may occur in phenotypic male and without chromosomal abnormalityUsually sporadicMajor Syndromes Associated with Cardiovascular AbnormalitiesDisordersCV Abnormalities: Frequency and TypesMajor FeaturesEtiologyOsteogenesis imperfectaOccasional; aortic dilatation, aortic regurgitation, MVPExcessive bone fragility with deformities of skeleton, blue sclera, hyperlaxity of jointsAD/ARRubella syndromeFrequent (>95%); PDA and PA stenosisTriad of the syndrome: deafness, cataract, and CHDs. Others include intrauterine growth retardation, microcephaly, microphthalmia, hepatitis, neonatal thrombocytopenic purpuraMaternal rubella infection during the first trimesterMajor Syndromes Associated with Cardiovascular AbnormalitiesDisordersCV Abnormalities: Frequency and TypesMajor FeaturesEtiologyTrisomy 13 syndrome (Patau's syndrome)Very common (80%); VSD, PDA, dextrocardiaLow birth weight, central facial anomalies, polydactyly, chronic hemangiomas, low-set ears, visceral and genital anomaliesTrisomy 13Trisomy 18 syndrome (Edwards' syndrome)Very common (90%); VSD, PDA, PSLow birth weight, microcephaly, micrognathia, rocker-bottom feet, closed fists with overlapping fingersTrisomy 18Major Syndromes Associated with Cardiovascular AbnormalitiesDisordersCV Abnormalities: Frequency and TypesMajor FeaturesEtiologyVATER association (VATER/VACTERL syndrome)Common (>50%); VSD, other defectsVertebral anomalies, anal atresia, congenital heart defects, tracheoesophageal (TE) fistula, renal dysplasia, limb anomalies (e.g., radial dysplasia)SporadicEtcMajor Syndromes Associated with Cardiovascular AbnormalitiesOrgan System and MalformationFrequency (Range) (%)Specific Cardiac DefectsCentral Nervous SystemHydrocephalus6 (4.514.9)VSD, ECD, TOFDandy-Walker syndrome3 (2.54.3)VSDAgenesis of corpus callosum15No specific defectsMeckel-Gruber syndrome14No specific defectsThoracic CavityTE fistula and/or esophageal atresia21 (1539)VSD, ASD, TOFDiaphragmatic hernia11 (9.622.9)No specific defectsGastrointestinalDuodenal atresia17No specific defectsJejunal atresia5No specific defectsAnorectal anomalies22No specific defectsImperforate anus12TOF, VSDVentral WallOmphalocele21 (1932)No specific defectsGastroschisis3 (07.7)No specific defectsGenitourinaryRenal agenesisBilateral43No specific defectsUnilateral17No specific defectsHorseshoe kidney39No specific defectsRenal dysplasia5No specific defectsPrevalence of Associated Congenital Heart Defects in Patients with Other System Malformations