pleno 2 cardiovaskuler
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7/25/2019 pleno 2 cardiovaskuler
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PLENO 2
CARDIOVASKULARKELOMPOK 08
DOKTER PEMBIMBING: dr.Resti Sp.PA
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Tuan ponirin 8 ta!un datan" #e RSBA$den"an #e%u!an n&eri dada #iri !e'at se(a#) (a* &an" %a%u. N&eri *en(a%ar #e 'a!u+tan"an #iri dan %e!er. Os *en"e%u!'erde'ar,de'ar+ 'er#erin"at din"in dan%e*as.
Dadaku sakit
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Tuan ponirin 8 ta!un Ke%u!an n&eri dada #iri !e'at Se(a# ) (a* &an" %a%u
N&eri *en(a%ar #e 'a!u+ tan"an #iri dan%e!er
Berde'ar,de'ar+ #erin"at din"in dan %e*as
Keyword
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Tuan ponirin 8 ta!un *en"e%u! n&eri dada#iri !e'at se(a# ) (a* &an" %a%u
Problem
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In-ar# *io#ard An"ina pe#toris Peri#arditis a#ut
DD
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Pe*eri#saan si#
TD: )0/0 **$"+ Nadi: 1 2/*enit+
Rr: 33 2/*enit
Pe*eri#saan EKG: e%e4asi se"*en ST5%ead 63,67
Pe*eri#saan en9i*: K,MB ; 71
ore i!"o
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Tuan ponirin 8 ta!un *en"e%u! n&eri dada#iri !e'at se(a# ) (a* &an" %a%u dise'a'#ano%e! in-ar# *io#ard a#ut
#i$otesa
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Lear!i!% Issue
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In-ar# Mio#ard A#ut 5IMA *erupa#an"an""uan a%iran dara! #e (antun" &an"*en&e'a'#an se% otot (antun" *ati. A%irandara! di pe*'u%u! dara! ter!enti sete%a!
ter(adi su*'atan #oroner a#ut+ #e
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Pada u*u*n&a didasari o%e! adan&aarteros#%erosis pe*'u%u! dara! #oroner.Ne#rosis *io#ard a#ut !a*pir se%a%u ter(adia#i'atan pen&u*'atan tota% arteri #oronariao%e! tro*'us &an" ter'entu# pada p%a#ateros#%erosis &an" tida# sta'i%+ (u"a serin"*en"i#uti ruptur p%a# pada arteri #oronerden"an stenosis rin"an.
E'IOLO(I IA
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Pato&siolo%i$iper#o%estero%
Lesi pada pe*'u%u!dara!
Tur'u%ensi a%iran dara!
A"re"asi tro*'osit
Ruptur tro*'us
Arteros#%erosis
Men&u*'at arteri
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In-ar# Mio#ard A#ut di#%asi#asi#an 'erdasarEKG )3 sandapan *en(adi :
, In-ar# *io#ard a#ut ST,e%e4asi 5STEMI : o#%usitota% dari arteri #oroner &an" *en&e'a'#an
area in-ar# &an" %e'i! %uas *e%iputi se%uru!#ete'a%an *io#ardiu*+ &an" ditandai den"anadan&a e%e4asi se"*en ST pada EKG.
, In-ar# *io#ard a#ut non ST,e%e4asi 5NSTEMI :
o#%usi se'a"ian dari arteri #oroner tanpa*e%i'at#an se%uru! #ete'a%an *io#ardiu*+se!in""a tida# ada e%e4asi se"*en ST padaEKG.
Klasi&kasi IA
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Dia"nosis IMA den"an e%e4asi se"*en STdite"a##an 'erdasar#an ana*nesis n&eridada &an" #!as dan "a*'aran EKG adan&ae%e4asi ST >3 **+ *ini*a% pada 3sandapan pre#ordia% &an" 'erda*pin"anatau >) ** pada 3 sandapan e#stre*itas.Pe*eri#saan en9i* (antun" teruta*atroponin T &an" *enin"#at a#an*e*per#uat dia"nosis
Dia%!osis IA
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) O#si"en : sup%e*en o#si"en !arus di'eri#an adapasien den"an saturasi o#si"en ?0. Pada se*uapasien STEMI tanpa #o*p%i#asi dapat di'eri#ano#si"en se%a*a 1 (a* perta*a. )7
3 Nitro"%iserin : Nitro"%iserin su'%in"ua% dapatdi'eri#an den"an a*an den"an dosis 0+7 *" dandapat di'eri#an sa*pai @ dosis den"an inter4a% *enit.
, Morn : san"at e-e#ti- da%a* *en"uran"i n&eridada dan *erupa#an ana%"esi# pi%i!an da%a*tata%a#sana STEMI. Morn dapat di'eri#an den"andosis 3,7 *" dan dapat diu%an" den"an inter4a% ,) *enit sa*pai dosis tota% 30 *".
'atalaksa!a
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, Aspirin : *erupa#an tata%a#sana dasar pada pasien &an" di 10 #a%i per*enit+
te#anan dara! sisto%i# > )00 **$"+ inter4a% PR ? 0+37 deti# danron#i tida# %e'i! dari )0
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) Dis-un"si 6entri#u%ar3 Gan""uan $e*odina*i#
@ S&o# #ardio"eni#
7 In-ar# 4entri#e% #anan
Arit*ia pas#a STEMI1 E#strasisto% 4entri#e%
i'ri%asi 4entri#e%
8 i'ri%asi atriu* Arit*ia supra4entri#u%ar
Kom$likasi
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eka!ismeLa#i,%a#i 8 t!
N&eri dada!e'at
INARK MIOKARDAKT
P2.si#TD :)0/0**!"
RR :332/*enitNadi :12/*enit
Penata%a#sanaan
Ana*nesisN&eri dada !e'at*en(a%arSe(a# ) (a*Kerin"at din"inBerde'ar,de'ar
Pro"nosis
P2.penun(an"EKG: e%e4asise"*en ST %ead63,67En9i* KMB:71
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$ipotesa ter'u#ti Tuan ponirin 8 ta!un*en"e%u! n&eri dada #iri !e'at se(a# ) (a*&an" %a%u dise'a'#an o%e! in-ar# *io#arda#ut
Kesim$ula!
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'erima kasi*
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