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Haji General Hospital Surabaya
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“There is a disorder of the breast, marked with st rong and pecul iar
symptom s, cons iderable for the k ind of danger belonging
to it , and no t extremely rare, of wh ich I do not recol lectany m ent ion among
medical authors. The seat of i t , and sense of st rangl ing and anxiety wi th
wh ich i t is at tended, may make i t not impro per ly be called angina
pectoris....”
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common complaint
life threatening
Chest pain
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• Tabel 1. Cardiac and Noncardiac Causes of Chestpain
• Cardiac Causes
• Ischemic
• Angina
• Myocardial Infarction
•
Aortic Stenosis• Hyperthrophic cardiomyopathy
• Coronary vasospasm
• Non ischemic
• Pericarditis
• Aortic dissection
• Mitral valve prolapse
•
Differentiating Cardiac non Cardiac
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Noncardial causes
Gastroesophageal
Reflux esophagitis
Esophageal Gastritis
Peptic ulcer
Pulmonary
Pneumothorax
Pulmonary embolism
Pleuritis
NeoplasmBronchitis
Musculoskeletal
Costochondritis
Rib fracture
Compression radiculopathy
Dermatologic
Herpes zoster
Karnath,et al. Review of clinical signs. Hospital physician.2004
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ANGINA PECTORIS
The initial assessment requires a focused history (including
risk factor analysis), a physical examination, an
electrocardiogram, and frequently serum cardiac markers
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ANAMNESA
•
character/CircumstanceTabel 2
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Gambar 1
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Tabel 3. Tabel 4.
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Exacerbating/Alleviating Factors
Exercise, activity
Take a rest, drugs
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Canadian Cardiovascular Society Functional Classification of Angina
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> Pattern: acute or chronic,contanstan or intermitten,
frequency,accelerating> Onset: sudden, gradual
> Duration of episode of problem, change in duration
> Why is patient coming now
Timing
Relevant past medical history
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Relevant social history
• Alcohol, tobaco, or illiit drugs (cocaine)
Relevant family history
Impact patient perception of the problem , not add to
diagnosis
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Physical Examination
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Serum Cardiac Biomarkers
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