acute coronary syndrome
DESCRIPTION
SlidesTRANSCRIPT
![Page 1: Acute Coronary Syndrome](https://reader035.vdocuments.net/reader035/viewer/2022070414/55cf96a3550346d0338cd268/html5/thumbnails/1.jpg)
Powerpoint TemplatesPage 1
Powerpoint Templates
Pembimbing:dr. Adi Purnawarman, Sp.JP, FIHA
ACUTE CORONARY SYNDROME (ACS)
YUDI PRATAMA0907101010065
Presentasi Referat
![Page 2: Acute Coronary Syndrome](https://reader035.vdocuments.net/reader035/viewer/2022070414/55cf96a3550346d0338cd268/html5/thumbnails/2.jpg)
Powerpoint TemplatesPage 2
DEFINISI
• Sindrom koroner akut (SKA) adalah keadaan gangguan aliran darah koroner parsial hingga total ke miokard secara akut.
• Sindrom koroner akut dibagi berdasarkan gambaran EKG, yaitu: dengan elevasi segmen ST (STEMI) dan tanpa elevasi segmen ST (NSTEMI) atau angina pectoris tidak stabil
![Page 3: Acute Coronary Syndrome](https://reader035.vdocuments.net/reader035/viewer/2022070414/55cf96a3550346d0338cd268/html5/thumbnails/3.jpg)
Powerpoint TemplatesPage 3
Faktor Resiko Yang Tidak Dapat
Dimodifikasi
Faktor Resiko Yang Dapat Dimodifikasi
•Jenis kelamin •Usia•Genetik
•Merokok •Hipertensi•Obesitas•Dislipidemia•Kurang aktivitas fisik
FAKTOR RESIKO
![Page 4: Acute Coronary Syndrome](https://reader035.vdocuments.net/reader035/viewer/2022070414/55cf96a3550346d0338cd268/html5/thumbnails/4.jpg)
Powerpoint TemplatesPage 4
PATOFISIOLOGI
![Page 5: Acute Coronary Syndrome](https://reader035.vdocuments.net/reader035/viewer/2022070414/55cf96a3550346d0338cd268/html5/thumbnails/5.jpg)
Powerpoint TemplatesPage 5
Risk Factor
Endothelial dysfunction
CAD
IschemiaMI
Remodeling
Progresif dilatation
Heart FailureDeath
PERJALANAN PENYAKIT PADA PJK
![Page 6: Acute Coronary Syndrome](https://reader035.vdocuments.net/reader035/viewer/2022070414/55cf96a3550346d0338cd268/html5/thumbnails/6.jpg)
Powerpoint TemplatesPage 6
SINDROM KORONER AKUT
Non ST Elevasi ST Elevasi
KLASIFIKASI
NSTEMIUAP STEMI
![Page 7: Acute Coronary Syndrome](https://reader035.vdocuments.net/reader035/viewer/2022070414/55cf96a3550346d0338cd268/html5/thumbnails/7.jpg)
Powerpoint TemplatesPage 7
1. UAP/NSTEMI
• Angina pectoris tidak stabil adalah keadaan pasien dengan symptom iskemi sesuai SKA, tanpa terjadi peningkatan enzim petanda jantung (CK-MB, troponin) dengan atau tanpa perubahan EKG yang menunjukan iskemia (depresi segmen ST, inverse gelombang T dan elevasi segmen ST yang transien)
• Infark miokard tanpa elevasi segmen ST (NSTEMI) adalah keadaan pasien dengan manifestasi sama seperti UAP, tetapi disertai peningkatan enzim petanda jantung
![Page 8: Acute Coronary Syndrome](https://reader035.vdocuments.net/reader035/viewer/2022070414/55cf96a3550346d0338cd268/html5/thumbnails/8.jpg)
Powerpoint TemplatesPage 8
2. STEMI
• Infark miokard dengan elevasi segment ST (STEMI) merupakan bagian dari spektrum SKA yang menggambarkan cedera miokard transmural, akibat oklusi total arteri koroner oleh trombus.
![Page 9: Acute Coronary Syndrome](https://reader035.vdocuments.net/reader035/viewer/2022070414/55cf96a3550346d0338cd268/html5/thumbnails/9.jpg)
Powerpoint TemplatesPage 9
LOKASI NYERI INFARK MIOKARD
![Page 10: Acute Coronary Syndrome](https://reader035.vdocuments.net/reader035/viewer/2022070414/55cf96a3550346d0338cd268/html5/thumbnails/10.jpg)
Powerpoint TemplatesPage 10
• Anamnesis
• Pemeriksaan Fisik
• EKG
• Biomarker
DIAGNOSIS
![Page 11: Acute Coronary Syndrome](https://reader035.vdocuments.net/reader035/viewer/2022070414/55cf96a3550346d0338cd268/html5/thumbnails/11.jpg)
Powerpoint TemplatesPage 11
• Hipotensi
• Keringat dingin
• Takikardi-bradikardi
• Ronki di lapangan paru
• Edema paru
Pemeriksaan Fisik
![Page 12: Acute Coronary Syndrome](https://reader035.vdocuments.net/reader035/viewer/2022070414/55cf96a3550346d0338cd268/html5/thumbnails/12.jpg)
Powerpoint TemplatesPage 12
• Identifikasi dalam 10 menitElevasi segmen STDepresi segmen STInversi gelombang TLeft bundle beanch blok (Baru )Q Wave
EKG
![Page 13: Acute Coronary Syndrome](https://reader035.vdocuments.net/reader035/viewer/2022070414/55cf96a3550346d0338cd268/html5/thumbnails/13.jpg)
Powerpoint TemplatesPage 13
![Page 14: Acute Coronary Syndrome](https://reader035.vdocuments.net/reader035/viewer/2022070414/55cf96a3550346d0338cd268/html5/thumbnails/14.jpg)
Powerpoint TemplatesPage 14
Lanjutan…..
Lokasi infark Gelombang Q, elevasi ST(sadapan)
Arteri koroner
Anteroseptal V1 dan V2 Left anterior descending (LAD)
Anterior V3 dan V4 Left anterior descending (LAD)
Anteriorekstensif V1-V6 Left anterior descending (LAD), Left circumflex (LC)
High-lateral I, aVL, V5 dan V6 Left circumflex (LC)
Posterior V7-V9 Left circumflex (LC) Posterior Left Ventricular Artery (PL)
Inferior II, III, dan aVF Posterior descending Artery (PDA)
Right ventrikel V2R-V4R Right coronary artery (RCA)
![Page 15: Acute Coronary Syndrome](https://reader035.vdocuments.net/reader035/viewer/2022070414/55cf96a3550346d0338cd268/html5/thumbnails/15.jpg)
Powerpoint TemplatesPage 15
Biomarker (enzim jantung)
![Page 16: Acute Coronary Syndrome](https://reader035.vdocuments.net/reader035/viewer/2022070414/55cf96a3550346d0338cd268/html5/thumbnails/16.jpg)
Powerpoint TemplatesPage 16
![Page 17: Acute Coronary Syndrome](https://reader035.vdocuments.net/reader035/viewer/2022070414/55cf96a3550346d0338cd268/html5/thumbnails/17.jpg)
Powerpoint TemplatesPage 17
• Pada STEMI
Penilaian Stratifikasi Risiko
![Page 18: Acute Coronary Syndrome](https://reader035.vdocuments.net/reader035/viewer/2022070414/55cf96a3550346d0338cd268/html5/thumbnails/18.jpg)
Powerpoint TemplatesPage 18
• Pada NSTEMI
![Page 19: Acute Coronary Syndrome](https://reader035.vdocuments.net/reader035/viewer/2022070414/55cf96a3550346d0338cd268/html5/thumbnails/19.jpg)
Powerpoint TemplatesPage 19
Kelas Killip Mortalitas RS (%)
I. Tidak ada tanda CHF 6
II. HF ringan, Ronki, S3, distensi vena jugularis
17
III. Edema Paru 38
IV. Syok kardiogenik 81
Skor Killip
![Page 20: Acute Coronary Syndrome](https://reader035.vdocuments.net/reader035/viewer/2022070414/55cf96a3550346d0338cd268/html5/thumbnails/20.jpg)
Powerpoint TemplatesPage 20
Nyeri dada Hubungi RS
HOSPITAL
Cath LabPREHOSPITAL
Delay in Initiation of Reperfusion Therapy
Increasing Loss of Myocytes
PenatalaksanaanPenatalaksanaan
![Page 21: Acute Coronary Syndrome](https://reader035.vdocuments.net/reader035/viewer/2022070414/55cf96a3550346d0338cd268/html5/thumbnails/21.jpg)
Powerpoint TemplatesPage 21
Penatalaksanaan
![Page 22: Acute Coronary Syndrome](https://reader035.vdocuments.net/reader035/viewer/2022070414/55cf96a3550346d0338cd268/html5/thumbnails/22.jpg)
Powerpoint TemplatesPage 22
Powerpoint Templates
TERIMA KASIH