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NYERI DADA

BADAI BHATARA TIKSNADI, dr., SpJP, MM

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PEMBAHASAN

1. Pendekatan diagnosis pada Nyeri Dada

2. Tatalaksana awal pasien nyeri dada

3. Penyakit terkait gejala

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1. PENDEKATAN DIAGNOSIS NYERI

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NYERI DADA

5-20% of all EMG admissions

Benign & self-limited serious or life threatening

Establish accurate diagnosis effective treatment

Martínez-Sellés M, et al. Chest pain in the emergency department: incidence, clinical charac

risk stratification. Rev Esp Cardiol. 2008;61(9):953-9.

Ebell MH. Evaluation of chest pain in primary care patients. Point-Of-Care Guides. 2011;83(5

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DD/ NYERI DADA

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DD/ NYERI

DADA

Agostini-Miranda AA, Crown LA. An approach to the initial care of patients with chest pain in an emergenlocated in a non-cardiac center. amjmed. 2009;6(1):24-8.

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EPIDEMIOLOGI

Cayley WE. Diagnosing the cause of chest pain. Am Fam Physician. 2005;72 (10):2012

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ALUR DIAGNOSIS NYERI DADA

Anamnesis

• Karakteristik nyeri dada

• Riwayat penyakit

• Riwayat obat, family history , sosial

Pemeriksaan fisik• Inspeksi

• Sistem kardiovaskular

• Sistem respirasi

• Sistem GI

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ALUR DIAGNOSIS NYERI DADA

Investigasi / Penunjang

• EKG

• Pemeriksaan darah

• Toraks foto

• Ekokardiografi

• CT Scan

• V/Q scan

• Exercise test

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KARAKTERISTIK NYERI DADA

Provokes

Q

RadiateSeverity

Time

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HISTORY TAKING PHYSICAL FINDINGS

McConaghy JR. Outpatient diagnosis of acute chest pain in adults. Am Fam Physician. 2013;8

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HISTORY TAKING PHYSICAL FINDINGS

McConaghy JR. Outpatient diagnosis of acute chest pain in adults. Am Fam Physician. 2013;8

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ECG

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CXR

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LAB EXAM

CKMB

Troponin

ACSD-dim

PE

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CT-SCAN

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Tes treadmill

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2. TATALAKSANA AWAL NYERI D

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4/5/2016 copyright 2006 www.brainybetty.com

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3. PENYAKIT TERKAIT GEJALA

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SindromaKoroner AKut Kardiovask

Muskuloskeletal

PerikarditisakutParu

EmboliParu

GERD GITDiseksiaorta

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Sindroma

Koroner Akut

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CAD

Endothelial dysfunction

Risk Factors

Dyslipidemia , BP, DM, Insulin Resistance,

Platelets, Fibrinogen, etc

Adapted from

Dzau et al. Am Heart J. 199

plaque

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CAD

Endothelial dysfunction

Risk Factors

Dyslipidemia , BP, DM, Insulin Resistance,

Platelets, Fibrinogen, etc

Adapted from

Dzau et al. Am Heart J. 199

Myocardial 

Ischemia

plaque

STABLE ANGINA

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CAD

Endothelial dysfunction

Risk Factors

Dyslipidemia , BP, DM, Insulin Resistance,

Platelets, Fibrinogen, etc

Adapted from

Dzau et al. Am Heart J. 199

Myocardial 

Ischemia

plaque

STABLE ANGINA

UNSTABLE P

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Adapted from

Dzau et al. Am Heart J. 199

CAD

Endothelial dysfunction

Risk Factors

Dyslipidemia , BP, DM, Insulin Resistance,

Platelets, Fibrinogen, etc

Myocardial 

Ischemia

Co

thro

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GERD

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Perikarditis

Akut

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Emboli Paru

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Diseksi Aorta

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THANK YOU