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Skill Lab Cath & Echo
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ApakahKateterisasi Koroner ?
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Primary PCI in AMI
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Predilation
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Stent Positioning
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Stent Deployment
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Successful Primary PCI
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Primary PCI- RCA
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PCI (Percutaneous Coronary Intervention)
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Apakah PTCA Koroner ?
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Apakah Stent ?
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Contoh Kasus I
Tn A
Usia 50 tahun
Perokok
Tekanan Darah Tinggi
(150/90 mmHg) Gemuk
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Primary PCI
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Pengembangan Balon
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Peletakan Stent
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Pengembangan Stent
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Successful Primary PCI
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Contoh Kasus II
Tn B
Pensiunan
Usia 67 tahun Penderita Kencing manis
Tekanan Darah Tinggi
(160/90 mmHg) Kolesterol Tinggi
Jarang Olahraga
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Diffuse LCA
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99% stenosis RCA
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Pengembangan Stent
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Contoh Kasus III
Ny Z, 35 tahun
Sering nyeri dada
Batu ginjal rencana operasi
Dikonsulkan ke Heart Center
EKG tanda iskemik Anjuran Kateterisasi Koroner
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Fistula
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Coil
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Contoh Kasus IV
Tn C
Usia 64 tahun
Merokok Tekanan Darah Tinggi
Kolesterol Tinggi
Pusing Bunyi bising di leher
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A severe tandem
stenosis of the
right internalcarotid artery
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Penyempitan Pembuluh Darah Leher
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Hasil Akhir
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Angioplasty (stent)
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Echocardiography
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Treadmill Stress Test
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TILT TABLE TEST
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Holter Monitoring
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C di i
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Cardioversion
Cardioversion
Chemical
Anti-Arrhythmias
Electrical
DC-Cardioversion
C di i
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CardioversionElectrical cardioversion (="direct-current" or DC cardioversion)
A procedure whereby a synchronized (perfectly timed) electrical
shock is delivered through the chest wall to the heart throughspecial electrodes or paddles that are applied to the skin of the chest
and back .
The goal of the cardioversion
To disrupt the abnormal electrical circuit(s) in the heart and
to restore a normal heart beat.
The shock causes all the heart cells to contract simultaneously,
thereby interrupting and terminating the abnormal electrical rhythm
(typically fibrillation of the atria) without damaging the heart.
This split second interruption of the abnormal beat allows
the heart's electrical system to regain control and restore a normal
heartbeat.
EPS
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EPS
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DSCT/MDCT/MSCT
Cardiac CT-Indications
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C C
1. Exclusion of coronary artery disease in the low to intermediate
risk patientIt is the best test that is now available with a
negative predictive value approaching 100%. It canvisualize early disease before it is detectable on cardiac
catheterization. It may be used to clear patients for surgery
instead of stress testing. Screening is controversial and
not supported by peer reviewed literature.
2. Evaluation for cardiac/pericardial anatomic abnormalities
including masses, thrombus, etc.
3. Triple rule out study for chest pain and can evaluate for other
causes of chest pain
4. Evaluate status of bypass grafts and stentsare they open? CT
may not be able to fully assess in stent stenosis and grafts
with metal clip artifacts.5. Evaluate wall motion and valve functionthis information
comes with extra reconstructions and post processing.
Cardiac MRI takes more imaging time but offers superior
capability and without radiation.
6. Detect anomalies including myocardial bridging
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Cardiac CT for Arrhythmias
C
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Cardiac MRI
Cardiac MRI- Indications
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Quantifying left and right ventricular function
Cardiomyopathy
Heart failure
Arrythmogenic right ventircular dysplasia (ARVD) Pulmonary hypertension Defining cardiac anatomy
Constrictive pericarditis
Cardiac neoplasm or thrombus
Congenital heart disease
Demonstrating the presence of a patent foramen ovale (PFO)Myocardial Perfusion:
for suspected ischemic heart disease (e.g. angina)
Quantifying blood flow
Valvular disease (e.g. aortic regurgitation,mitral regurgitation,
aortic stenosis, etc.) Shunts: ASD, VSD, PAPVR, and PDA
Assessing myocardial scar / viability
Identifying hibernating myocardium before revascularization
Differentiating cardiomyopathy from old myocarditis
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