PEMERIKSAAN FISIK JANTUNG

OLEH Dr. Asrizal, Sp.J Keluha Ja !u " #

$. &. (. +. -. .. 0. 2. 7. Sesa% apas Sa%i! 'a'a )er'e*ar U'e, )iru /lu*i " Fi "er Failure TD Rhri1e H3p45i6 Spell Fee'i " Di88i6ul!3

Pe,eri%saa Fisi% #
$. &. (. +. -. .. Kea'aa u,u, 9 Ta,pa% sa%i! Kesa'ara Te%a a Darah Na'i Suhu Per apasa

Na'i 9 Ar!erial Pulse #

A. Ra'ialis Fre%ue si $. )ra'i Kar'i : ; .< = &. Tahi Kar'i : > $<< = Ira,a Na'i $. N4r,al ? ?

Ira,a si us Ari!,ia Si us $. I spirasi &. E%spirasi

&. A* 4r,al $. A!rial Fi*rilasi &. E%s!ra Sis!4l ? Fre%ue ? Pulsus )i"e,i us ? Pulsus Tri"e,i us

A,pli!u'4 $. A,pli!u'4 Re 'ah ? Le,ah, Pu 6a% !u,pul, Re 'ah ? S!e 4sis a4r!a, Hip4!e si &. A,pli!u'4 Ti ""i ? Me i "%a! !i ""i, !uru 6epa! ? I su8isie si A4r!a Pulsus Seler

Isi Na'i Ter"a !u " Ju,lah Darah $. Pulsus Ma" us 9 Na'i 3a " *esar ? De,a, Ti ""i ? Ora " ,e "eluar%a !e a"a &. Pulsus Par1us : Na'i 3a " %e6il = ? Per'araha ? Dehi'rasi ? S!e 4sis A4r!a

Je is Lai # $. Pulsus Para'4%sus ? I spirasi Le,ah 9 hila " ? E%spirasi Ti,*ul %e,*ali ? Peri%ar'i!is K4 s!ri%!i1a ? E8usi Peri%ar'iu, &. Pulsus Al!er a ? De 3u! %ua! @ le,ah *er"a !ia ? Kerusa%a 4!4! Aa !u " Na'i Peri8er Lai # ? A. Fe,4ralis ? A. Ti*ialis P4s!eri4r ? A. P4pli!ea ? A. Duralis Pe'is ? A. /ar4!is

JUGULAR VENOUS PULSE ( JVP )

? ? ? ? ? B. Ju"ularis I !er a )er*ari " (< C +< Palpasi Pulsasi :?= ( Gel4,*a " U%ur JBP Ber!i%al su'u! s!er u, : Sa,*u "a i"a & 'e "a s!er u,

? ? ? ?

Te%a a Hi'r4s!a!i% 'i Aa !u " 9 A!riu, %a a N4r,al # +,- 6, /HF # > & 6, Re8lu% Hepa!4 Au"ular # De 3u!a 1e a a%a le*ih !i ""i Ai%a peru! 'i!e%a .

I.

Inspeksi Jantung
$. )e !u% pre%4r'iu, 9 *a"ia 'a'a 3a " 'i!e,pa!i pr43e%si Aa !u " /e%u " # Peri%ar'i!is ,e ahu A!ele%!asis Paru S%4li4sis 9 Ki84s%4li6 MD *4 A4l # Pe,*esara Ja !u " E8usi Peri%ar'iu, Pe 3a%i! Ja !u " )aEaa Tu,4r Paru

$. Ape%s Ja !u " ? )a"ia pali " i 8eri4r 9 la!eral, 3a " *er'e 3u! ? N4r,al, Si -, A"a% ,e'ial "aris ,i' 6la1i6ula ? Ja !u " *esar, Ape%s %eluar 'ari "aris ,i' 6la1i6ula ? )er"eser TOF, RBH, LBH S%4li4sis, Ki84s%uli4sis E8usi Pleura P eu,4 Th4ra%s

II.

Palpasi
Pe,eri%sa 'ise*elah %a a Pasie 'u'u% +- Me,a%ai !elapa% !a "a 9 UAu " Aari )ila ape%s :?= : "e,u%, e8usi peri%ar'iu, e,pise,a paru = > 'u'u%, Ea%!u e%spirasi )ila ape%s :?= De%s!r4 %ar'i De 3u! Ja !u " a. N4,al *. Ge!ara 9 Thrill )isi " Ja !u " 3a " sa "a! %eras 6. H3per 'i a,i6 : F Thrus!i " F = De 3u!a sa "a! %ua! Ou! Pu! *esar I su8isie si a4r!a 9 ,i!ral

'. Sus!ai e' : F Hea1i " F = De 3u!a %ua! S!e 4sis a4r!a, hiper!e si

III.

Perkusi
? ? Ma 8aa! 3a *er%ura ", *ila a'a 84!4 R4G !h4ra%s )erar!i pa'a # $. E8usi peri%ar'iu, &. A euris,a a4r!a (. Ga"al Ja !u "

IV.

Auskultasi
"$ Pe u!upa %a!up ,i!ral 'a !ri%uspi' 9 4 se! sis!4l Pa'a 'aerah ,i!ral 9 ape%s, )A $ le*ih %eras Pa'a 'aerah a4r!a 9 Pul,4 al, )A & le*ih %eras Si %r4 'e "a a'i %ar4!is N4r,al )A $ # Spli!!i " :?= I !e si!as )A $ P4sisi %a!up pa'a 4 se! sis!4l B4lu,e @ !e%a a 'arah ,elalui %a!up # ? Pr I !er1al ? Ke6epa!a pe u!upa %a!up ? M4*ili!as %a!up ? Ke%ua!a sis!4l ? Be !ri%el

a. )u 3i Ja !u " &. )u 3i Ja !u

Spli!i " S I Ti'a% si %r4 Be !ri%el %iri 9 %a a R))) ASD S!e 4sis !ri%uspi' E*s!ei Ds A 4,al3 &. )u 3i Ja !u " & # ? Pe u!upa %a!up a4r!a @ Pul,4 al ? AEal Dias!4l ? N4r,al, sp%i!i " :H=, %a!up a4r!a le*ih 'ulu K4,p4 e A # Hiper!e si sis!e,i% Da'a %urus :!ipis, pr43e%si a4r!a le*ih ,aAu =

K4,p4 K4,p4

e A # M4*ili!as %a!up !er*a!as :%alsi8i%asi= Dila!asi A4r!i6 R44! e Pul,4 al # Hiper!e si pul,4 al N4r,al, le*ih %eras pa'a i spirasi A* 4r,al, !e!ap : 8i5e' = ? ASD ? Ga"al Ja !u " Ka a ? Le8! T4 Ri"h! Shu !

Spli!!i " #

Re1erse' Spli!!i " K4,p4 e le*ih 'ulu $. L))) &. Pa6i " Si "le S & # Kalsi8i%asi %a!up pa'a s!e 4sis a4r!a S!e 4sis Pul,4 al TOF E8usi Peri%ar'iu, O*esi!as

(. )u 3i Ja !u " ( # ? AEal 'ias!4l ? Ka'a " !er'e "ar pa'a 4ra " 4r,al 'i*aEah +< !ahu ? A%i*a! F Rapi' Be !ri6ular Filli " F ? )erar!i # Fra%si EAe%si B4l Be !ri%el +. )u 3i Ja !u " + # )iasa 3a a* 4r,al, !i'a% !er"a !u " u,ur A%i*a! F Be !ri6ular Dis!e si*ili!3 F $. S!e 4sis A4r!a &. Pe 3a%i! Mi4%ar'iu, EAe6!i4 /li6% # Pa'a aEal, *isi " s!e 4sis a4r!a Pa'a s!e 4sis a4r!a 'i,a a %a!up a4r!a ,asih ,4*ile Ne"a!i8 $. Kalsi8i%asi %a!up a4r!a &. S!e 4sis supra 1al1al, su* 1al1al

Le*ih Aara " , eAe6!i4 6%i6% pa'a s!e 4sis pul,4 al

Ope i " S ap # Pa'a s!e 4sis ,i!ral 9 !ri%uspi', *ila %a!up ,asih ,4*ile Pre sis!4li% Gall4p # ? Seper!i ira,a %u'a *erlari ? Gall4p )J + : Fre%ue si !i ""i = ? $. Ga"al Ja !u " &. I 8ar% Mi4%ar' )aru Pr4!4 Dias!4li% Gall4p # ? Gall4p )J ( : Fre%ue si !i ""i = ? Ka'a " pa'a a a% 9 Ea i!a ha,il pa'a 'aerah ,i!ral ? $. Ga"al Ja !u " &. Peri%ar'i!is K4 s!ri%si1

BISING /

UR UR

$. L4%asi ? 'i%a!up I &. Pe Aalara (. Fase # $. Sis!4li% 9 Dias!4li% &. AEal, !e "ah?!e "ah, a%hir +. I !e si!as ? . DeraAa! # $. Le,ah se%ali &. Le,ah (. A"ar Keras +. /u%up Keras -. Keras .. Sa "a! Keras -. KEali!as ? Na'a re 'ah 9 !i ""i ? Halus 9 Kasar ? Seper!i !iupa a "i , *er"e,uruh. BISING SIS!OLI" $. S3s!4li6 EAe6!i4 ,ur,urs 9 S/M S!e 4sis A4r!a S!e 4sis Pul,4 al S%ler4sis A4r!a &. Pa S3s!4li6 Mur,urs 9 PSM I su8isie si ,i!ral I su8isie si !ri%uspi'

(. I 46e ! Mur,urs ? Kare a Fl4E Darah # Ha,il A e,ia Th3!r4!45i /4sis BISING #IAS!OLI" $. Earl3 Dias!4li6 Mur,urs 9 EDM I su8isie si A4r!a I su8isie si Pul,4 al &. Mi' Dias!4li6 Mur,urs 9 MDM S!e 4sis Mi!ral S!e 4sis Tri%uspi' (. La!e 9 Pre S3s!4li6 Mur,urs S!e 4sis Mi!ral 9 Tri%uspi' A!rial Fi*rilasi :?= S!E!OS"OP $ Me,*ra, # Na'a !i ""i )el # ? Na'a re 'ah ? MDM B S!e 4sis Mi!ral