BUKU KEGIATAN PESERTA PPDS

( LOG BOOK )

STASE PENCITRAAN KARDIOLOGI

Nama PPDS : Tommy Daindes

No BP : 1450311202
Periode : 16 Mei 2018 – 30 Juni 2018

PROGRAM STUDI PENDIDIKAN PROFESI DOKTER SPESIALIS

ILMU PENYAKIT JANTUNG DAN PEMBULUH DARAH
BAGIAN KARDIOLOGI DAN KEDOKTERAN VASKULAR
FAKULTAS KEDOKTERAN UNIVERSITAS ANDALAS
RSUP DR. M. DJAMIL PADANG
2018

1
PENILAIAN :

Afektif / atitude
1 Kecermatan kerja
2 Disiplin kerja
3 Tanggung jawab
4 Etik kedokteran
5 Perilaku
6 Komunikasi dan empati

*Note : sesuai kebutuhan

Evaluasi Hasil Pendidikan :
1 Pengetahuan dan pemahaman
2 Pemecahan masalah dan pengambilan keputusan klinik
3 Keterampilan klinik
4 Keterampilan teknik/prosedur
5 Keterampilan Interpersonal
6 Sikap dan kebijaksanaan kerja profesional

Dalam melakukan penilain di gunakan pedoman sebagai berikut :

ANGKA NILAI MUTU MARKAH INTERPRETASI

88-100 4.0 A Baik Sekali

80-87 3.5 B+ Baik

70-79 3.0 B
65-69 2.5 C+ Cukup
60-64 2.0 C
52-59 1.5 D+ Kurang
45-51 1.0 D
0-44 0 E Kurang sekali

IPK Predikat
3.00-3.49 Memuaskan
3.50-3.74 Sangat Memuaskan
3.75-4.00 Dengan Pujian (Cum Laude)

Note : Sistem penilaian meliputi

1. Pengamatan sehari-hari ( observasi )
2. Pengamatan sewaktu ( ujian tulis dan lisan )

SUB BAGIAN KARDIOLOGI NUKLIR

2
Nama PPDS : Tommy Daindes
Rumah Sakit : RSUP Dr. M. Djamil Padang Tanggal : 16 Mei – 30 Juni 2018
Modul : Kardiologi Nuklir Tahap : Pertama
Staf Pengajar : dr Manoefris Kasim SpJP,SpKN Semester :8
dr Celly Anantaria A SpJP
dr Elen SpJP

Tindakan/ prosedur yang dikerjakan Jumlah Jumlah Tingkat Capaian

Minimal Optimal Kompetensi
1 Menginterpretasi kardiologi nuklir 10 50 II
2 Menginterpretasi MR kardiovaskular 0 10 I
3 Menginterpretasi CT kardiovaskular 10 50 II

Kegiatan akademik/ Ilmiah Melakukan

1 Pre Test 1
2 Journal reading
3 Referat kecil
4 Case presentation)
5 Diskusi kasus/bedside Tak terbatas
6 Penelitian di modul Peminatan
7 Post test 1

3
Lampiran 1 :
Pengelolaan Pasien (SPECT)

Tanda Tangan
No Nama Pasien Kasus/ Penyakit Staf Pengajar
1 Asnari Ischemic burden sebanyak 2,5% LCx dan RCA territory
2 Sony M Tidak ada ischemic burden
3 Suherman Ischemic burden sebanyak 6,25 % di LAD teritory
4 Lukman Ischemic burden sebanyak 3,75% di LAD dan RCA
territory
5 Mirc Pierre Louis Ischemic burden sebanyak 21,25% di LAD, LCx dan
RCA territory
6 Suzanne Indrawati Ischemic burden sebanyak 7,5% di LAD territory
7 Hioe Pudjadi Ischemic burden sebanyak 1,25% di LCx territory
8 Freddyyanto Sajuti Tidak ada ischemic burden
9 Supriyatin Ischemic burden sebanyak 25% di LAD, LCx dan RCA
territory
10 Sumuang Tidak ada ischemic burden
11 Yati Ischemic burden sebanyak 1,25% di LAD territory
12 Gumay Ischemic burden sebanyak 6,75% di LAD dan RCA
territory
13 Ahmad lemi Ischemic burden sebanyak 12,5% di LAD, LCx dan RCA
territory
14 Asnari Ischemic burden sebanyak 2,5% LCx dan RCA territory
15 Broto Widiyoko Ischemic burden sebanyak 2,5% di RCA territory
16 Budi Nurani Tidak ada ischemic burden, balanced ischemic belum
dapat disingkirkan
17 Diah Hadianto Ischemic burden sebanyak 2,5 % di LAD dan LCx
territory
18 Eka Haji Sihoting Ischemic burden sebanyak 11,25% di LAD, LCx dan
RCA territory
19 Erwin Wahyudi Ischemic burden sebanyak 2,5% di RCA territory
20 Hermyda M Ischemic burden sebanyak 1,25% di RCA territory
21 Lina Lingga Ischemic burden sebanyak 3,75% di LAD territory
22 Mangiman Siregar Ischemic burden sebanyak 3,75% di LCx/ RCA territory
23 Mashadi Ischemic burden sebanyak 15% di LAD, LCx dan RCA
territory
24 Meriana Sitompul Ischemic burden sebanyak 8,75% di LCx territory
25 Muharso Ischemic burden sebanyak 2,5 % di LAD dan LCx
territory
26 Muprin Ischemic burden sebanyak 15% di LAD, LCx dan RCA
territory
27 Tiramin Aritonang Ischemic burden sebanyak 16,25% di LAD, LCx dan
RCA territory
28 Tjhin Mie Yoen Tidak ada ischemic burden
29 Ratna Juita Ischemic burden sebanyak 7,5% di LAD dan LCx
territory
30 Rhenald Kasali Mild hypokinesia di anteroseptal, normal LV function
EF 67%, ischemic burden 5% di LAD territory
31 Suastini Ischemic burden sebanyak 2,5% di LAD dan LCx
territory
32 Merah Erman Ischemic burden sebanyak 12,5% di LAD, LCx dan RCA
territory

4
33 Milono Samuel Ischemic burden sebanyak 8,75% di LAD dan RCA
territory
34 Suharto Tjahja Ischemic burden sebanyak 5% di LAD dan LCx territory
35 Soerono Akbar Ischemic burden sebanyak 7,5% di LAD dan LCx
territory
36 Yakob Tangkin Ischemic burden sebanyak 7,5% di LAD, LCx dan RCA
territory
37 Ai Maryam Ischemic burden sebanyak 3,75% di LAD dan LCx
territory
38 Tjhin Tjhai Moi Ischemic burden sebanyak 15% di LAD dan LCx
territory
39 Bunawi Suparman Tidak ada ischemic burden
40 Dian Medy Ischemic burden sebanyak 15% di LAD, LCx dan RCA
territory.
41 Peng King Liong Ischemic burden sebanyak 2,5% di LCx dan RCA
territory
42 Uberson Ischemic burden sebanyak 3,75% di LAD dan LCx
territory
43 Henny Irsan Ischemic burden sebanyak 7,5% di LAD dan LCx
territory
44 Wirdawati Ischemic burden sebanyak 3,75% di LCx territory
45 Aden Gultom Ischemic burden sebanyak 16,25% di LAD, LCx dan
RCA territory
46 Basmi Sarman Ischemic burden sebanyak 7,5% di LAD dan LCx
territory
47 Nugroho Ischemic burden sebanyak 15% di LAD dan LCx
territory
48 Saadah Ischemic burden sebanyak 8.75% di LAD, LCx dan RCA
territory
49 Arief Ahmad Ischemic burden sebanyak 12,5% di LAD, RCA and LCx
territory
50 Hagai T P Ischemic burden sebanyak 5% di LAD, RCA, dan LCx
territory
51 Marojahan P H Ischemic burden sebanyak 3,75% di LAD dan LCx
territory
52 Supardi Ischemic burden sebanyak 2,5% di LCx territory
53 Noviar Tidak ada ischemic burden
54 Mattheos A P Ischemic burden sebanyak 12,5% di LAD dan LCx
territory
55 Handy Kosasih Ischemic burden sebanyak 1.25% di LCx territory
56 Nami Sulasmi Tidak ada ischemic burden
57 Tirtawati Ischemic burden sebanyak 3,75% di LAD territory,
possible balanced ischemia
58 Otoh Sunarto Ischemic burden sebanyak 2.5% di RCA territory
59 Sudharni Low risk
60 Halimuddin High Risk
61 Hasbiyanto Ischemic burden sebanyak 5 % di LCx dan RCA territory
62 Tjaryana Ischemic burden sebanyak 5% di LCx dan RCA territory
63 Erwan Tidak ada ischemic burden
64 Sumarni Ischemic burden sebanyak 16.25% di LAD, LCx, dan
RCA territory
65 Janet Bertha Ischemic burden 7.5% di LAD dan LCx territory
66 Johndri Tatilu Low risk
67 Jusman S High risk patient with severe LV dysfunction, nNot

5
 eligible for RCA revascularization, eligible to
revascularization for LAD and LCx
68 Suchairi Sibarani Ischemic burden sebanyak 2.5% di LAD & RCA
territory
69 Sunarko Ischemic burden sebanyak 1.25% di LCx territory
70 Hasanah Ischemic burden sebanyak 2.5 % di LCx territory
71 Juati Ischemic burden sebanyak 1.25 % di LCx territory
72 Rama C Alam Ischemic burden sebanyak 1.25% di LCx territory
73 Marzuki High risk patient with severe LV dysfunction
74 Zulkarnain Ischemic burden sebanyak 11.2 % di LAD dan LCx
territory
75 Go Ing Kiat Low risk patients with good LV function
76 Nuhrison M Nuh Ischemic burden sebanyak 5 % di LCx territory
77 Yuskifar Ischemic burden sebanyak 10 % di LAD, LCx, dan RCA
territory

Lampiran 1 :
Pengelolaan Pasien (MSCT)

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 Tanda Tangan
No Nama Pasien Kasus/ Penyakit Staf Pengajar
1 Endang Supriati Mild stenosis pada dua serial stent di proximal – mid
LAD ( <50% stenosis), Severe stenosis di distal RCA;
moderate stenosis di distal LAD dan proximal -mid
RCA; mild stenosis di proximal LCx
2 Endang Maryatun Patent graft LIMA-LAD, SVG-PDA, Total oklusi di
osteal graft SVG-OM, Severe stenosis di osteal LCx
3 Erni Yunita Mild calcium plaque burden, Mild stenosis di proksimal
LAD
4 Hasmita Zero calcium plaque burden, Normal coronary arteries,
Disseksi aortic root-aorta descendens
5 Hernani Zero calcium plaque burden, Normal coronary arteries
6 Rennie Tjia Minimal calcium plaque burden, Mild stenosis di osteal-
proximal LAD
7 Sih Kuniawati Mild calcium plaque burden, Minimal stenosis di
proksimal RCA, ASD sekundum dengan ukuran 38.8-
41.3 mm, Anomaly origin of RCA
8 Sumarsih Minimal calcium plaque burden, Mild stenosis di
proksimal LAD (vulnerable plaque)
9 Weneprida Minimal calcium plaque burden, Spotty calcification di
mid LAD
10 Yani Mild calcium plaque burden, Mild stenosis di osteal,
proksimal LAD dan mid RCA
11 Ridwan Usman Moderate calcium plaque burden, Moderate stenosis di
LM dan mid LAD, mild stenosis di proksimal LCx
12 Ahmad F Zaini Zero calcium plaque burden, Normal coronary arteries
13 Ahmad Yogaswara Stent di mid LAD, D1 patent; kesan stent patent di OM1,
Mild stenosis di LM-osteal LAD, mid LAD sebelum
stent, proximal D1 sebelum stent dan proksimal RCA
14 Ali Rintop Severe calcium plaque burden, Severe stenosis di osteal -
proximal LAD; moderate stenosis di mid LAD dan osteal
LCx ; mild stenosis di distal LM, proximal-distal RCA
15 Andi Putra Patent graft LIMA-LAD, SVG-PDA, Total oklusi di
osteal graft SVG-OM
16 Antonius AG Extensive calcium plaque burden, Moderate stenosis di
mid-distal LAD, D1; mild stenosis di proximal LM,
proximal LAD, proximal LCx, proximal dan distal RCA
17 Armen Mild calcium plaque burden, Severe stenosis di
proksimal, mid LAD (vulnerable plaque), dan distal LCx;
moderate stenosis diproksimal dan mid RCA (vulnerable
plaque); mild stenosis di proksimal LCx (vulnerable
plaque) dan distal RCA
18 Budi Utomo ASD sekundum dengan diameter 19,1-21,7 mm.
RA,RV dilatasi, Diameter MPA 30,1mm, RPA 29,5mm,
LPA 37,5mm (PH?)
19 Didik Setiawan Minimal calcium plaque burden, Mild stenosis di
proksimal LAD (vulnerable plaque), Superficial
myocardial bridging di mid LAD
20 Hendriyanto Mild Calcium plaque burden, Moderate stenosis di
osteal-proksimal LAD; Mild stenosis di proksimal LCx
21 Inosentius S Moderate calcium plaque burden, Severe stenosis di D1
dan distal LCx, moderate stenosis di proksimal LAD,
mild stenosis di mid LAD, proksimal LCx, proximal dan
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 mid RCA
22 Isak Simamora Moderate calcium plaque burden, Severe stenosis di mid
LAD, osteal-proximal D1 dan proximal PLB; moderate
stenosis di osteal OM1, mild stenosis di osteal LM,
osteal-proximal LAD, RIM, proximal LCx, proximal dan
distal RCA
23 John Mulia S Mild stenosis pada stent di proximal LCx, Severe
stenosis di LM dan OM1; moderate stenosis di distal
LCx, mild stenosis di osteal LCx, Kesan severe stenosis
di proximal-mid LAD
24 Joni Budiono Zero calcium plaque burden, Superficial myocardial
bridging di mid LAD
25 Murdifi Widya Mild calcium plaque burden, Mild stenosis di proximal
LAD
26 Percayak Patent graft SVG-LAD-D3, SVG-PDA, Total oklusi di
osteal graft SVG-OM, Total oklusi di OM1, severe
stenosis di proximal dan distal LCx
27 Suwignyo Tampakdiseksipada aortic root dan aorta desendens,
intimal flap di aortic root dan aorta descendens, IMH (+)
di aorta descendens
28 Tia Setia Permana Moderate calcium plaque burden, Severe stenosis di mid
LAD, D1, OM1 dan proksimal RCA, moderate stenosis
di proksimal LAD dan di distal RCA
28 Yunus Rante Moderate calcium plaque burden, Moderate stenosis di
mid LAD, osteal LCx, mild stenosis di osteal-proksimal
LAD, distal LCx, proksimal dan distal RCA
30 Subekti Nadimin Patent graft LIMA-LAD, SVG-OM, Total oklusi di D1,
Severe stenosis di osteal-distal RCA
31 Teo H Sinaga Zero calcium plaque burden, Normal Coronary Arteries
32 Thu Suryanto Moderate calcium plaque burden, Severe stenosis di
proksimal LAD (vulnerable plaque) dan proksimal LCx
(vulverable plaque), Double ostium of LCA
33 Gunawan Zero calcium plaque burden, Normal coronary arteries
34 Liem Siok Hwa Mild calcium plaque burden, Moderate stenosis di distal
LAD, Tampak mild rest hypoperfusion di LAD territory
35 Nurgiati S Mild calcium plaque burden, Severe stenosis di mid LAD
Tampak mild rest iskemik di LAD territory
36 M Nasir Moderate calcium plaque burden, Moderate stenosis di
osteal-mid LAD
37 Michael David Zero calcium plaque burden, Normal rest perfusion,
Normal Coronary Artery
38 Loe Nam H Moderate calcium plaque burden, Mild stenosis di distal
LM, proximal LAD, proximal LCx, dan proximal PLB
39 Kateno Minimal calcium plaque burden, Mild stenosis di
proksimal LAD
40 Daud Ginting Mild stenosis pada stent di mid LAD; stent di OM1
patent, Total oklusi di distal D1 dan distal LCx; Severe
stenosis di proximal D1 dan proximal RCA; moderate
stenosis di osteal-proximal dan distal LAD, osteal dan
distal OM1; mild stenosis di LM dan proximal LCx
41 Arif Qosimi Zero calcium plaque burden, Tampak mild rest iskemia di
anterior dan inferior, Anomali origin RCA
42 Angelina M Zero calcium plaque burden, Normal coronary arteries
43 Safuadi Moderate stenosis di osteal LAD, Severe stenosis di mid

8
 LAD, Moderate stenosis di osteal LCx , stent patent di
proximal, Moderate stenosis di proximal RCA, Total
oklusi di distal RCA, patent stent di Mid, Tampak mild
rest iskemia di anterior dan inferior ( LAD dan RCA
territory)
44 Sabri Darimin Total oklusi di pangkal graft LIMA-LAD, Severe stenosis
di LM, osteal dan mid LAD; moderate stenosis di
proksimal LAD
45 Pardi Mild calcium plaque burden, Moderate stenosis di mid
LAD, Moderate stenosis di proximal RCA, Tampak mild
rest iskemia di anterior (LAD territory)
46 Thomas Jeffry Zero calcium plaque burden, Mild rest ischemia di
inferior, Moderate stenosis di mid RCA
47 Anne Monalisa Zero calcium plaque burden, Normal coronary arteries
48 Syamsul Bachrie Moderate calcium plaque burden, Severe stenosis di
osteal LAD, proximal LAD setelah D1, OM1; moderate
stenosis di mid LAD, setelah D2, D1 dan distal RCA
Tampak mild rest ischemia di anterior wall dan inferior
49 Ka Siong Minimal calcium plaque burden, Moderate stenosis di
osteal dan mid LAD, Tampak mild rest iskemia di LAD
territory
50 Gunawan Zero calcium plaque burden, Normal coronary arteries
51 Anton Ginting Zero calcium plaque burden, Moderate stenosis di distal
LAD, Terlihat rest ischemia di segmen apeks
52 Tjen Sui Kiun Severe calcium plaque burden, Severe stenosis di
proximal-mid LAD dan D1; moderate stenosis di mid
RCA dan PLB, rest ischemia di anterior wall & inferior
53 Romasi Mild calcium plaque burden, Moderate stenosis di
proksimal LAD
54 Karnadi Gunawan Moderate calcium plaque burden, Severe stenosis di mid
RCA; moderate stenosis di osteal-proximal LAD; mild
stenosis di distal LM dan proximal RCA
55 Mesradarti Zero calcium plaque burden, Normal coronary arteries
56 Firsyah Manan Moderate calcium plaque burden, Moderate stenosis di
proximal-mid LAD, proximal LCx; mild stenosis di
distal LM, distal LAD, proximal, OM1, dan distal RCA ,
minimal stenosis di distal LCx, Diseksi di ao desendens
57 Sudirman Mild calcium plaque burden, Mild stenosis di proksimal
LAD dan proximal LCx
58 Hindria Severe calcium plaque burden, Severe stenosis di osteal-
proximal dan mid LAD, osteal-proximal D1, mid RCA.
Moderate stenosis di proximal OM1. Mild stenosis di
proximal LCx, distal RCA
58 Siti Mardiyah Zero calcium plaque burden, Deep myocardial bridging
di mid LAD
59 Sarni Ningsih Mild calcium plaque burden, Mild stenosis di prox LAD
60 Nia Mild calcium plaque burden, Mild stenosis di prox LAD
61 Hasnah Zero calcium plaque burden, Normal coronary arteries
62 Diana Nainggolan Mild calcium plaque burden, Moderate stenosis di osteal
LAD; mild stenosis di mid LAD, osteal D1, dan proximal
RCA
63 Yedia Artanto Zero calcium plaque burden, Normal coronary arteries,
LAA trombus
64 Fransiskus Moderate calcium plaque burden, Total oklusi di mid

9
 RCA; severe stenosis di osteal-proximal LAD, proximal
OM2; mild stenosis di proximal RCA (vulnerable plaque)
65 Martinus JH Minimal calcium plaque burden, Mild stenosis mid LAD
66 Andan Saripudin Mild calcium plaque burden, Spotty calcification di
proximal LAD
67 Andrianty Severe calcium plaque burden, Severe stenosis di osteal-
mid LAD; moderate stenosis di osteal-proximal LCx
Accessory RSPV
68 Suryani Severe stenosis di osteal LAD; moderate stenosis di
osteal D1 dan proximal LCx, Stent patent di mid LAD,
distal LCx, proximal OM1
69 Widianti Zero calcium plaque burden, Tidak ada stenosis koroner,
Diseksi aortic root – aorta desendens
70 Elyp Santoso Minimal calcium plaque burden, Total oklusi di mid
setelah D1, Fistula dari proximal LAD ke MPA
71 Abdul Manap Severe calcium plaque burden, Severe stenosis di mid
LAD, osteal D1, proximal OM1; moderate stenosis di
proximal D2, High take off LM
72 Mudzakkir Extensive calcium plaque burden, Total oklusi di mid
LAD, proximal LCx, dan mid RCA; severe stenosis di
osteal-proximal LAD, D1, dan proximal RCA
73 Desy Yani Moderate calcium plaque burden, Total oklusi di
proximal-distal LCx, severe stenosis di mid LAD
74 Ferdinand P Mild calcium plaque burden, Moderate stenosis di mid
LAD dan distal OM1; mild stenosis di osteal-proximal
LAD dan osteal-proximal LCx
75 Sulikah Zero calcium plaque burden, Normal coronary arteries
76 Meimey Megawati Zero calcium plaque burden, Normal coronary arteries
77 Andri Sudarpo Moderate calcium plaque burden, Moderate stenosis di
proximal LCx, mild stenosis di proksimal, mid dan distal
LAD, proksimal D1, proksimal RCA, minmal stenosis di
distal RCA, Superficial myocardial bridging di mid LAD
78 Irwan Mild calcium plaque burden, Mild stenosis di mid LAD
dan osteal-proksimal LCx, Diseksi aorta descenden
79 Pebruono Christian Zero calcium plaque burden, Normal coronary arteries
80 Junaidi Mild calcium plaque burden, Mild stenosis di proksimal
dan mid LAD, proksimal LCx, mid dan distal RCA
81 Yenni Warsidah Moderate calcium plaque burden, Severe stenosis di
osteal-proksimaldan mid LAD
82 Imam Sapto N Mild calcium plaque burden, Severe stenosis di osteal-
proksimal LAD (vulnerable plaque), mild stenosis di
distal LM
83 Suparman Extensive calcium plaque burden, Severe stenosis di
osteal-distal LCx, distal RCA dan moderate stenosis di
proksimal RCA, Kesan severe stenosis di proksimal-mid
LAD
84 Kartini Baay Zero calcium plaque burden, Normal coronary artery
85 Robinson S Extensive calcium plaque burden, Severe stenosis di
osteal-proksimal dan distal LCx, moderate stenosis di
distal LAD, mild stenosis di distal, LM dan proksimal
LAD, Kesan total oklusi di distal RCA, severe stenosis di
mid LAD dan D1
86 Syaifuddin Minimal calcium plaque burden, Severe stenosis di mid
LAD, LAA trombus

10
87 Ang Pun Tho Stent paten di proksimal LAD-mid
88 Mastri Sudibyo Patent graft LIMA-LAD, SVG-LCx distal dan SVG-PDA
89 Hilda Rahadian Minimal calcium plaque burden, Spotty calcification di
proksimal LAD
90 Rudi Saputra Zero calcium plaque burden, Normal coronary arteries
91 Suhartati Minimal calcium plaque burden, Severe stenosis di mid
RCA, minimal stenosis di proksimal LAD

Lampiran 1 :
Pengelolaan Pasien (MRI)

Tanda Tangan
No Nama Pasien Kasus/ Penyakit Staf Pengajar
1 Any Rubiati Reduced LV volume with normal systolic function
(LVEF 67 %), Normal RV volume with systolic
dysfunction (RVEF 45 %), Global normokinetic, Severe

11
 MS, mild MR, mild TR, and mild AR (visual qualitative),
Non ischemic scar at apicoseptal, basal anteroseptal,
basal inferoseptal, basal inferior
2 Syahruddin Increased LV volume with systolic dysfunction (LVEF
15 %), Increased RV volume with systolic dysfunction
(RVEF 23 %), Akynetic mid-basal anterior, mid-basal
anteroseptal & mid-basal inferoseptal, hypokinetic at
other segments, Mild AR, mildTR, Nonischemic scar at
mid-basal anteroseptal, Impression of nonischemic
cardiomyopathy
3 Abdul Hair Normal LV volume with mild systolic dysfunction
Ramelan (LVEF 54 %), Normal RV volume with normal systolic
function (RVEF 54 %), Hypokinetic at mid-basal septal,
mid-basal inferior, normokinetic at other segments, Mild
MR (visual qualitative), Myocardial edema at mid-basal
anterior, mid anteroseptal, basal inferior, Ischemic scar
with no viability at mid-basal inferoseptal (partial RCA
territory), Hypoperfusion relevant ischemia at
apicoseptal, mid-basal anteroseptal, apico-basal anterior
(LAD teritory), and apicolateral (LCx territory)
4 Dahori Increased LV volume with systolic dysfunction (LVEF 37
%), Normal RV volume with Normal systolic function
(RVEF 60 %), Akynetic at apex, mid-basal inferior,
hypokynetic at apico-basal septal, mid anterior, Trivial
MR (visual qualitative), Ischemic scar with no viability at
mid- basal inferior, mid-basal inferoseptal (most of RCA
territory), Hypoperfusion relevant ischemia at apico-
septal, mid-basal anteroseptal, apico-basal anterior (LAD
territory-- myocardial stunning??), mid-basal
anterolateral (LCx teritory)
5 Suprapto Increased LV volume with severe systolic dysfunction
(LVEF 25 %), Normal RV volume with normal systolic
function (RVEF 49 %), Akinetic at apico-mid anterior,
apico-mid anteroseptal; hypokinetic at other segments,
Normal valves(visual qualitative), Ischemic scar with
remaining viability at apico-mid anteroseptal, mid
anterior, mid inferoseptal, mid anterolateral,
Hypoperfusion relevant ischemia at apico-basal
anteroseptal, apico-basal anterior (LAD territory), apico-
basal inferoseptal, apico-basal inferior (RCA territory),
apicolateral, mid-basal anterolateral, mid inferolateral
(LCx territory)
6 Haryono Increased LV volume with severe systolic dysfunction
(LVEF 16 %), Reduced RV volume with normal systolic
function (RVEF 63 %), Dyskinetic mid anterior, akinetic
at apico anterior, apico-mid anterolateral, apico-mid
inferolateral; severe hypokinetic at other segments, Mild
MR, mild TR (visual qualitative), Ischemic scar with
remaining viability at partial LAD, LCx and RCA
territory, Hypoperfusion relevant ischemia at apico-basal
anterior, mid-basal anteroseptal (LAD territory), mid-
basal inferoseptal, apico-basal inferior(RCA territory),
apico-basal anterolateral, mid-basal inferolateral (LCx
territory)

12
7 Rini Asrini Increased LV volume with systolic dysfunction (LVEF 33
%), Normal RV volume with systolic dysfunction (RVEF
38 %), Moderate hypokinetic at apico-basal anteroseptal,
mid-basal inferoseptal, mid anterior; mild hypokinetic at
other segments, Trivial TR (visual qualitative), No
myocardial edema, Non ischemic scar at at mid-basal
anteroseptal, mid-basal inferoseptal, mid-basal anterior,
and basal inferior, mid-basal inferolateral, Impression of
nonischemic cardiomyopathy dd myocarditis
Increased LV volume with systolic dysfunction (LVEF 28
8 Sukma Tanjung %), Normal RV volume with normal systolic function
(RVEF 55 %), Akinetic at apico-mid anteroseptal, apico-
mid anterior; hypokinetic at other segments, Mild MR
(visual qualitative), Ischemic scar with remaining
viability at apex, apico-mid anterior, mid-basal
anteroseptal, apicolateral, mid-basal anterolateral,
apicoinferior, Hypoperfusion relevant ischemia at apex,
apico-basal anteroseptal, apico-basal anterior (LAD
territory),apico-basal inferoseptal, apico-basal inferior,
apicolateral, mid-basal anterolateral (LCx/RCA territory)
Normal RV volume with normal systolic function
9 Zainidar (RVEF 61 %), Global normokinetic, Mild TR (visual
qualitative), No ischemic scar, Hypoperfusion relevant
ischemia at mid-basal anteroseptal (LAD territory),
apicolateral, mid-basal anterolateral, basal inferolateral
(LCx territory)
Decreased LV volume with normal systolic function
10 Asti Fujihartanti (LVEF 63 %), RA and RV dilatation, normal RV volume
with systolic dysfunction (RVEF 11 %), Global
normokinetic, IVS paradoxical movement, D-shaped,
Mild TR, Myocardial edema at basal anteroseptal,
Pericardial effusion
Normal LV volume with mild systolic dysfunction
11 Iis Istikomah (LVEF 59 %), Hypertrophic and trabeculated RV; Normal
RV volume with systolic dysfunction (RVEF 47 %),
Global normokinetic, Moderate PS, IVS gap at LV inlet
(7-10mm) (visual qualitative), Non ischemic scar at
anterior and inferior RV-LV junction, mid-basal
inferolateral
Normal LV volume with normal systolic function (LVEF
12 Ratna Kumala 61 %), Increased RV volume with systolic dysfunction
(RVEF 23 %), Dyskinetic at septal wall, LV D-shaped,
Mild TR, Non ischemic scar at anterior and inferior RV-
LV junction
Normal LV volume with mild systolic dysfunction
13 Rosita Minarti (LVEF 56 %), Increased RV volume with systolic
dysfunction (RVEF 17 %), Dyskinetic at septal wall, LV
D-shaped, Mild TR, ASD secundum, No myocardial
edema, Non ischemic scar at anterior and inferior RV-LV
junction, Pericardial effusion at anterior RV
Normal LV volume with normal systolic function (LVEF
14 Widyanto 74 %), Normal RV volume with normal systolic function
(RVEF 57 %), Global normokynetic, Mild MR (visual
qualitative), Ischemic scar with remaining viability at

13
 mid-basal anterolateral, Hypoperfusion relevant ischemia
at mid-basal anteroseptal, apico-basal anterior (LAD
territory), mid-basal inferoseptal (LCx/RCA territory)
Reduced LV volume with normal systolic function
15 David Christian (LVEF 62%), Reduced RV volume with normal systolic
function (RVEF 62%), Global normokinetic with LV
septal bounce (+), Midwall fibrosis at apico-mid septal,
Mild TR (visual qualitative), Left pleural effusion,
Impression of pericarditis and post myocarditis
Normal LV volume with normal systolic function (LVEF
16 Firman Lukman 61%), Normal RV volume with normal systolic function
(RVEF 65%), Hypokinetic at mid basal anteroseptal,
normokinetic at other segments, Mild MR (visual
qualitative), Ischemic scar with remaining viability at
apicoseptal, apico-mid anterior, mid-basal anteroseptal,
apico-basal inferior, mid-basal inferoseptal,
Hypoperfusion relevant ischemia at apico-basal anterior,
mid-basal anteroseptal (LAD territory), mid-basal
inferoseptal, apico-basal inferior (RCA territory -->
myocardial stunning
Normal LV volume with normal systolic function (LVEF
17 Juabedah 68%), Normal RV volume with normal systolic function
(RVEF 61%), Global normokinetics, Ischemic scar with
remaining viability at mid-basal anteroseptal,
Hypoperfusion relevant ischemia at apicoseptal, mid-
basal anteroseptal, apico-mid anterior (LAD territory),
basal inferoseptal, apico-mid inferior, apico lateral
(RCA/ LCx territory)
Reduced LV volume with normal systolic function
18 Sutarno (LVEF 68%), Reduced RV volume with normal systolic
function (RVEF 59%), Global normokinetic, No scar,
Hypoperfusion relevant ischemia mid-basal anteroseptal,
mid anterior (LAD territory;stunning?), mid inferior
(RCA territory), apicolateral, mid anterolateral (LCx
territory)
Normal LV volume with normal systolic function (LVEF
19 Eni 57%), Normal RV volume with normal systolic function
(RVEF 50%), Mild hypokinetic at mid anteroseptal,
normokinetic at other segments, Normal valves (visual
qualitative), Hypoperfusion relevant ischemia at
apicoseptal, mid-basal anteroseptal, basal anterior (LAD
territory), basal anterolateral (LCx territory)
Normal LV volume with normal systolic function (LVEF
20 Preslin Simatupang 70%), Normal RV volume with normal systolic function
(RVEF 70%), Global normokinetic, Mild MR (visual
qualitative), Hypoperfusion relevant ischemia at basal
anterior (LAD territory), and basal anterolateral, basal
inferoseptal (LCx/RCA territory)
Normal LV volume with mild systolic dysfunction
21 Suharningsih (LVEF 56%), Increased RV volume with systolic
dysfunction (RVEF 22%), Dyskinetic at septal wall, D-
shaped LV, Mild TR (visual qualitative), Secundum ASD,
Non ischemic scar at basal anterior and inferior RV-LV
junction, Pericardial effusion at apical RV

14
 Increased LV volume with systolic dysfunction (LVEF
22 Agus Sumarsono 32%), Reduced RV volume with normal systolic function
(RVEF 56%), Dyskinetics at apex, akinetic at
apicoseptal, apicoinferior, apicoanterior, mid
anteroseptal, mid inferoseptal; Moderate-severe
hypokinetic at other segments, LAVi 48.2 ml/m2, Mild
MR, mild TR (visual qualitative), Ischemic scar with no
viability at apex, apicoseptal, mid-basal anteroseptal,
mid-basal inferoseptal; Ischemic scar with remaining
viability at apico-mid anterior, apico-lateral, apico-basal
inferior, Hypoperfusion relevant ischemia at mid-
anterolateral and mid inferolateral (LCx territory, < 2/16
segments)
Normal LV volume with normal systolic function (LVEF
23 Oberlin Hasibuan 65%), Normal RV volume with normal systolic function
(RVEF 54%), Global normokinetics, No ischemic scar,
Hypoperfusion relevant ischemia at apicoseptal,
apicoanterior, mid-basal anteroseptal (LAD territory),
basal inferoseptal, apicoinferior, apicolateral, mid-basal
anterolateral, basal inferolateral (LCx/RCA territory)
Normal LV volume with normal systolic function (LVEF
24 Ismail Sumarjo 71%), Normal RV volume with normal systolic function
(RVEF 75%), Global normokinetic, Mild AR, mild MR,
mild TR (visual qualitative), Hypoperfusion relevant
ischemia at apicoanterior, apicoseptal, mid anteroseptal
(LAD territory), mid inferior, basal anterolateral, basal
inferolateral (RCA/ LCx territory)
Normal LV volume with normal systolic function (LVEF
25 Megawati 63%), Normal RV volume with normal systolic function
(RVEF 62%), Global normokinetics, Mild TR (visual
qualitative), Hypoperfusion relevant ischemia at mid-
basal anteroseptal, basal anterior (LAD territory, < 2/16
segments)
Normal LV volume with systolic dysfunction (LVEF
26 Tunggul Sitompul 53%), Reduced RV volume with normal systolic function
(RVEF 65%), Hypokinetic at apico-midanteroseptal,
apico-mid anterior, normokinetic at other segment,
Trivial TR (visual qualitative), No myocardial edema,
Ischemic scar with remaining viability at a apico-mid
anterior, apico septal, mid-basal anteroseptal,
Hypoperfusion relevant ischemia at basal anterior,
apicoseptal, mid-basal anteroseptal (LAD territory), mid-
basal inferoseptal, apico-basal inferior (RCA territory),
mid-basal inferolateral (LCx territory)
Normal LV volume with normal systolic function (LVEF
27 Kanti 75%), Reduced RV volume with normal systolic function
(RVEF 71%), Global normokinetic, Normal valves, No
ischemic scar, Hypoperfusion relevant ischemia at
apico-basal anteroseptal, apico-mid anterior (LAD
territory- stunning?), apicolateral, mid-basal
anterolateral, mid inferoseptal, apico-mid inferior
(LCx/RCA territory)
Normal LV volume with systolic dysfunction (LVEF
28 Maisuroh 47%), Reduced RV volume with normal systolic function

15
 (RVEF 69%), Dyskinetics at apex; Hypokinetic at apico-
basal anteroseptal, apico-mid anterior, mid inferoseptal
normokinetic at other segments, Myocardial edema at
basal anterior, Ischemic scar with remaining viability at
basal anteroseptal, mid anterior, mid inferoseptal,
Hypoperfusion relevant ischemia at mid anterior (LAD
territory—stunning?), basal inferoseptal, apico-basal
inferior (RCA territory), apico-basal inferolateral (LCx
territory)
Normal LV volume with normal systolic function (LVEF
29 Handoko 66%), Normal RV volume with normal systolic function
(RVEF 53%), Global normokinetic on both LV and RV
wall, Mild MR, mild TR (visual qualitative), Patchy
fibrosis at basal septal, basal inferior and basal
inferolateral LV, Hypoperfusion relevant ischemia at
apicoseptal, mid-basal anteroseptal, apico and basal
anterior (LAD territory), No sign of ARVD nor
myocarditis on MRI examination
Normal LV volume with normal systolic function (LVEF
30 Rugun Sinaga 68%), Normal RV volume with normal systolic function
(RVEF 62%), Global normokinetic, Normal valves,
Hypoperfusion at basal anteroseptal and basal anterior
(LAD teritory, < 10%)
Normal LV volume with systolic dysfunction (LVEF
31 Sriyono 26%), Normal RV volume with systolic dysfunction
(RVEF 44%), Akinetic at basal anterior, apicoinferior,
mid inferolateral, midanterolateral, hypokinetic at other
segments, Normal cardiac valves (visual qualitative),
Ischemic scar at apicoinferior and mid inferolateral,
Hypoperfusion relevant ischemia at apicoseptal, mid-
basal anteroseptal (LAD teritory), mid-basal inferoseptal,
basal inferolateral (RCA/ LCx territory)
Increased LV volume with systolic dysfunction (LVEF
32 Sutamto Supardi 23%), Reduced RV volume with systolic dysfunction
(RVEF 38%), Dyskinetic at apico-mid anterior, apico-
mid anteroseptal, aneurismatic at mid-basal inferolateral
(10x20 mm), akinetic apico-basal inferior, apico-basal
inferolateral, moderate hypokinetic at other segments,
Normal cardiac valves (visual qualitative), Ischemic scar
with remaining viability at apico lateral, mid-basal
inferolateral, mid anterolateral, Hypoperfusion relevant
ischemia at mid-basal anteroseptal, mid anterior (LAD
teritory), basal anterolateral (LCx teritory)
Normal LV volume with normal systolic function (LVEF
33 Joni Kurniawan 60%), Normal RV volume with normal systolic function
(RVEF 51%), Mild hypokinetic at basal septal,
normokinetic at other segments, Normal cardiac valves
(visual qualitative), Mid wall fibrosis at mid-basal
anterior, mid-basal inferior, Moderate hypoperfusion at
mid-basal septal, anterior and inferior, mild
hypoperfusion at mid-basal lateral, Impression of post
acute myocarditis
Normal LV volume with normal systolic function (LVEF
34 Adin Nulkhasanah 57%), Normal RV volume with normal systolic function

16
 (RVEF 58%), Global normokinetic on both LV and RV
wall, Mild TR (visual qualitative), Patchy fibrosis at mid-
basal anteroseptal, mid-basal inferoseptal, No sign of
ARVD on MRI examination; impresion of myocarditis
Increased LV volume with systolic dysfunction (LVEF
35 Henry Drajat 9%), Increased RV volume with systolic dysfunction
(RVEF 9%), Global severe hypokinetic, Mild AR,
Moderate MR, moderate TR (visual qualitative),
Nonischemic scar at basal anteroseptal, mid-basal
anterior, Impression of nonischemic cardiomyopathy
Normal LV volume with normal systolic function (LVEF
36 Junaedi 65%), Reduced RV volume with normal systolic function
(RVEF 69%), Global normokinetic, Normal cardiac
valves (visual qualitative), Myocardial edema at mid
inferior, No ischemic scar, Hypoperfusion relevant
ischemia at apico anterior, mid-basal anteroseptal, basal
anterior (LAD teritory, stunning?), mid inferoseptal
(RCA teritory), basal inferolateral (LCx teritory,
stunning?)
Normal LV volume with normal systolic function (LVEF
37 Arif Qosimi 63%), Normal RV volume with normal systolic function
(RVEF 55%), Mild hypokinetic at anterior and septal,
normokinetic at other segments, Normal cardiac valves
(visual qualitative), No ischemic scar, Stress inducible
ischemia at anterior, septal (LAD teritory) and inferior
(RCA territory)
Normal LV volume with normal systolic function (LVEF
38 Ery Susanty 60%), Increased RV volume with systolic dysfunction
(RVEF 20%), Dyskinetic at septal wall, LV D-shaped,
Moderate TR, moderate PR (visual qualitative), ASD
secundum, No myocardial edema, Non ischemic scar at
mid-basal inferior RV-LV junction
Increased LV volume with systolic dysfunction (LVEF
39 Kartini Siahaan 32%), Normal RV volume with normal systolic function
(RVEF 68%), Akinetic at apico septal, mid-basal
anteroseptal, severe hypokinetic at other segments, Mild
MR, mild TR (visual qualitative), Myocardial edema at
basal anterior, basal septal, basal inferior, and basal
lateral, Ischemic scar with no viability at pico septal,
mid-basal anteroseptal, apico-mid anterior (most of LAD
territory); ischemic scar with remaining viability at apico
lateral, mid-basal inferoseptal, mid-basal inferior
(RCA/LCx territory), Hypoperfusion relevant ischemia at
basal anterior (LAD teritory), mid inferior, basal
inferolateral (RCA/LCx teritory) --> less than 10%
Reduced LV volume with normal systolic function
40 M Soleh M (LVEF 59%), Reduced RV volume with normal systolic
function (RVEF 54%), Global normokinetic on both LV
and RV wall, Normal cardiac valves (visual qualitative),
No LGE at LV and RV, No sign of ARVD nor
myocarditis on MRI examination
Normal LV volume with mild systolic dysfunction
41 Dirk P (LVEF 55%), Small RV volume with normal systolic
function (RVEF 68%), Hypokinetic at mid anteroseptal,

17
 mid-apico anterior, apicoseptal, mid-apico inferior, apex,
Myocardial edema at anterior wall, Scar at anteroseptal
and inferior wall with transmurality of 25-35% and scar
volume of 14.9%, Stress induced ischemia at anterior and
septal (LAD territory), inferior (RCA territory), lateral
(LCx territory), Eligible to revascularize LAD, LCx,RCA
Increased LV volume with severe systolic dysfunction
42 Wanto (LVEF 15%), Small RV volume with normal systolic
function (RVEF 52%), Akinetic at apico-basal inferior,
apicolateral, mid inferolateral, apicoseptal, severe
hypokinetic at other segments, Myocardial edema at
basal-mid anterior, Ischemic scar with no viability at
apico-basal inferior, apicoseptal; Ischemic scar with
remaining viability at other segments
Increased LV volume with normal systolic function
43 Yunita Carmelia (LVEF 62%), Increased RV volume with systolic
dysfunction (RVEF 42%), Global normokinetic LV,
Moderate-severe MR, moderate TR (visual qualitative),
Suspect small thrombus at apex RV, Non ischemic scar at
basal-mid anteroseptal, basal anterolateral and inferior
LV-RV junction
Normal LV volume with normal systolic function (LVEF
44 Ike Dianasari 64%), Normal RV volume with normal systolic function
(RVEF 59%), Global normokinetic, Mild TR (visual
qualitative), Nonischemic scar at basal-apicoseptal,
basal-apicoanterior, mid-apicoinferior, Hypoperfusion at
apicoseptal, apicoanterior and basal inferoseptal
Normal LV volume with normal systolic function (LVEF
45 Soegiyo 73%), Normal RV volume with normal systolic function
(RVEF 68%), Global normokinetic, No ischemic scar,
Microvascular dysfunction
Normal LV volume with normal systolic function (LVEF
46 Herma Yunita Sari 61%), Increased RV volume with mild systolic
dysfunction (RVEF 54 %), Apical displacemet of
posteroseptal TV leaflet with severe TR, RA dilatation,
Dyskinetic septal, Non ischemic scar at basal anterior
junction, basal-mid inferolateral LV, Stretched PFO
Increased LV volume with moderate systolic dysfunction
47 Kasri Astini (LVEF 46%), Normal RV volume with normal systolic
function (RVEF 59%), Akinetic at apico septal, mid-
apico anterior, hypokinetic at basal-mid anteroseptal,
mid-apico lateral, basal-mid inferoseptal,
basal-apicoinferior, Ischemic scar with no viability at
apico anterior; Ischemic scar with remaining viability at
basal-mid inferolateral, mid anterior, Hypoperfusion
relevant ischemia at basal-mid anterior, basal-mid
anteroseptal, apicoseptal (LAD territory), basal-apico
inferior, basal-mid inferoseptal (RCA territory), basal-
apico lateral (LCx territory)
Normal LV volume with mild systolic dysfunction
48 Sukirman (LVEF 46%), Normal RV volume with normal systolic
function (RVEF 65%), Akinetic at mid anteroseptal,
apicoseptal, apicoanterior, apex, hypokinetic at basal
anteroseptal, Ischemic scar with no viability at most LAD

18
 territory, Thrombus at apicoseptal, apex, Hypopefusion
relevant ischemia at basal anterior (LAD territory)
Increased LV volume with severe systolic dysfunction
49 Sopyan Yusuf (LVEF 25%), Normal RV volume with systolic
dysfunction (RVEF 38%), Akinetic at mid-apicoanterior,
mid anteroseptal, apico septal, apex; hypokinetic at other
segments, Myocardial edema at basal-apico septal and
basal anterior, Ischemic scar with no viability at mid
anteroseptal, apicoseptal, apex ; Ischemic scar with
probable viability at mid-apico anterior, and with
remaining viability at basal anteroseptal, basal-mid
inferoseptal, basal-apicolateral
Increased LV volume with mild systolic dysfunction
50 Tjioe Winarto (LVEF 46%), Normal RV volume with normal systolic
function (RVEF 51%), Hypokinetic at basal-apico
anterior, basal-apico septal, basal-apico inferior, and
apex, Myocardial edema at mid-apico anterior, mid-apico
septal, and mid-apico inferior, Non ischemic scar at
basal-apico inferior junction, basal-mid septal, basal
anterior, Hypoperfusion at apicoseptal, Impression of
myocarditis with non ischemic cardiomyopathy
Normal LV volume with moderate systolic dysfunction
51 Anton Bangun S (LVEF 38%), Small RV volume with mild systolic
dysfunction (RVEF 46%), Akinetic at basal-mid inferior,
basal-mid inferoseptal; hypokinetic at apico
inferior,basal-mid anteroseptal, basal-apicoanterior,
Ischemic scar with no viability at most RCA territory
segments; Ischemic scar with probable viability at basal-
mid anterior, Hypoperfusion relevant ischemia at basal-
mid anteroseptal, apicoanterior, apicoseptal (LAD
territory)
Normal LV volume with normal systolic function (LVEF
52 Junaidi 62%), Normal RV volume with normal systolic function
(RVEF 63%), Global normokinetic, Non ischemic scar at
apex, apico inferior, mid lateral, Increased apical wall
thickness, Impression : Apical HCM
Increased LV volume with severe systolic dysfunction
53 Joko Santoso (LVEF 28%), Normal RV volume with normal systolic
function (RVEF 57%), Global hypokinetic, Myocardial
edema at mid anterior and mid lateral, Non ischemic scar
at inferior RV-LV junction, basal-mid lateral, Impression
of chronic myocarditis with non ischemic
cardiomyopathy
Normal LV volume with mild systolic dysfunction
54 Achmad Muhajir (LVEF 50%), Normal RV volume with decrease systolic
function (RVEF 48%), Hypokinetic at basal-mid lateral,
normokinetic at other segments, Ischemic scar with
remaining viability at basal anterolateral, basal
inferolateral, Hypoperfusion relevant ischemia at basal-
mid anteroseptal, apico septal, basal anterior (LAD
territory), basal-mid inferior, mid inferoseptal (RCA
territory), mid-apico lateral (LCx territory)
Increased LV volume with severe systolic dysfunction
55 Henri Rasjad (LVEF 30%), Normal RV volume with normal systolic

19
 function (RVEF 58%), Akinetic mid-apico septal,
hipokinetic at other segments, Ischemic scar with no
viability at apex, apico septal, mid anteroseptal, mid
inferoseptal; ischemic scar with probable viability at mid-
apico inferior, Hypoperfusion relevant ischemia at basal
anteroseptal, mid-apico anterior (LAD territory), basal
inferoseptal, basal inferior (RCA territory), basal-apico
lateral (LCx territory)
Increased LV volume with severe systolic dysfunction
56 Patar Simanjuntak (LVEF 25%), Normal RV volume with normal systolic
function (RVEF 53%), Akinetic mid-apico anterior, mid-
apico septal, apex, hipokinetic at other segments,
Ischemic scar with no viability at most LAD territory,
Hypoperfusion relevant ischemia at basal anterior (LAD
territory), basal-apico inferior, basal-mid inferoseptal
(RCA territory), basal-mid anterolateral, mid
inferolateral, apico lateral (LCx territory)
Normal LV volume with normal systolic function (LVEF
57 Sarkum 61%), Normal RV volume with normal systolic function
(RVEF 50%), Global normokinetic, Myocardial edema at
mid lateral, basal anterior, basal inferior, Non ischemic
scar at inferior RV-LV junction, basal anteroseptal,
Microvascular dysfunction, Impression of myocarditis
with non-ischaemic cardiomyopathy

Lampiran 2 :
Journal Reading/ Presentasi Kasus

Tanda Tangan
No Tanggal Judul
Staf Pengajar

20
Lampiran 3 :
PENGETAHUAN
Kuliah Pasca Sarjana/Tutorial/ Diskusi

No Topik Tanggal Tanda Tangan

Staf Pengajar
21
 TINGKAT KOMPETENSI

1. Pengetahuan ( P )

22
P1 :
Mampu mengetahui dan mengingat materi ilmiah
P2 :
Mampu memahami dan mengerti materi ilmiah
P3:
Mampu menerapkan, menganalisis, mengevaluasi dan merumuskan materi ilmiah

2. Keterampilan ( K )

K1 :
Mampu mendiagnosis, memberi terapi sementara, dan meilih modalitas dignostik yang
sesuai. Tingkat kompetensi ini tidak mencakup pengerjaan suatu tekhnik prosedur.
K2:
Mampu mendiagnosis, memilih dan menginterpretasi hasil, modalitas diagnostik yang
sesuai, dan memilih tatalaksana yang sesuai. Pengalaman praktik, tetapi tidak sebagai
operator mandiri, menjadi asisten pengerjaan teknik tertentu atau prosedur dibawah panduan
yang berpengalaman
K3 :
Mampu mendiagnosis, mampu secara mandiri melakukan prosedur tanpa dibantu dan
memberi terapi paripurna

3. Sikap ( S )

S1 :
Hubungan interpersonal dan sikap serta kebiasaan kerja profesional kurang
S2 :
Hubungan interpersonal dan sikap serta kebiasaan kerja profesional sedang
S3:
Hubungan interpersonal dan sikap sertakebiasaan kerja profesional baik

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 KESIMPULAN AKHIR

Nama PPDS : Tommy Daindes

NPM :
Modul : Pencitraan Kardiologi

Kesimpulan akhir : LULUS/ TIDAK LULUS*)

Komentar Staf Pengajar :

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Tanggal
Penilai :
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Komentar PPDS :

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