Materi UKMPPD

KARDIOVASKULAR
-

dr Twang
.
Zeb
.
 Materi UKMPPD

KARDIOVASKULAR
-

FREEBEES
dr Twang
.
Zeb
.
 ① .
Basic EKG

Cth :
sinus Tachycardia : HR 160×4 Regular : Normoaxis dengan
STEMI Lateral

: Baca an Dasar EKG

IBP
"arisasi
: kelainan Pd EKG Aktivitag
( white
Reepolarisi
zany
coelom bang Pasar EKG
I mm = I kk
R
Gel dari Atrium

appt
°
. P → Terbentuk presses Depolarisasi
(N C 0,12 Sec 13mm )
\, s point
Q
s
o

kompleks QRS → Terbentuk dari p roses Depolarisasi

Ventrikel C Duras,
-

0,12 -
0.2 Sec I
.

PR interval i 2 5 Kk
5 MM )
-

3 -

Q patdogis :( O Ml ) : >
Yz R • Gel . T → Terbentuk dari
poses Repo Ian Sasi
'

ST eleva si

ST depres ,
-
} 31 k k Ventrikel C Amplitude c
'
13 Gel .
R)

Cara Membaca EKG

① Pastikan Bahwa EKG 99 di Gaea -0 Ter Galik

.

①
Indicator lead AVR Pat
I
:

"

Pd lead AVR Gel 00

P.AT Depleksi Negatif
'

W
→ EKG Terpasang Behar "
-0

R Deeleksi nega tie

: gelombang

Whr
✓
,

P Q T
Depletesi positif n.ge/ombang
g T
② Menentukan Tenis Gelombang : Kama : HR
.

a) . Jen is Gelombang
* Sinus → Tika Setelah I Gel -
P dilkuti Oleh I kompleks QRS

QRS QRS

P T P T

SMART WAY : Tika diantara R -

R Interval "

2 Gel
"
-0 Sinus

* A sinus → Tika Setelah Gel P ① diikuti Oleh

-

kompleks QRS

QRS QRS

P P P P p p p p

' Kb = 5- lek

SMART WAY : jika dianfara R .

12 Interval 1/22 Get → Asinus

Jikadiantara Interval
"

SMART WAY → Get sinus → R -

R terdapat
2 Gel "
→ Gel . Sinus

( gel .
PET )

b) .
Kama

Regular R R Interval Tarak SAMA

"
"
→
-

Irregular → R - K Interval Tarak "

① Sama
"

R, F Rz F Rs Rg Rs

mush

d. Heart Rate

Regular → Rumus Kotak Besar : 3001 Jumlah Kotak Besar R R

-

Interval lead I

Rum vs Kotak Kecil : 1500 ( jomlah Kotak Kecil R -

k

Interval pd lead I
 30 Kotah Besar

T
'
Jumlah R di Interval 6 Sec Ii
Irregular → x to = -
. . .

⑧ o
30 KB

1mm = 0.04 Sec

Interpretasi :

1 KB = 5k Kecil
. = 5mm = 0,20 Sec o 260mi → Bradikardia

1- detik 10,2 = 5 K . Besar o 60 -

1007 -

.
→ Normal 1 Ritmik

6 defile * 5 = 30 K .
Besar o 7100mi → Taki Karaka

si
③ Menentukan Axis po si
.
jantung .
→

Kanan
Indicator Lead Ct ) IC I t
Pengurangan
}
"

I Tinggi
-

: .

QRS
lead Auf Ct ) le ) Gel .
R dgn Gel .
S
"

→ Kiri
R

Imffmm
lead lead #

FYI
5mm

15 -

5 = 1-10 5 -

15 = -
IO

(t ) s = 5mm C -
) . I 15mm

SMART WAY : Tika Gel 1275 → Ct )

jika Gel s > R → C -

I

Kanan Kiri

Lead Ict) dan lead Auf Ct ) → Normoaxis

lead Ict ) dan lead Auf C- I → left Axis Deviation CLAD )

lead I C -

I dan lead Auf Ct ) → Right Axis Deviation CHAD )

lead I C-7 dan lead are C-7 → Extreme RAB → Kel Icongenital
.

t
dextrocardia
Tent up an Apa Kah EKG Lagat Baca 1 Tidal -0 lead
A④
C-I

P T

Ctl

A-
,

Ritmik HR 93 Mi Rego ler Right Deviation

Interpretasi : sinus : i Axis CRAD ) .
④ . Perry kardiologi
.

a) . Angina Pectoris Statoil I APS

E : o
Mero Kok °
Riw .
ketunnan .

°
Obesitas

•
Perry .
Lain : DM :
Dislipidemia : HT

Diagnosis .

: C 20 men it

Gejala Khas : o
Nyeri Dada I 15 men it dan Menghi lang Saat

lstirahat i Fak .
Reiko Cti

Pem .
Penunjang
EKG sinus Ritmik
"

Post
"
* → → Exercise stress

1ST Depresi
"
Test →
"
Gamb .
T -
Inverted

white
1-redmill Test

* Enzim Jointing : o Mio globin CI -

2 jam onset )

Smart way o Ck -

MB C3 -

Ajam onset )

Mace T •
Troponin IIT C 5 -
6 jam onset ) .

1 -
2 3-4 7 ↳ spesieik
C Normal ) .

* Exercise stress Test C Treadmill Test ) →

Angina ⑦
"
"

Gold standar :
angiogram
Tatalaksana
° Edu Kasi :
life style Modification
° Tatalaksana : o Pemberian Vasodilator C Gol .
Nihat ) → ISDN / Nitro gli serin

5mg P.co/djamCkI:Hipotensi )(post .

konsumsi sildenafil cryojam
°
Got B Blocker C -
0101 ) Ros wastatin

{
20
-

yo mg
.
. -

• Cool .
Statin High intensity
Ator rastatin yo - do
mg
 VAP
- NS TE MI
1A
-

⑥ .
Sindroma Kovner Aleut CSKA ) \ STE MI
E : o
Mero Kok °
Riw .
ketunnan .

°
Obesitas

o
Peng .
Lain : DM :
Dislipidemia : HT

Diagnosis > 20 men it

Gejala Khas : o
Nyeri Dada I 15 men it doin -0 Membaik Saat

Istra hat

•
Menjalar to

o Usia 340 Than →

Nyeri Ulu Hati ⑤ R

P .

Penunjang : o
ST segmen elevasi
"
M -

shaped
"
It ST

dada , jam
ingen hat
: ⑦ P .
Enzim Jantung : TT Meninga at
both

¥¥g%isuAP
tira
is Dx : STEM I
Ik ,

bait Jam
c.) '

dad
Whyy
'd
atau
shaped
"
W
ST segmen Depress
"
-
•

nyeri T
nyeri dada i jam
istiridhat
'
Ik both .

istirahat
,
'

both res .
S
baik
deep C-7 si
Steleva

Mfg
1k bail ST
,
"
,
E ka
:
C Idi Calahan
Inverted
T
granting
-

A : -

, en zim
wa STE
-
g. STEM I
µ ⑤ TT Meningeal Enzimjantung → NSTEMI

⑤ E. jointing ④ → UAP .

Tika EKG ① Ada : E .

jantung -0 ada → Sin drama koroner Akut

Memento Kan Lo Kasi lnfark

left circumflex
Lateral :
I Aul Us -
Us → LCX artery → 1 Area dikatakan

Auf RCA right coronary

Bermakna
Inferior :
I , II →
artery

Septal Vi Uz left anterior artery Minimal Menge nai

y
"
: -

LAD
Anterior
→
descending Lead "

vz Vg 2
:
-

Va Vo I AVL → Anterior ekstensie II IIT .

AVL → inferior
,
-
. .
 PJK

APS ACS
- EKG CN )
-
Enzim ( N)
-
Tredmill test (t) EKG EKG
( ST elevasi ) ( nonstelera.si
d
'
STE MI
Lenzini )

'r7Iiokar€ ! I'm
Cintaakut
)
a :&:*,
Cth di lead I HI Auf Vi
: St Depress ,
, , -
Us -
Vg -
Us Tt Ck -
MB .

Dx : NSTEMI Inferior Anterior lateral C. Extensive Anterior )

L I L S A A

M -

shaped di lead I ,
I Aul ,
V Us Vg Tt Mio globin
, , . . .

Dx : STEM Anterolateral

Interpretasi : sinus Ritmik : 759, -

Regular : RAD dengan NSTEMI

Inferior

Tatalaksana :

① .
Modifikasi 6 .

Hidup .

② Terapi loading ONACOM

"

A- wall
"

Oksigen →
sp .
Oz s 90%

-
Nitrate → ISDN 5mg sublingual ( Interval 5 merit ) → Mak

( Vasodilator ) 15mg .

( TDS mmHg)
KI :
I Hipotensi CSO

- Post Konswmsi Sildenafil

 ACS
#
0

'
STEM o O
inferior

1
STEM
anterosppital

→
maintenance I
loading
→
① WACOM
 tab : 80mg ,

rot
dikunyah loading Cztab )
"

Aspirin → 160
"

-
-
320 mg →

C Antiplatelet ) . I tab : 75mg

~
clopidogrel 600mg ditelan 4 tab
"
→
"

-
→ 300 -

UAPINSTEMI :
aspirin (clopidogrel
C Antiplatelet )

Morfin → 2mg Bolus IV dgn Nad O ,g%

( Analgesic -

opioid ) KI :
Hipotensi STE MI : -
Primary PCI
-
Fibrinolisislstreptokinase
• Tera pi Utama :
Rujuk ke Rs → Tera pi Reperfusi
Syarat onset cizjam .

Primary PCI C Mekanik ) .

Fibrinolisisl streptokinase Iv Cfarmakolosi ) .

② .
Gagaljantung .

1) Gaga I Jantung
.
Kron is

E : o
P roses Degenerate'f
•
Perry .
Cain : HT :
Peng - Tiro ;D : P J
- -
Kato 6 : P J
-
. Bawa a n

Anemia

Diagnosis

Gagal Jantung
"

Beng Kak
"
• Kanan : o

C
Decompensation Cordis D. extra ) - Edema pre tibial o onset s
,

-
TT Tvj 3 Bulan

Hepatosplenomegali
- A sites

Pem .
Penunjang :

•
Radiologic Foto Thorax ) → CTR 750%

RAH : Jantung pendulum 1 Globular 1 Ken di

RVH Boot shape

"

appearance
"
:
 Genta Sagal Ja "
lung

y↳
Kanan
ri

"
BengKak
"
"
Sesak Natas
"

Dispread eyeport
'

/ TT TVT ,
DOE

- A sites , PND Paroxysmal nocturnal

dyspnea

- Hepa to Splenomesali - OP ortho pnea

- Edema pretrial - Ronkhibasab

Racial (Auskultasi )

chronic Heart Failure 7 3 Out an

 Tanda Gaga Jantuz
d
Kardio mesali

y- Kiri
Kanan

a
.

e-Foto
Ekg Foto
EKG
thorax , Aki Thom
- Aka - Aka ptlitral Aki
ppulmonal Globular evki Double
( V ka Shapelkendi Koi Volvo Cantor
evka
Rfs di V
,
71 1- Savva
Nkt
Va -51
Hs & Root Shape I 735mm
apex terangkat
Apex
Downward"
tertanam
Aka → Atrium Kanan Aki → Atrium Kiri

V ka → Ventrikel Kanan Vki → Ventrikel Kiri

 R
Pem EKG p

NY ht
•
.

T
RAH : o P -
pulmonal ( Amplitude P > 0,12 Sec )

Q
.
s

RVH : o Gel . Rls di lead U

,
atau Vz > I atau

Gel . Rls di lead Us atau Us < 1

RAH RUH

RUH
 Gaga l jantung Kiri Sesak
" "

° -7

( Decompensatio Cordis sinistral -

Sesak Saat Beraktifitasctypsnea on

effort )
-

Terbangun Tengah Malam Karens

sesak ( PND )

-
Sesak Saat lstirahat Cortophnea )
-
Rhonki Basah Basal

-
53 Gallop Ct )

P .
Penunjang → Foto thorax Ckadiolosi ) → CTR 750%

LAH contour
"
Double
"

Jantung Tertanam I Tenggekm

"
s

WH →

EKG :

LAH → P . Mitral → Gel . P Berbentuk Sepertihuruf

"

Iif
"

~
m
LUH → Gel .
R di Us atau UG t Gel .
S di
Sokolow Lyon
U ,
atau Vz 3 35 Mm .
→

LVH
LAH
.
1- AH

WH
SMART WAY EKG "
6. jantung "

Tika R di U
,
-
Vz Tinggi clan Sdi Us -
Us Dalam → RUH

R di Us Va dans di Vz Dalam LUH

-

Tinggi V
,
- →

SMART WAY I
° Gj .
Kanan t Perry .
Pan Kron's CPPOKI Asma Kunis )

→ Cor Pulmonate Diseases → -0 Sesak Nafas Progresif → Kron is

⑦ Sesak Nafas Progress f

'

s zmgg

→ Aleut

° LVH ( Radio Cosi / EKG ) : Asimtomatis t

Hipertensi
→ Hipertensive Heart Diseases

• G. jantuns Kiri t 6 .
Janning Kanan →
congestive Heart

failure

klasifikasi 6 .
3- antung

a) .
Anatomis
-
Class A = -0 Cardio mega Ii : Hipertensi Ct )

- Class B = to cardio megali : Asimtomatis

class c = ⑦ Cardio nnegali : Sesak Natas Munch Saat aktiuitas

simtomatik
-

Berat -

Ring an .

- class D= to cardio mega Ii :

sesak Natas Mun cul Wala u

sedans lstirahat ref rather dengay pember ian obat In

,

thy Transplanted Santy

b) . Fungsional CNYHA ) .

NYHA I : to cardio megali : AsimTomah's

 naik tangga
NYHA I : Sesak Nafas Munch Saat Aktivitas Berat ( oerjalan > room
)
NYHA II : Sesak Nafas Munch Saat aktivitas Ring an ( KE Kamar
mandi )
NYHA II : Sesak Nafas Munch Saat lstirahat

Tatalaksana :

o Edu Kasi : o
Batasi Cai ran dan Garam

farmakolosi Furosemide ( Diuretic ) Anti RAAS

1-7
° : '

alot -
Ace Ihh C -

pril ) / ARB C - tan ) → Anti

Remodeling .

9 - Beta Blocker C- pro lol ) → Anti simpatico

- MRA ( spironolactone ) anti fibrosis
Denaro : seoelum

Jantung Edema
/ nya tampa CHF
2) .
Gaga I Afoot 1 Paw Akut
\
IMA dll At HF : seeelum
PIB
acuff
E : o 6 jantung Kron is : P J katub :

dengan CHE
.
:
nya
.
. .

decompensated
heart
Diagnosis : o Sesak Nafas Progresifl Member at Ys di pengawhi Failure
Oleh Posisi to → orthopne Berat

④
•
Onset C 2mg g
°
PD → Rhonki di seluwh lap . Pan
o

Gejala F .
Resiko Ct )

P Foto thorax
.

Penunjang →

"
Bat appearance / Kerley D line
wing
"

TY .
Bed Rest

Posisi C45° )
° Semi
fowler .

4 6 Eli
o
Oksigenasi -

Farmakologi Lasix Cteuretik ( furosemide )

}
• : o
→ Iv

•
Morfin N tense

a Nitro gli serin drips

Ik sesak nap as Saat aktiuitas berat
Goth i blnyglalu .
hipertensi CA
Riw . .

1401g
. .

tibial 1*1 Rt 4cm TD

PF : ron ki basah basal ft) edema pre
TVJ . : o
,

Diagnosis
-

x ti 36 t C
HR : 100×6 RR : 30 T : , . .

Diagnosis
a. G J Congestive
Kiri
b. Gaga l jan tung
c . Denovo heart failure
④ AD # lF. Kron is
e .

Gaga j antung
④ Perry
. .
Jantongkafub .

E : D .
Reumatik : Endocarditis I Miokarditis

Klasifikasi :

•
stenosis → ketidakmampuan kata jointing Membuka Sempurna
°
lsufisiensilkegurgitasi →
ketidakmampuan Kath Jantung
Menu top Secara Sempurna

Diagnosis :

• Moolah lelah o
"
Murmur "

o
Palpitasi I Berdebar debar .
°
Fak .
Resiko Ct)

.
Angina CH

Sesak Nafas P Penvnjang Echo

→
cardiograph
.
•

SMART WAY : Cusco Doppler

① .
Tentukan Jembatan lnsatan Jantung ) .

( stenosis Aorta ) ( Aorta lsufisiensi )

MI -
SA -
S "
sistolik "
Ms -
Al -
D
"

Diastolic "

( Mitral kufisiensi ) ( Mitral stenosis ) murmur pansistolik

A =P
M parasternal
= T les z
Kiri
② .
Tentukan Lokasi Kath Is Mengalami Murmur

Aorta ICS II Para sternal Kanan Uk SB

→
MI SAS
-

pulmonate Para sternal Kiri ULSO

-
KS II
stenosis aorta

Tricuspidalis II Kiri / USB

-
→ Ics para sternal stenosispulmonate
-
Mitral → Ics II 15 Midd avi auk Kiri 1 Apex

Cth : Murmur Pansistolik Grade III di Apex

④ -

SA -
S Mitral

Dx : Mitral kufisiensi
 Kelainan Katup
D Tentukan Murmur :
Sistolihatau Diastolic

27 Tentukan Posies .

murmur st①h ICS 2 para

te
sternal Kanan

aorta
MI SA S
aortal '
stenosis

murmur midd lcszparasternalla.NL

↳ pulmonal
M S A l D insupisiensil
I regusrgitasi
aorta
insyrisiensi

murmur earlykk ICS

qparasta.in
de

MI SA S insufisiensitrikvspid

mitral insutpisiensi
 ⑦ AID
mitral stenosis

aorta insufisiensi

⑤SAS
insufisiensi
mitral
Cth : Murmur split Diastolik Sr III di les II Para sternal

Kanan

Ms ④ D Aorta
"
"
-

Dx : Aorta lsufsiensi

Murmur Holo Holik III les tu Para sternal

'

•
Sr di kin

Ml -

SA - S Tricuspid alis
"

Dx Tricuspid alis lsufisiensi

Tatalaksana :
Rujuk ke Rs

② . Perry .
Jantung Bawaan → kardiologi Anak

E : o
Defect Kon genital
°
lhfeksi kehamilan → TORCH
"
Rube la
"
→ PDA

Mu dah blah H
Diagnosis : o o
PD → Siano sis -

o Sesak Nafas Murmur ⑦

Kesulitan Miriam
Palpita si et )
° .

o
Fak . Resiko Ct )

Tumbuh dan Kemba ng

•
Gaguan
P .

Penunjang → Echo cardiograph cuss Doppler

jantung ) .
SMART WAY
°
PJB Tipe Asian is C Tidal Bin )
-
Murmur Pansistolik → Ventricular septal Defect CVSD )

- BJ : Wide Fixed Splitting Cse) → Atrial septal Defeat C ASD )

-
Murmur Machinery 1 Contini ous → Pattern Ductus Arteriosus CPPA )

Sztunggalzkeras ↳ rubella
TGA :

shape
(
RO :
egg
PIB Ckebinan ) spell jongkok
Tipe Siano sis TOF → tet biru
o →
,

-
VSD
"

Murmur Pansistolik
" ↳ RO : boot shape
-

Steno his pulmonal

"

Murmur Sisto lik di les II para sternal Kiri -.

Overriding
-
Aorta
IEOV -

RUH
-

Dx : Tetra logi of Fallot

-
ASD 1USD → Siano sis

Dx :
Eisenmenger syndrome

Tata laksa na :
Rujuk ke Rs

⑤ .
Perry .
Jantung lnfektif

Denham Reumatik
1) .

E :
Streptococcus B -
Hemoliticus Group A ( SOHGA )
Risk : 15pA
KRITERIA JONES
saat dada
Dx Mayor nyeri
mengembang P
'

A STO
: kriteria
murmur ,
.

Penury ang : CH
- endokardies miokarditis
.ro/itis-Nyen-dadapleuritikPoliatritis
ka , ,

Nyeri Sender dan Bertin dah kriteria : Minimal

→ 71 72
Gejak
Chorea → Gerakan lnvolunter Mayor ± A STO Ct )

Eritema Marginal um -
→ kemerahandikulit

Subkutan Nodal → Nodul di sutkutan Aerynlay di Pawan lentil

 astiainotik
asianotik
×
→

Lo TD eks at as =/ TD eksbawah
↳ RO figure :
of
three

O
→ boot shape sianotik
X
X .

X
x
kriteria Minor

o Demain 738°C

Atralgia I Gejala Mayor 2 Gejala Minor

"
o t

•
P .
Lab : leukositosis I ASTO Ctt )

°
Tt CR -

p
•
Prolong PR Interval C Duras i > 5mm )

Riw
1 17
Reumatik Murmur
1

SMART WAY : Demain t → Perry .

Tanto ng Reumatik
( le si Kronig)

TY .
Rujuk ke RS coccus → Gram ① ex : N . Gonorrhea

Basil → Gram -0 ex :
Corynebacterium
2) Endocarditis lnfektif Clostridium
sentik Irikuspid .

#
.

E : o Jahr N C Penggunaanobat : Nar Koba ) → Staphylococcus Aureus

-

Hanover Gigi → Streptococcus uiridans Mitral

•
• ,
→
- TAS Megan Vox -

Meeksi Pata Gigi - - - - -

Dx : o
Demain 730°C Tanda Khas :
KRITERIA DUKE
-

Nyeri Dada Pleuritic o Osler Nodes

•
=
Natas
Sesak o Janeway cession

•
Palpita si o
Roth spot
-

o Fak . Resiko Cf )

P .
Penunjang → o Echo cardiograph Cusco Doppler jantung )
-
"

kumpulan c- Vegetasi pd katub Jantung "

selvegetasi °
P .
Lab → Kultur Darah 3 Waktu
-

Thf .

Rujuk ke Rs
Infeksi Tenggorokan Peng Santy
.
Roman

Demain Rema til

3) .
Pericarditis
E :
lnfektif .
→ Endocarditis : D .
Reumatik : TB Paro .

Non lnfekfif : Auto lmun CSLE : R .

Atif's id" ) .

Dx : o
Nyeri Dada pleuritic 110cal tiedPD → Murmur
"

• sesak Natas
"
Fraction Rub Murmur ⑦

o
Palpita si
o Fak . Resiko Ct ) P .

Penunjang → EKG
°
Denham 4-
"
St elevasi di Senna Sada pan "

tht Kujuk ke Rs

④ .
Bradycardia

6g konduksijantung Block
"
E
"
: .

Dx :
o Mudah blah ( Capek

Depr@sipRdisemuasadapanoP.T l Ping San

"
o Sin Kop

TV → HR L 60×4 -

P Penunjang
.
→ EKG → AV Block

Klasifikasi :

a) .
AV Block Grade I

-
HR < 60×4 .
-0 ada Gel .

Pyg kehilangan QRS

-

Prolonged Interval PR C > 0,2 Sec ) .

b) .
AV Block Grade II

-
HR C 60×4
-

I atau Lebih Gel . P 49 kehilangan Komp leks QRS

Morbitz I →
Prolonged PR Interval ( makin Lama makin panjang)

Morbitz I → Interval PR Regular Iteitap

 tendokarditisineekctif → DUKE

→ vegeta si

AV blok I → Paca ran LDR

AV blok I → PHP

AV blok II → Potus
c) .
Au Block Grade II Ciotat Au Block )

HR < 60×4 '

-
Hama Jantung -0 Normal → Gel -

p → QRS
Send iri send iri )
C P -

QRS Berjalan -

a. Tatalaksana
-

-
Asimtomatis

simtomatis

1St

2nd
:

:
:

Sulfa s
:

Epinefh he / Adrenalin
-
.

Atop in
Observasi

N Cos my
IM
)

3rd :
Dopamine IV

Mobile 2 atau AU blok St III : Tran cutaneous

pacemaker
④ -
Takikardia
E : o 114A : G Ianto ng
-
Aleut :
Perry .
Hi perthyroid : Tension Pneumothorax
Cordis dll
Tamponade : .

Dx : o Berdebar - debar 1 Palpita si

• TTU : HR 7 100×1 -

P .

Penunjang → EKG

a) .
Sinus Tachycardia
tht .-: 601 Digitalis
.
Gol - B -

Blocker

Atari Pen b .
Pasar
b) .
A-sinus → Tipe Atrial CQRS Sempit : so , 12 Sec 13mm) .

°
Gel .
P Ct )

o QRS Sem pit CLO , 12 Sec )

1) Supra .
ventricular Tachycardia
Tanda dan
: o
Gel .
p Gel .
T Tumpang Tindih

SMART WAY : QRS Sempit :

Hk> 100% : R - R Interval "
I Get "
→ SVT

2) .
Atrial flutter

Tanda : o
HR 7100×4 - °
Gel .
A- sinus ⑦ ✓

•
Gel . P CH : QRS Sem
pit too lrama Regular ✓

SMART WAY : Tika diantara R -

R Interval 72 Get .P ; lrama Regular .

saw tooth

3) .
Atrial fibril asi

Tanda HR Gel A sinus

100×4
°

: o > - .

Get QRS Sempit

u -

Pct) : .
Kama Irregular .

SMART WAY : jikadianta R -

R Interval 72 Gel : Kama Irregular .
 HR 2100×1:

mfs
QRS Lebar
Qrssempit
( cskk ) ( 73kt )

Regular
regular
regular Regular
t
t t
Atrial Ventricular Ventricular
r r r r
f- ibrilasi
- -

R Fibril.si takikardi
get
-

2.
> 2. gel
Igel
t t
t sinus Atrial
SVT takikardi flutter
( supra ventricular)
Takikardi
 Tatalaksana
Tackyarrhythmia
-
Tentukan Statoil atau Tidal staoil
Cabral dingin )
S : syok
dada )
A : angina ( nyeri

hipokngi ( TDs ago mmHg )

H :

ronkibasah)
A : acute
lung oedema (

M :
mental alteration , ( t kesaidaran)

tail :
Farmakokg .

- Tentuhan trap ;
Tidal ?
Ekhtnk
stagy
Tipe Ventricular

Ciri :O HR 7100×4 .

• Gel . P C -
) ada :
QRS Lebar C > 0,12 Sec )

a) .
Ventricular Takikardia

HR 7100×4 tram a Regular

-

° o

c. Gel .
P C -
Jada : QRS Lebar C > 0,12 See )

12--12=12

b) .
Ventricular Fibrilasi
HR 7100×4 Kama Irregular
'
o
•

° Gel . P C- Jada : QRS Lebar C > 0,12 Sec )

Tatalaksana

① Tentokan duh Tipe Statoil / Tidal Statoil

.

Hipotensi C TDs mmHg )

.com/-oofitfehi'uIn
-

ago

- Peru Gahan status Mental Ctt kesadaran )

"o " spat

jinns
- ""

-
Ischemic Jantung → Nyeri Dada I Tanda

- Alo → Sesak ,

⑦ Statoil → Terapi Farmakologi

① Statoil → Terapi Listrik
 pijatsalahsdtua.karotis-bersinlbatuk.kompresding.in
stall 88 or ace
A Flutter : :

Karoli overs 50
•
S
'
100
tidal Staal
. -

• SVT 1A -
.
Flutter : Statoil :
1st : Hanover Vagal →

KI : o Riw .
TIA :
VTIVF : Bruit tarots

2nd : Adenosine II

① Statoil : kardioversi joule 50 - 100

• A . Fibril asi : Statoil : Rate : 601 Beta Blocker.

Bistro lol :

o A . Fibril asi :
o
Gol . CCB : o Diltiazem : Vera pamill Iv

Digitalis → CHF
•
: .
Digoxin

Rhythm : o Amiodarone Iu
① Statoil Karoli overs i Bifasik 120 200 joule
-

: a
-

Karoli overs i Monofasik 200 joule

-
•

•
V .
Taki Karelia Statoil : o
Amiodarone II
with pulse ① Statoil : o kardioversi 100 joule
( synchronized

• V Fibril asi : ① Statoil Defibrilasi / Dc shock Ikardioversi

unsyncronized
.
:

①
Bifasik 200
Joule
①
Monofasik 360 joule

⑤ .
Cardiac Arrest
E : 5h t 5T

Hipotensi -

Hipothermia -

Tromboem Goli Pan f

-

Hidrogen Ion -
Toxic jantung .

Hipovolemia .
-

Tamponade Cordis

-
Hi Pol Hiperkalemia -
Tension Pneumothorax

DX att kesadaran
:
a
Fat . Resiko CH .

•
-0 Nadi Kant's
 Depibrilasi Kardioversi
list rile Saat seteleah puncak
•
G) perk disinkronisasi .
kejut
gel QRS
•
Hentijantung .
Mengembalikanirama ke sinus

M) → VT mo nomore
ik

Hipomagnesemia
MMMMMM f
(
→ VT polimorfik

Torsa de points
^
Statoil f) Statoil

Detpibrilasi
"
In;
Magnesium
QRS pit i regular
stabit
s em

ti da k
A. fibril as i

↳ QRS
amp
it regular
Igel → SVT C- I stabit
t
list rile
 Cardiac Arrest
-

Penurunankecsadaran
-
Putsasi Nadi tidah ada

Shockable Unshockable
VT without A systole ① had
-
pulse : rescuer -

{
① listnk
-
VF : irregular
① nah .

PEA ✓
← I
gamba EKG ① listnh
If
Senna ran

i DC Shock Kee . VT k V F

-
Epineprin th : 120190
- Ami odaron 2x
, Epineprin
- RJPO
I

:
 Ventricular
takikardi
→

trace

Stock able

→ PEA ( unshockable)

↳ Vfibrilasi

shockable
RTP dihentikan : 15 men it a asistol
Total aksana :

o
① Sadar → call For Help .
→ Cela Nadi Kar tis lo -
20
"

① Nadi → RIP 30 : 2 sampai perto longan

Batang / Monitor Data ng

t
o Monitor Batang → RIP dihenlikan → Evaluasi Coelom bang .

klasifikasi
a) .
Tipe shock able → V. Takikardia IV. Fibril asi

TY .
DC shock I Defibrilasi Monofasik 360 joule
Bifasik 200 joule
°
Lanjutkan dgn Rjp .

C 2 me hit )

b) shockable Pulse less electrical activity

.

Tipe Non → C QRS Sem pit ) .

Asi stole C- )

try Epinefine 1mg lntubasi

'

Tf1 . RIP t . t

( 2 merit ) .

③ .
Cardiac Tamponade
E : o Trauma Thorax
DX : o TRIAS BECK
-

Hipotensi CTD 5<90 mmHg )

TT TVI CTT Jvp )

- Swara Jantung It ( Hila ng C Muffled Heart Sound ) .

Fak Rest ko Ct )
-

•
.

P Penunjang EKG Low Voltage electrical activity

" "

. →

Tf1 . Resusitasi ABCDE → clear

↳
Needle Pen cardiosinless
-

C Bantu an 056 ) .

Utama Thora Otomi

"

Rujuk
"
•
→ ke Rs
 ( TDs ago mmHg)
④ .
Hipotensi
E : o Masalah Rate → Bradycardia

• Masala h volume → Hipovolemia

o
Masa Iah Pompa Cj antung ) → IMA : ALO

DX : o
TDs s go mmHg
Th Io Cela Nadi HRC Go Mi → Proto Kol Bradikardia
'

observant
'
Ii
Lanjutkan
HR 760 -1

°
Beri Cai ran Kristakid Had 0cg % 20 milks 1313/15-30 merit

TT Naik → observasi

① Naik -7 Gant Protocol → syokkardiogenik

t
o Farmakologi
TDS 570 mmHg t Akral Ding in → lnj .
Norepinefrine ( Nene k )
177570 - too
mmHg t Akral Ding in -7
lnj -

Dopamine ( Ba pak )
177570 -
100 MmHg t ① Akral Ding in -7
lhj .
Dober famine ( Ibu )
m
PVC ( Premature Ventricular contraction)
② Ventricular Extra Sisto le ( QRS tear )
.

oleh P
E : . 6g elektro lit
.
.
↳ tanpadidahdui
•
Efek Sam
ping Perigo batan
° Kelainan Hormonal "
Timid "

o ACS

DX ' .
Jan tung Berdebar debar -

( Palpita si
•
TTV :
HR 7100×4
EKG
P .

Penunjang →

"

Munch Komp leks QRS Tampa di dahului

Oleh Gel . P
"
koan
 I

Berdasarkan Morfologi
o Ves Monomorfik
o Ves Polimorfik ( Mufti Fok al .

2 3
4
Tipe Lain : . Ves Big emin , I Trigemini / Tetra gemini
I -

.
o Ves coupled .

o Ves R ont

Total aksana Amiodarone II disease

:

Berger
Lr IgA nee ropati
④ Perry
.
.
Vascular
C. Burger Diseases )
a) . Tromboangitis obliterates .

E :
Thomas Pd Arter Peifer
Heb at Pd distal Eastern it
Dx :
o

Nyeri as

o Fak .
Resiko Ct) → Pero Kok Berat

t.lu/Hilang.Ujungekstremitas ianosis/NekrosisTh/.Rujuk eRs-

°
PD → .
Pulsar Arter Distal

Terapi operatif
b) .
lsufisiensi Vena Kunis

E : Thomas Pd Vena distal .

→ lsufisiensi Pd katub vena

Dx : o
Kaki Moolah Capek Ile Iah
o Kaki Pegal
o -

Edema to
• Kull't Meng Ki lat :
Hiperpigmentasi
° Luka suit sembuh Pol Tung Kai

o Riw . Perry .
Va rises 4 Metabolite

P .
Penunjang → USG Doppler Gold standar :
venograpi

Thf .
Non Farmakologi :
Pemakaian Stocking 1 Elastic verb an

Farmakologi Rojo k ke RS Anti koagulan

" '
• →

Deep Vein Trombosis stroke

c) rice jauh
perjalanan
.

→
E : -0 Mobilisasi Tung Kai → ri w

Dx : o
Nyeri Pd Tung Kai Bawa h

° Edema to

°
Fak .
Resiko Ct )

Tanda Khas : Homan 's sign to

P .

Penunjang : 056 Doppler

D- Dinner TT

Thf Rujuk ke Rs → Anti

-

koagulan .
→ heparin ,
warfarin

d) .
Tromboflebitis TV . 6 anti Tempat IV line

E : o Pemakaian Iv Line Terlalu Lama .

Tera pi
"

Simtomatis "

Dx : o Demain 738°C

°
Atralgia : Mialgia , Anoreksia : Nausea -

Vomiting .

Tanda lnfkmasi ⑦ di Seki tar Line

-

PD : IV

Fak -
Resiko Ctl .
 Perry Vaekular
.

aktiuitas ,

Arteri nyeri7 istira

hat
Vena
e. c-

6ejala/ :c pain , klaudikasio intermittent

65daL Edema (
surely
Tanda - akral Singin ( polar ) Tanah - Eilema

/
paresthesia i Nyeri
Ulkug
-
pallor ,

- pulse less
/ paralysis
liter an
tromboangitisob
arterial disease
¢ :L Superfund
,

Cf
→
: TAO '

fer s
Varices
pen
→
'
PAD → klauclikagio I Al

acute ←- AH → 22 wingers GP - thromofkfiho '

limbnjry
,

- Cll → 72 mingsn
,
B@ulk.us
GP 4 Deep
t t -
BUT
chronic limb ischemi
ABI LO ,
g
I
rises thiperpigmentasi

→
arter

( BBB → William

RBBB → MARROW
 onsetakuttnyeri
( BBB : William →
dada
I
RBBB :
MARROW ACS
kupingkelincillp
'