Materi UKMPPD

KARDIOVASKULAR
-

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

R
Gel dari Atrium

appt
°
. P → Terbentuk presses Depolarisasi
(N C 0,12 Sec 13mm )

Q
s
o

kompleks QRS → Terbentuk dari p roses Depolarisasi

Ventrikel C Duras,
-

0,12 -
0.2 Sec I
.

3 -
5 MM )

Gel T Terbentuk dari Repo Ian Sasi

'

→ poses
•
.

'
Ventrikel C Amplitude c
13 Gel .
R)

Cara Membaca EKG

① Pastikan Bahwa EKG 99 di Gaea -0 Ter Galik

.

①
Indicator lead AVR
I
:

"

Pd lead AVR Gel 00

P.AT Depleksi Negatif
'

W
→ EKG Terpasang Behar "
-0

Whr P Q
g
T
② Menentukan Tenis Gelombang : Kama : HR
.

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

SMART WAY : Tika diantara R -

R Interval "

2 Gel
"
-0 Sinus

* A sinus → Tika Setelah Gel P ① diikuti Oleh

-

kompleks QRS

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

③ .
Menentukan Axis jantung .

Indicator Lead Ct ) IC I t
Pengurangan
"

I Tinggi
-

: .

lead Auf Ct ) le ) Gel .

R dgn Gel .
S
"

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

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
Tent up an Apa Kah EKG Lagat Baca 1 Tidal -0 lead
A④

A-
,

Ritmik HR 93 Mi Rego ler Right Deviation

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

a) . Angina Pectoris Statoil

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
C Normal ) .

* Exercise stress Test C Treadmill Test ) →

Angina ⑦
"
"

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

5mg P.co/djamCkI:Hipotensi ) .

°
Got . B -
Blocker C -
0101 ) .

• Cool .
Statin
⑥ .
Sindroma Kovner Aleut CSKA )

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

⑦ P .
Enzim Jantung : TT Meninga at
Dx : STEM I

Whyy shaped atau

"
W
ST segmen Depress
"
-
•

T - Inverted
Mfg
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

Lateral :
I Aul Us -
Us → LCX → 1 Area dikatakan

Inferior :
I , II Auf → RCA Bermakna

Septal Vi Uz Minimal Menge nai

y
"
: -

→ LAD
Anterior :

vz -

Vg 2 Lead "
 Remo Daran
Sadapan Anatomi .

II. III. AUF Interior RCA

1. an lateral LCX
Ve Vz -

Septal LAD
Vz -

Vg Anterior LAD
Us -
VG lateral LCX

Artem Kononer

- -
Right #
left Anterior
Coronary left
Artery Descending
CLAD Circumflex
f CLCX )
11 ,
III. AUF Vi -

V4 VS Vo 1. AUL
-

,
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
Tera
pi loading :
ONACOM

Dx : STE Mil NSTEMTIUAP

/
Tatalaksana : →
-

I onset s
kjam
① .
Modifikasi 6 .

Hidup .
Tera pi teferfst
② Terapi loading ONACOM
"

A- wall
"

Oksigen →
sp .
Oz s 90% → 4 - G Eli

7 got . t I - 2 eli

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

( Vasodilator ) 15mg .

( TDS mmHg)
KI :
I Hipotensi CSO

- Post Konswmsi Sildenafil

⑤ Peng kardiologi
.
.

Ku :
Nyeri Dada ⑦ I → Onset 7,15 men it i ① Hi lang dgnlstirahat →
Dx : Sindroma Kovner Aleut

Angina Usia > 40 Thin → Nyeri Epigastrium to / Angina Pectoris -0 Statoil .

-
b
Ste leva si IM shaped
Onset C 15 Men it atau Hiking dgn P Penonjang EKG :
-
.
. :

lslirahat to
.f¥
pug
t TT E -

jointing = STENT

"ht nifty
FR : Ro Kok :
Obesity : DMIHT
:
Riw .

keluarga
EKG
Pjk 411
Normal / sinus Ritmik
ST Depress IT .
Inver si :

If
P .

Penunjang
: →

Mio globin E.jantung T

NSTEMI
Ejantung t 2
jam :

}
: o
-

. CK MB
-
3-9 jam " " m" E anting N :
Llap .

troponin Iq , - G
jam
P Tamba han
.
→ Treadmill Test → Angina to

Dx :
Angina pectoris Statoil
Lokasi lnfark .

Minimal lead di
Lateral I Aul Vs dan Vs Ji " Mensenai a

ther?:{jaan
)
:
, ,

Inferior :
II. II dan Auf

Septal : V. dan Vz

Anterior : V , dan Va

L I I S A A

Cth : EKG : M -

shaped di IX. AVE .

II. * 4. Vg ,
dsn Tt Ck -
MB .

Dx :
STEMI Antero Inferior .

LI L S S A

EKG T - Inver si di I.IX. Avl ,

V
, ,Vz # ,
dsn TT Mioglobin

Dx : NSTEMI Later septal .

 ooze
-

→
dikunyah loading
"

Aspirin 160
"

-
→ -
320 mg →

C Antiplatelet ) 75 y -

y
600mg ditelan
clopidogrel
" "

-
→ 300 -

C Antiplatelet )

Morfin → 2mg Bolus IV dgn Nad O ,g%

( Analgesic -

opioid ) KI :
Hipotensi

• 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
"

/ TT TVT ,
DOE

- A sites , PND

- Hepa to Splenomesali - OP

- 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 Shape Koi Volvo Cantor
evka
Rfs di V
,
71 1- Savva
Nkt
Va -51
Hs & Root Shape 735mm

Apex
Downward
 R
Pem EKG p

NY ht
•
.

T
RAH : o P -
pulmonal ( Amplitude P > 0,12 Sec )
I A
Q
.

Y µ ) Sm -
s

RVH : o Gel . Rls di lead U

,
atau Vz > I atau

Gel . Rls di lead Us atau Us < 1

RAH RUH
Gel .
Rls "
k -

Es
Q
-

÷; ;
ai
:

M
O O
-

O <I

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 :
teh
LAH → P . Mitral → Gel . P Berbentuk Sepertihuruf
Durasi "

Iif
"

~
is is
m
O
.

LUH →

0=00Gel
U ,
.

atau
R di

Vz
Us atau
3 35 Mm
UG

.
t Gel . o
S di

LVH
LAH
.
1- AH

Get ⑤ .

0
-

So

I 3
5
5:28
g-
Gel .
R .

①
5

I ① 21 t 2b

-
-

e
=
4g .

12--21
-
,
.

O s

I sus

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

Berat -

Ring an .

- class D= to cardio mega Ii :

sesak Natas Mun cul Wala u

sedans lstirahat ref rather dengay pember ian

,

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
° : '

/ ARB tan ) Anti

-
Ace Ihh C -

pril ) C -
→
Remodeling .

- 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
E : o 6 jantung Kron is PIB : P J katub :

dengan CHE
.
:
nya
.
. .

Diagnosis : o Sesak Nafas Progresifl Member at Ys di pengawhi

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 wing appearance
"

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

IO Gaga I jantong
.

Ku : Sesak Nafas Saat lstirahat : → Dx :

Gaga I Jantung Kiri

Terbangun Malam Hari

"

Sesak . C Decompensation Cordis sinistral .

{
Sesak Saat aktifitas : Rhonki

Basah Basal :
S3 Gallop .

Heart Failure Cath

Dx congestive
p.onsgetnus.g.no?aeno+o+nora
: .

. . *,

→
LAH atau → Asimtomah's

+ HT → Dx : HHD .

Ku : Edema Preti 6cal : TT Tvj → DX :

Gaga ' j anting Kanan sesak Berat Lzmgg

C
"

A sites :
Heptosplenomegali Decompensation Cordis Dextral . Akut "

S3 Gallop to t Perry .
Pan Kunis CPPOK)

onset 33 Bln D× Cor -

pulmonate Disease COPD)

P Foto thorax EKG

Penunjang
:
.
:

Statoil → tennis
→ RAH dan RVH
Gagal jointing Aleut 1 Edema Paw Akut

SeSak Thf Oz 9 eh
o
Natas pwgresif C 2 mgg . ; : -

se Sak di pengawhi posisi Posisi semi fowler

PD : Rhonki Lap Paw / Selunh Lap

. .
Pan

I Dobutomiu
FP : Riw .
Perry .
jointing TD I -1 TT Dopamine

[ Gjantung .

. P J katub
.
.
:
Pj lnfeksi )
.
.
Hore pine fine

Foto Rontgen Bat wing appearance Lasix / Furosemide

"

-1 / TDT → w

Kerley B -

fines
"
Morfin w

Nitro
gli serin drips
Dx :
GJA / Acute Deco mpesaho Cordis
Acute Heart failure / Acute lung oedem .
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 )

② .
Tentukan Lokasi Kath Is Mengalami Murmur

-
Aorta → ICS II Para sternal Kanan Uk SB

pulmonate KS II Para sternal Kiri ULSO

Tricuspidalis → Ics II para sternal Kiri / USB

-
Mitral → Ics II Midd avi auk Kiri 1 Apex

Cth : Murmur Pansistolik Grade III di Apex

④ -

SA -
S Mitral

Dx : Mitral kufisiensi
Ku :
Palpitasi : Moolah Celan Sesak : → Murmur : Sistolik Cst )
"

Ml
"

Nafas SA S
-
-

Murmur ⑦ Mitral lsufisiensi

}
PD : MI :

M : sistolik
P .
Penutian : Echo cardiograph -

sa , stenosis Aorta

Murmur Diastolic ( Sz )

/
"
"

Tx :
Kojak Ke RS -
"

Ms -

Al -
D
"

Mitral stenosis
u Ms
} Diastolic
.

Murmur AI Aorta lsufisiensi

↳ Kasi :

ICS II
'

Parasternal Kanan : Aorta

Murmur Pansistolik di KS para sternal Kanan
ICSI Para sternal Kiri = Pulmonal -
o II
= -

KSII Para sternal Kii :

tricuspid alis MI 5 a
Aorta
.

Midd acicula kin Mitral

'

KS II
'

( Apex Dx : stenosis fork .

 Diastolic di KJ
Murmur Diastolic di Apex up Kei
split
.

§f¥¥
MOS -
Al -17 "

Mitral
"
-
D . tricuspid .

Dx
.
. Mitral stenosis

Sisto lik
Murmur Ejection di les II puiddcuiculc Kii

MiG -

.
SA -

5 Mitral .

Sisto lik di k5
ftp.kini
Mi SA -
S pulmonate
t t

TI
④ .
Kelainan Katup
D Tentukan Murmur :
Sistolihatau Diastolic

27 Tentukan Posies .
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
"

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 ) .
 Perry jantungkatub
.
.

Anak : Palpita si : Moolah lelah → PD :

-0 Siano sis 1 Biru

Se Sak Nafas :
Murmur ⑦ - Pansistolik -1 USD .

diastolic ASD
-

Slipt -1 .

|
- Continious Murmur / Machinery
Murmur -1 PDA
O

⑤ Siano sis / Biru to →

DX :
TOF P .

Penunjang : Echo cardiograph

Overriding Rs
-

USD : Aorta Tx :
Ryuk ke

stenosis Pulmonal C Sisto lik di les II Kiri )

RUH C Boot shaped )

-
USD / ASD → Bin → Dx :
Eisenmenger syndrome
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 )

PIB Ckebinan )
o
Tipe Siano sis

Pansistolik
"

Murmur
"
-
VSD

Steno his pulmonal

"

Murmur Sisto lik di les II para sternal Kiri -.

Overriding Aorta

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

Mayor P A STO
'

Dx : kriteria .

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

 Perry Jantungbawaan
.

#RtL shiny
Asian otih ( ↳ R shunt ) fianotik
- ASD * wide fixed , TOF

splitting Sz * pamsitoeil
* RUH RAD RBBB
, ,
murmur eius

* TS relate * Ejection systolic

• VSD * pashsistolih murmur murmur Queso

di USB * Sianosir
Ht LUH , Eisenmenger

/ PDA * Continuous ) Syndrome

machinery
murmur di Shoda via

* UH
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 )

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 .

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

• Hanover Gigi → Streptococcus uiridans

Meeksi Pata Gigi

Dx : o
Demain 730°C Tanda Khas :

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 )
-
"

Vegetasi pd katub Jantung "

Lab Kultur Darah 3 Waktu

°
P . →
-

Thf .

Rujuk ke Rs
Infeksi Tenggorokan Peng Santy
.
Roman

Demain Rema til

Peng .
jantung lnfekfif

Ko Kardifis Nyeri dada pleoritik

)
o
: :

Poliatritis :
Nyeri > I Sendi Minimal 2
Gejak
Chorea : Gerakan ① Ter Kendal i
+
f ASTO Ct ) → Dx :
Deman Rev Malik

Eritema Marginatom : Kuh't kemerahan IFR : Riw .

15pA ⑦ Murmur
7
Subkutan Model Perry jantung
.
Pneumatic

I E :
SABHA
O

Ben Kut Minor

"

1-
Gejala Gejala
"

t 2
-

PR Interval
-

Deman .
EKG :
Prolonged ( Normal C 5mm ) .

Atralgia
- Tt CR -
P Tx :
Rujuk ke Rs → Ab : 1st :
penicillin G

-
leukositosis Ind : Einhorn is in Pio .
Ku :
Nyeri Dada pleuritic : Denham to

Palpita si : Sesak Nafas : → PD :

Roth spot : Osler Nodes :

Moolah blah Janeway hession

P .

Penunjang : Echo → Vegeta si katubjantuns

o
Kultur Darrah

PD :
Murmur :
friction Rub Murmur ① Dx : Endo Karlis lhfektif
EKG : St elev asi di Senna lead E :
Staphylococcus Aureus Csuntikan )

Perdicarditis S Vin dans C Hanover Gigi )

'

Dx : .
.

E :
lnfeksi Primer Pd jointing ; TB

Autolmun
Tx :
Rujuk ke Rs .
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

Morbitz I → Interval PR Regular

 Bradiaritmia
akilat AV Block

Interval R R
-
Interval K R -

regular Irregular →
moggy
2nd type
↳ 1st : PR Interval ↳ -1
.
:
lengthening
memanjaef PR Interval before

↳ 3rd
:
Pt QRS misery Qrs

↳ 2nd Type Tl : constant

PR Interval Before

messy QRS
Bradikardia .

"

Ko : Moolah Idah : Leman -0 EKG : AV Block "

HR :< 60×4 : Hast fi Kasi : Grade I : HRC 607 -

,
:
Prolonged PR Interval

Ping San Csinkop ) .

Grade II : HR c6oTi ; I atau lebih Gel .
P kehilanfan

Dx : Bradikardia QRS
Interval
Morbitz I :
Prolonged PR

Morbitz II : Interval PR Normal

Grade II : Gel .
P -
QRS Munch Sendiri -
Sendiri

① Singleton .
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 -

HR< 60×4 -

30011ha ,
>s r
Qu Qts
p 150%1 -
le -

p
QRS
pp p pp p
t
.

=
R R
75 -

p
T
Tp Tp Tatalaksana :

X Asimtomatis : Observasi
Q
- .

=
-
simtomatis
25 -
K

1St Sulfa s Atop in N Cos my )

T
:

P
P
X Epinefh he / Adrenalin IM
-

2nd :

3rd :
Dopamine IV

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
R R

12
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

R R

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 ✓

# Regular .

R = R =
K

1 2 34

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 .

R F Rft

12 3 45

SMART WAY : jikadianta R -

R Interval 72 Gel : Kama Irregular .
 tehyarrhythmia_

QRS sempit QRS tear

Regular Irregular
Irregular Regular
t t
t
VT VF
Atrial Fibrilagi with pulse

sinus PAI PEI

l P → A QRS day 71 f
t t
ST Atrial SVT
Flutter
Takikardia

EKG
Ku : Berdebar -

debarlpalpitasi →
:
QRS sempit
C 3mm .

Hk > 100mi - diantara K -

k Interval Terdapat I Get → Svt

2 Get → sinus

V
| 72 Get →
Takikardia

Regular

QRS Lebar > 3mm A -

flutter

Regular : V. Takikardia Irregular

Irregular .
:
V .
fibrilagi A. Fiori last
 Tatalaksana
Tackyarrhythmia
-
Tentukan Statoil atau Tidal staoil

S : syok → Akmal Pinyin

A : angina →
Nyeri Dada

H : hipokngi TD Cso
Mn
Hf .

A : acute
lung
Sesak tofu beret
oedema
t Rho Ki ① .

M :
mental alteration ,
It kesadaran .

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

HR 7100×4
=
-
Takikardia
NhWETwu o
tram a Regular
c. Gel .
P C -
Jada : QRS Lebar C > 0,12 See )

000
12--12=12

Im

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
Palpita si : HR > 100×4

EKG -
.
Get QRS Munch ① dilkuti Gel . P .

Dx :
VES

Ahhhh
 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

HR < 1604, -
-1 Rhythm •
Digitalis : .
Digoxin → CHF

7160×4 Kate
→
Rhythm Amiodarone Iu
.

: o

① Statoil Karoli overs i Bifasik 120 200 joule

-

: a
-

T -

- -

Karoli overs i Monofasik 200 joule

-
•

- -

•
V .
Taki Karelia Statoil : o
Amiodarone II
= = I

with pulse ① Statoil : o kardioversi 100 joule

=
=

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

= =
=
Bifasik
T
200
Joule
-

Monofasik =
360 joule
=

⑤ .
Cardiac Arrest
E : 5h t 5T

Hipotensi -

Hipothermia -

Tromboem Goli Pan f

-

FEI EE
-

Hidrogen Ion -
Toxic jantung .

Hipovolemia .
-

Tamponade Cordis =

-
Hi Pol Hiperkalemia -
Tension Pneumothorax

DX att kesadaran
:
a
Fat . Resiko CH .

•
-0 Nadi Kant's
Hent
.

jantungl Cardiac Arrest

y
Hgntikin kjp →
Efgfygsi Coelom bang .

flu kesadaran Nadi Karotis -0 shockable VT IVF murmur

.t #:. . ./. . .ihi ioa.i: : i

: -
a

Dx : cardiac Arrest -
Non shockable =
PEA / Asi stole

it
IN
-

① .
Pastikan ① Sadar

28:&:
"
.

to -

kjp .

⑦ Ada
"

fjp -

Pert longan Non shoot

Datanglf Rjp lntubasi
-

-
-

d lay Epi refine

'

it .
AED / Monitor
= =
 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
① listnh
If i DC Shock

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

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

Dopamine
177570 -
100 MmHg t ① Akral Ding in -7
lhj .
Dober famine

② Ventricular Extra Sisto le ( QRS tear )

.

E : . 6g elektro lit
.
.

•
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
Ku : TD ego mmHg
Dx :
Hipotensi -0 E : HR th C Bradikardia ) -0 Tx : Tx Bradikardia

( E : volume C Derhidrasi ) → Tx : Nacl 0,9%

(
10 -
20 Ml
'

( Ks BD /
' 5-30 merit

E :
Pompa C Riw peng
.
.

janning ,
( Norepinefnne
TD 570 mmHg t Akrd Ding in -1 nj .

TD 70 -
too mmHg t A Kral bing in -7
lnj Dopamine
.

TD 70 -
too mmtf t ① Akmal Dingin x
lnj -

Dobutamine
 Tata laksa na
Hipotensi

1.) Rate :
algoritma bractikardialtakiaritmia

2) Volume : Cai ran A-Iuid challenge

3) Pump
Sh Okk Dolatamine
-
Tbs 70 Yd 100 mmHg →

70%1100 Minty ⑦
Dopamine
•
TDS shock →

mmHg ④
TDs to
Norepinephrine Shock →
 I

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

Tipe Lain : . Ves Big emin , I Trigemini / Tetra gemini

I -

.
o Ves coupled .

o Ves R ont

Total aksana : Amiodarone II

④ Perry
.
.
Vascular
Diseases )

000C
C. Burger
a) . Tromboangitis obliterates .

I
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
 Ventricular Extrasystole

↳ QRS Hoar
,
tampa clidahului Sel .
P
.

Frequent 75×4 many

{
:

I kekerapan
Infrequent 541
.

.
,
l -

merit

Unifokal
2 Ben tuk ✓
.

- Multifold ( Polimorfih

Oisemini
3 .
Repetti # Thiamin
(Oerulag )
.

\ Quaohrigemini
Qouplet
¢ .
Berkel ompok 1- Triplet

\ Quadri plet
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

Thf .
Non Farmakologi :
Pemakaian Stocking 1 Elastic verb an

Farmakologi Rojo k ke RS Anti koagulan

" '
• →

c) .
Deep Vein Trombosis

E : -0 Mobilisasi Tung Kai

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

Thf Rujuk ke Rs → Anti koagulan

-

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
.

Arteri Vena

6ejala/ :c pain , klaudikasio intermittent

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

/
paresthesia i Nyeri
Ulkug
-
pallor ,

- pulse less
/ paralysis
¢ :L Superfund
,

Cf : TAO s
Varices
'
PAD → klauclikagio I Al

- AH → 22 wingers
,
GP - thromofkfiho '

- Cll → 72 mingsn GP 4 Deep

,

-
BUT