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
R : 12 Kk → 1/3 × 12 i
4
R Q : 5 Kk
Gel dari Atrium

appt
°
. P → Terbentuk presses Depolarisasi

• (N C 0,12 Sec 13mm )

\, J point
Q
s
o

kompleks QRS → Terbentuk dari p roses Depolarisasi

Ventrikel C Duras, Sec I
miokard 0,12 0.2
-
-

old
.

Kk
PR interval in park
: 2 5
→
-

3 -
5 MM )

Qpatolog is : > 43 R ( OMD Gel T Terbentuk dari Repo Ian Sasi

'

→ poses
•
.

Ste levasi Ventrikel '

R)
C Amplitude 13 Gel
} ? I kk c .

ST depress
.

Ik k = I mm

Cara Membaca EKG

① Pastikan Bahwa EKG 99 di Gaea -0 Ter Galik

.

①
Indicator lead AVR P IT
I
:

"

Pd lead AVR Gel 00

P.AT Depleksi Negatif
'

W
→ EKG Terpasang Behar "
-0

R Deeleksi nega tip gel bang d

: om

Whr P Q
g
T
Dee leks i positif :
gelombang P
② Menentukan Tenis Gelombang : Kama : HR
.

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

QRS QRS

P p

SMART WAY : Tika diantara R -

R Interval "

2 Gel
"
-0 Sinus

* A sinus → Tika Setelah Gel P ① diikuti Oleh

-

kompleks QRS

→ recycler
I kb = 5 kk

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 Rs Rg
irregular
F 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 →
.
posisijantung
Kanan
Indicator Lead Ct ) IC I t
Pengurangan
"

Tinggi
ly
I
-

: .

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

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 .

kongenital ( dextro cardi )

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

(t)

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 La spesifik
C Normal ) .

* Exercise stress Test C Treadmill Test ) →

Angina ⑦
"
"

Gold standar :
angiografi
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 .

cydj
Got B Blocker C 0101 )
Ros was takin
° -
-

20 yomg
.
.

• Cool Statin ( high intensity ) -

\Atorrastatin
.

yo -80mg
 VAP
'

Tg N STE MI
⑥ .
Sindroma Kovner Aleut CSKA ) 1A Cs \
-

IS TE 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 Jantung

i

Ik , Got , nyeri ⑦ P .
Enzim : TT Meninga at
hat
is tira
.

LI
bail Dx : STEM I
VAP
-

)
EKG CN
c n)
}
enzi m
Whyy shaped atau
"
W
ST segmen Depress
"
-
•

dada 5am dada yam

'

both nyeri hat

T
,
Ik . Got , nyeri
Ik ,
S C I baile is tira
hat .

istira
-

bail
Mfg
F- KG : Ste leva si

ST depresi
C-7 T - Inverted en ein JanTung C 7 di La Kuban
-

1
EKG STE MI
ACS
N STE
-

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 Minimal Menge nai
y
"
: -

→ LAD →

Anterior :

vz -

Vg
descending artery 2 Lead "

✓, - ✓6 ,
I ,
AVL → Antero ekstensie → left main
artery II III
, ,
✓6 → STEM ,
inferior
 P JK

ACS
APS
- EKG CN )
#
- enzim CN) EKG ETCG
( Stelevasi ) cnonstelevasi)
-
Tredmill test (t )
t
STEMI
X
.io#-a:i:e:ien:.:i:
( enzim T)

cite:*!
alcott
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

 0

STEM l o O

inferior

STEM I

maintenance dose
ON A COM
→

→ loading dose

Kili p
I : C I
-

komplikasi → hang ACSa

II :
Gejala gag al jan tung bony i S3 A TVJ
→ ,

III : edema paruakut ( batwing appearace 1 Kerley B line cronkhi)

w :
syok kardiogenik Cgg hemodinamik )
.
 tab : dong
pl 160 ( ztab )
dikunyah loading
"

Aspirin
"

-
→ -
320 mg →

C Antiplatelet ) Ita b :
75mg
p 300 600mg ditelan (y tab)
clopidogrel
" "

-
→ -
→

C Antiplatelet ) UAP IN STEM l :

Aspirin (clopidogrel

Morfin → 2mg Bolus IV dgn Nad O ,g%

( Analgesic -

opioid ) KI :
Hipotensi STE MI : -
Primary PCI

-
Fibrinolisislstreptookinase
• 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 effort
'

/ TT TVT ,
DOE

- A sites , PND Paroxysmal

nocturnal dsispnea

- 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 kendi evki Double
( V ka Shape Koi Volvo Cantor
evka
at au Rfs di V
,
71 1- Savva
Nkt
Va -51
Hs & Root Shape l 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

Rls di lead U atau Sokolow

}
RVH : o Gel . ,
atau Vz > I
( yonn
Gel . Rls di lead Us atau Us < 1

RAH RUH

R : IOkk

s : 4kk

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

atau Sokolow Lyon n

U , 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

Berat -

Ring an .

- class D= to cardio mega Ii :

sesak Natas Mun cul Wala u

pember ian obat

'

sedans lstirahat ref rather dengay

,

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 .

←
- 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
(
E : o 6 jantung Kron is : P J katub :

dengan CHE
.
:
nya
.
. .

Acute Decompensated
Heart Failure
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
"
/ Kerley B line

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 TDS L 100

mmHg
atrial fibrilasi
GTA t STE MI → PC I GJA tsyok t

GTA t atrial fibril asi → digoxin L,

digoxin t kardiorersi
↳ JA t syok → norepinefrinfdopaminfdob.atamin
a. edema a. CH F
Pana
Kut De novo Heart Failure
b .

b. GJA c -
A DH F

d -
Ga gal jantung Kiri

e -

Gajgaljantung Kanan
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 : I
Cusco Doppler
① .
Tentukan Jembatan lnsatan Jantung ) .

( stenosis Aorta ) ( Aorta lsufisiensi )

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

Diastolic "

( Mitral kufisiensi ) ( Mitral stenosis )

hole sistolik
murmur
M = T A =P
murmur
early diastolic
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
murmur holosist I CS z para sternal Kiri ( put moral stenosis )
Ml SA S mitral
→ insufisiensi
Cth : Murmur Pansistolik Grade III di Apex
④ -

SA -
S Mitral

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

27 Tentukan Posies .

pan diastolic
paragtemalstenosis
kin
.

murmur ICS 4

⑨§④D
'
tricuspid
stenosis

murmur late sistolik ICS 2 para

sternal Kanan
d
MISES stenosis aorta
stenosis

pansistoik ICS 2 parasternal kin

.

murmur
d
MI ⑤ A S
⑧ ( moral stenosis

holo diastolic sternal Kiri

lcsqpqra
murmur

⑨ Otrikuspid
syyttno!? Stenosis

\
murmur holosist ICS 2 para
sternal Kiri

s pultmonal
-
stenosis

tstenosis

⑧AID
-

→ stenosis
mitral

€④
=

→ aorta insufisiensi

④ SAS "
t
mitral aorta
insifisiensiinsupisiensilregurgita.si
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

Tuli
JanTung
② . Perry .
Jantung Bawaan → kardiologi Anak →
ka Tu
E : o
Defect Kon genital p ticalsifi Kasi
°
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 )
( Transposition great arteri )
TG A → 52 tung gal 2 k eras ,
Ro :
egg shape
y
PIB Ckebinan )
o
Tipe Siano sis \, TOF →
tet spell ( biru →
Jong Kok)
Lo Ro : boot shape
Pansistolik
"

Murmur
"
-
VSD
-

Steno his pulmonal

"

Murmur Sisto lik di les II para sternal Kiri -.

Overriding Aorta I BEI

-

RUH ( right ventricular hypertrophy )

-

Dx : Tetra logi of Fallot

asia notik
-
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
K RITE RIA JONES

Mayor P A STO
'

Dx : kriteria
a murmur
.

Penury ang : CH

- endokardies miokarditis
.ro/itis-Nyen-dadapleuritikPoliatritis
ka , ,

Nyeri Sender dan Bertin dah kriteria : Minimal

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

Eritema Marginal um -
→ kemerahandikulit

Subkutan Nodal → Nodul di sutkutan Aerynlay di Pawan lentil

 sianotik
g.

I n
,
RVH Stenosis pulmonal
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
frIricuspid
.

Lentils
.

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

• Hanover Gigi → Streptococcus uiridans → Mitral

-
-

Fegan Ioa
-

Meeksi Pata Gigi IES .

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 )
-
"

Vegetasi pd katub Jantung "

kumpvlancselinflamasi
°
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

Interval PR C 0,2 Sec ) > 5 Kk
-

Prolonged >
.
→

b) .
AV Block Grade II

-
HR C 60×4
-

I atau Lebih Gel . P 49 kehilangan Komp leks QRS

Interval ( makin lama makin panjang)

Morbitz I →
Prolonged PR

Morbitz I → Interval PR Regular ( Icons tan )

 endtokarditis i necktie # duke
L

→
vegetasi

AV block
.
> Grade I -7
pacaran LDR

.
> Grade II → PHP
•
a Grade III → 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
-
. Observasi

Atop in N Cos my
IM
)

3rd :
Dopamine IV

•
Mobitz 2 afar AV blok derajat 3 : trans 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

↳ QRS senpit regular a , 2 get

her Sinus takikardia
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

SVT
~

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 ✓

QRS sem pit regular

, , > 2 get → atrial
Flutter

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 .

atrial
↳ QRS sempit z i regular →

Fibrilas i
SMART WAY : jikadianta R -
R Interval 72 Gel : Kama Irregular .
 HR 2100×4
ruth
QRS Lebar
Qrssempit
( cskk ) ( > 3kk )

Regular
regular
regular Regular
t
t t
Atrial Ventricular Ventricular
r r r r
Fibrilasi
- -

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

S : syok ( a Kral ding in )

A : angina ( nyeri da da )
H : hipokngi ( TDs s go mmHg )

A : acute
lung oedema ( ronbkashin )
M :
mental alteration , ( t 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 Takikardia

HR 7100×4 tram a Regular

-

° o

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

12--12=12

Lr QRS Lebar ,
regular
T
b) .
Ventricular Fibrilasi ventricular Taki Icardi
mono morfik
HR 7100×4 Kama Irregular
'
o
•

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

↳ QRS Lebar , i
regular
t
ventricular fibrilas i
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
 88 ace Kiri / Kanan
Flutter stall : or tis
A Karo
:
res
Karoli overs 50
•
S
at Komp
'
100
tidal Staal a
. - .

pij tuk
:
bersin ,
→ ba
,

• 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 funsynchronize kardioversi

①
Bifasik 200
Joule
②
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
 →
Prkonstan , QRS hi Lang

→ atrial
Fibril asi
I

C-I stabit

→ SVT C-I stab

it
s
Acute lung oedem
→
→ atrial
SVT stab it
eibrilasi H
A
M
360 J
Monofasik →
alirian listrik hangar arah ,
but uh energi lebih tinggi
Bssipidsik berjalan bolakbalik energi lebihrendah
' ' ' '
→ ,

↳ 200J
 Cardiac Arrest
-

Penurunankecsadaran
-
Putsasi Nadi tidah ada

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

{
① listnk
-
VF : irregular
sik) ① nah .

360J Cmonof
a
PEA ✓
sik)
-

bi
J ( Fa t I
Shock → ① listnh
If i DC →
200
Semua
ke C VT
.
i ram a

z VF
listrile

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

2x
 →
VT → ( shockable)

→ PEA

→ VF
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 → C-I syok kardiogenik

① Naik -7 Gant Protocol → syokkardiogenik
t
o Farmakologi
TDS 570 mmHg t Akral Ding in → lnj .
Norepinefrine ( Neneh)
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)
.

② Ventricular Extra Sisto le ( QRS tear )

\,
.

6g elektro lit PVC ( premature ventricular

#
E
)
: . .
.

contraction
•
Efek Sam
ping Perigo batan
° Kelainan Hormonal "
Timid "

ipokalemi
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 .

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

I -

.
o Ves coupled .

o Ves R ont

disease
Total aksana : Amiodarone II
Berger
↳
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

Gold standar : art eriografi

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 →
venografi
Thf .
Non Farmakologi :
Pemakaian Stocking 1 Elastic verb an

Farmakologi Rojo k ke RS Anti koagulan

" '
• →

c) Deep Vein Trombosis riw

.
perjalananjauh
(strokesi
→ opera
.

riw
.

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 ①
→
heparin
①
Thf Rujuk ke Rs → Anti koagulan
-

→ 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
.

H
pulse
melemah C-lkelainan
T → pulsasi

Arteri mnysaeiafaktivirtas.hilangsafitrat.at 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
tromboangitis
,

Cf : TAO →
obliteras
s
Varices
'
PAD → klauclikagio I Al

- AH → 22 wingers
,
GP - thromofkfiho '

←
acute - Cll → 72 mingsn 8811ns
GP ,
4 Deep
fifteen
,

"
t klaudikasiointemiten .
-
BUT
limb brachial index )
Chronic ABI ( ankle
ischemic
↳ Log
 I
✓ arises
Raynaud disease → etio :
vasospasme peon
. da rah Cidiopatik )
dingin
?
Lr ujung jari Sianosis sa at cuaca
-

La C I merokok
-

hipertroi wMBBgE → dis Fung si diastole

usia muda at let

/
,

Kardio miopati -
dilatasiQTBWJM-ydisfungsihipertensi
sistok.la ,

\
usiatua , ,

gaga l Jan tung

restriktieEEOEE-YII .IE?Ijiraaiasi
Koarktasio aorta → etio : Kel Kon genital
↳ PF : TD ekstremitas atas f- TD ekstremitas

(
bawah

¢€)§ Ro :
Figure of
three ( three sign )