Presentasi Aneurisma Aorta

BAGIAN KEDOKTERAN KARDIOLOGI
REFARAT ANEURISMA AORTA

BAB I
LATAR
BELAKANG
LATAR BELAKANG
Aorta adalah pembuluh darah arteri yang terbesar, dan membawa
darah yang kaya oksigen dari ventrikel kiri ke seluruh tubuh,
melalui cabang-cabang arteri.
Dinding aorta memiliki gaya peregangan terhadap siklus perubahan
bentuk, resisten terhadap kerusakan struktur, dan juga mempunyai
daya tahan. Kemampuan ini dimungkinkan karena adanya sifat-
sifat biomekanis jaringan elastin dan kolagen pada tunika media dan
tunika adventisia, jika aorta terus menerus terpapar tekanan
berpulsasi dan regangan, menyebabkan aorta rentan terhadap jejas
penyakit (lemah) , sehingga dapat terjadi aneurisma.
s. Setiati, i. alwi, a. w. sudatana, m. simadibrata, b. setiyahadi and a. f. syam,

Ilmu Penyakit Dalam, Jakarta: Interna Publishing, 2015.
01 DEFINISI
02 Epidemiologi dan Faktor
Resiko
03 Patofisiologi
BAB II 04 Klasifikasi
TINJAUAN 05 Gejala Klinis
PUSTAKA 06 Diagnosis
07 Tatalaksana
01. DEFINISI
Dilatasi patologis segmen

aorta akibat tekanan yang
terlalu tinngi yang memiliki
kecenderungan untuk meluas
dan pecah. satu kriteria
adalah peningkatan diameter
setidaknya 50% lebih besar
dari aorta yang normal.
Aneurisma aorta dijelaskan
berdasarkan ukuran, lokasi,
morfologi, dan penyebabnya
aneurisma aorta
s. kunardi, "acute aortic desection," Penyakit Jantung dan Pembuluh Darah Universitas Udayana, Bali, 2017.
02. EPIDEMIOLOGI
1. 3.
lebih banyak pada pria Faktor resiko lain

meskipun prognosis meliputi meliputi
lebih buruk jika terjadi emfisema, hipertensi,
pada wanita dengan usia hiperlipidemia dan lebih
rata-rata 63 tahun dari 20% penderita
aneurisme aorta memiliki
riwayat keluarga dengan
aneurisme aorta
2. 4.
Perokok dan mantan Aneurisme aorta

perokok memiliki resiko torakalis lebih sedikit
5 kali lebih besar kejadiannya
dibandingkan yang tidak dibandingkan Aneurisma
merokok aorta abdominalis.
A. Saurabh and A. Q. , "Abdominal aortic aneurysm," Experimental and Clinic Cardiology, vol. 6, no. 1, p. 11, 2011.
03. ETIOLOGI DAN F. RESIKO
Degeneratif Infeksi Diseksi aorta kronis
Kelainan dan trauma
(aterosklerosis) kongenital
• Proses diseksi
aorta yang
melemahkan dnding
aorta
usia, riwayat •Sindrom marfan dapat
merokok, jenis (bermasalah •Sifilis berlanjut ke dilatasi
kelamin laki-laki, pada fibrillin) •tuberculosis dinding aorta
riwayat keluarga •Sindrom Ehlers •Trauma benda tajam
aneurisma aorta, Danlos (colagen atau tumpul
hiperkolestrol. protein bersalah)
s. Setiati, i. alwi, a. w. sudatana, m. simadibrata, b. setiyahadi and a. f. syam, Ilmu Penyakit Dalam, Jakarta: Interna Publishing, 2015.
04. PATOFISIOLOGI Hipertensi
Degeneratif
Induksi dann aktivasi

enzim proteolitik Sheer stress pada
Respon
inflamasi dinding aorta
Pemecahan Matrix
ekstraselular
Kelainan kongenital Aneurisma

Pembentukan
Penyakit kolagen
Aneurisma Aorta
vaskular
•K. Kent, "Aneurisma aorta perut," N Engl J Med, vol. 371, no. 22, pp. 2101-2102, 2014.
•J. Ruddy and J. Jones, "Patofisiologi aneurisma aorta abdomen (AAA)," Kemajuan dalam penyakit kardiovaskular, vol. 56, no. 1, p. 68, 2013.
•G. Ailawadi, J. Eliason and G. Upchurch, "Current concepts in the pathogenesis of abdominal aortic aneurysm," J Vasc Surg, vol. 38, no. 1, p. 548, 2003.
05. KLASIFIKASI
lokasi
Bentuk
Aneurisme aorta dapat diklaifikasikan atas

fusiform atau saccular.
1. Aneurisme fusiform adalah yang
paling umum ditemui, ditandai oleh
pelebaran simetris secara umum,
dengan bentuk yang cukup seragam,
dan melibatkan sekeliling dinding
aorta.
2. Aneurisme saccular (berry)
menunjukkan dilatasi lokal yang
melibatkan hanya sebagaian dari
keliling dinding aorta, muncul sebagai
suatu kantong yang keluar dari
dinding pembuluh darah.
06. Gejala Klinis
Aneurisma Aorta Torakalis
(AAT)
Symptom
asimptomatik
Nyeri dada, sesak nafas. sesak terjadi akibat

kompresi pada nervus rekurens laringeus
Batuk, wheezing, atau pneumonia rekuren,

akibat efek dari penekanan dari trakea dan
bronkus utama
Disfagia akibat kompresi esofagus
Pada ruptur aneurisma aorta torakal biasa

ditemukan keluhan sindrom akut aorta berupa
nyeri dada hebat, baik dileher, punggung dan
abdomen, disertai tanda-tanda syok
E. Isselbacher, "Thoracic and abdominal aortic aneurysms," Circulation, vol. 111, no. 1, p. 819, 2005.
06. >Gejala Klinis
Aneurisma Aorta Abdominalis
(AAA)
Symptom
Asimptomatik
Jika diameter lebih dari 5 cm dapat

menimbulkan gejala nyeri abdomen akut dan
hipotensi mendadak ,resiko ruptur ++
Nyeri abdomen menjalar ke bokong dan kaki
dengan tanda-tanda syok gangguan kesadaran

mulai dari anxietas sampai koma, muntah, dan
lain-lain
E. Isselbacher, "Thoracic and abdominal aortic aneurysms," Circulation, vol. 111, no. 1, p. 819, 2005.
> PEMERIKSAAN FISIK
AAT
Penekanan v. Cava > edema pada
leher, muka, dan extremitas
superior.
AAT
Dilatasi aorta menyebabkan
regurgitasi aorta yang berujung
pada gagal jantung kronik
AAA
Massa yang berpulsasi, luas, tidak
nyeri bila ditekan
AAA
Nyeri abdomen, pinggang, atau
skrotum disertai perut yang
berdenyut. Jika aneurisma
mambesar ++
AAA
Levido Retikularis > emboli arteri
tungkai A. Chervu, G. Clagett and R. Valentine, "Role of physical examination in detection of
abdominal aortic aneurysms," Surgery, vol. 117, no. 1, p. 454, 2006.
>PEM. PENUNJANG Ekokardiografi
Foto thoraks
pada dugaan aneurisma
pelebaran mediastinum dan
aorta torakalis adalah
kompresi trakea atau cabang
mengukur diameter aorta
bronkus kiri yang tergeser
terhadap diameter yang
atau tertekan
diperkirakan berdasarkan
umur dan besar tubuh
USG
USG dengan mudah
mendeteksi anerisma aorta,
dan aneurisma ditemukan
pada pemeriksaan pasien
tanpa disengaja
Aertografi
Merupakan pemeriksaan
CT Scan dengan kontras
emas (gold standar), dapat
untuk deteksi lebih lanjut ukuran
menunjukkan semua bagian
dari aneurisma aorta
anatomi dan bagian aorta
pemeriksaan yang akurat untuk
yang terlibat.
mendiagnosa adanya aneurisma
atau mengetahui ukuran
aneurisma
07. Penatalaksanaan
Pedoman ACC / AHA
2005
Menurut The national cholestrol merekomendasikan
Education Program ATP III pasien perbaikan bedah Add Text
dengan penyakit jantung koroner, dengan diameter AAA Get a modern
target terapi adalah LDL kurang dari 5,5 cm atau lebih besar PowerPoint
100 mg/dl. Terapi awal sebaiknya pada pasien tanpa Presentation that is
diberikan statin. gejala beautifully designed.
HIPERTENSI LDL EVAR Bedah Bedah penatalaksanaan
target tekanan darah dibawah 140/90 Penatalaksanna AA Pedoman ACC / AHA 2005 aneurisma
mmHg pada pasien dengan diabetes. Obat selanjutnya dengan tindakan berdiameter 3,0 cm hingga 4,0 cm harus
hipertensi yang jadi pilihan adalah invasif yaitu berupa dipantau oleh USG setiap dua hingga tiga
angiotensin-converting enzyme inhibitor, Endovascular dan open tahun, dan yang berdiameter mulai dari 4,0
angiotensin reseptor blockers, dan beta surgical. Emdovascular cm hingga 5,4 cm harus dipantau oleh USG
adrenergic-blocker. aneurism repair (EVAR) atau CT setiap enam hingga 12 bulan
•s. Setiati, i. alwi, a. w. sudatana, m. simadibrata, b. setiyahadi and a. f. syam, Ilmu Penyakit Dalam, Jakarta: Interna Publishing, 2015.
•K. Ouriel, R. Green and C. Donayre, "An evaluation of new methods of expressing aortic aneurysm size: Relationship to rupture," J Vasc Surg, vol. 15, no. 1, p. 12, 2002.
BAB III
PENUTUP
KESIMPULAN
ANEURISMA AORTA
“Untuk aneurisma aorta dimanapun

lokasinya, tujuan dari penatalaksanaannya
adalah menghindari komplikasi yang
mengancam nyawa yairu ruptur atau diseksi
aorta “
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Presentasi Aneurisma Aorta

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Presentasi Aneurisma Aorta

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BAGIAN KEDOKTERAN KARDIOLOGI

REFARAT ANEURISMA AORTA

s. Setiati, i. alwi, a. w. sudatana, m. simadibrata, b. setiyahadi and a. f. syam,

Dilatasi patologis segmen

lebih banyak pada pria Faktor resiko lain

Perokok dan mantan Aneurisme aorta

Induksi dann aktivasi

Kelainan kongenital Aneurisma

Aneurisme aorta dapat diklaifikasikan atas

Nyeri dada, sesak nafas. sesak terjadi akibat

Batuk, wheezing, atau pneumonia rekuren,

Disfagia akibat kompresi esofagus

Pada ruptur aneurisma aorta torakal biasa

Jika diameter lebih dari 5 cm dapat

Nyeri abdomen menjalar ke bokong dan kaki

dengan tanda-tanda syok gangguan kesadaran

HIPERTENSI LDL EVAR Bedah Bedah penatalaksanaan

“Untuk aneurisma aorta dimanapun

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