www.escardio.org/guidelines
Update in Coronary a.Disease
(CAD)
Skema jantung : pembuluh koroner & bilik jantungTAUFIQ Collection
RSPAD Dr. TAUFIQ AW SpBTKV
OVERVIEW
http://www.escardio.org/guidelineshttp://informahealthcare.com/action/clickThrough?id=2663&url=http://www.primalpictures.com/&loc=/doi/abs/10.1517/14656560802682213&pubId=40050324www.escardio.org/guidelines
1.CHEST PAIN
2.ANGINA PECTORIS
3.CAD (Coronary Artery Disease)
4.Stable Angina
5.Acut Coroner Syndrome (ACS)
6.UAP (Unstable Angina Pectoris)
7.AMI (Acut Myocard Infarc)
8.NSTEMI (Non ST Elevasi Myocard Infarc)
9.STEMI (ST Elevasi Myocard Infarc)
10.Cardiac Arrest , Suddent Death
Dr AW TAUFIQ, SpBTKV RSPAD
http://www.escardio.org/guidelineswww.escardio.org/guidelines
ACLSmodified by TAW
Asses responsiveness
Respon (+)
1. 0bservasi
2. Tx sesuai indikasi
(di bawah ini):
Respon (-)
C all: - activated EMS (Emergency Respon System)
- for defib
L ok
L isten
F eelBreath (-) 2 kali hembusan
PULSE
(+)
Positif Negatif
O2 (termasuk intubasi)
I v line
M onitor (12 lead)
CPR
1 seri/1mnt=100x/mnt
pola 15: 2 (unprotec airway)
5: 1 (protected airway)
Monitor
VT pulse(-)
AtauVFNon VT/VF
DC : 200-300-360PEA
ASISTOLE
Sirkulasi
Kembali
spontan
Persisten
VT pulseless
Atau VF
Observasi
ARITMIA
TAKIKARDI (>100)
BRADIKARDI
1. Serius
simptom,sign
2. HR >150
STABIL
AF
A Fluter
PSVT VT
( 140/90
-PCO2 >> PO2
N 12
- -V3
- -V6
AMI
VT
Pulse (+)
cardioversi
precordial thump
I0 or II0 tipe-1
TCP, iv pacingA-T-D-E-I Dr AW TAUFIQ, SpBTKV RSPAD
http://www.escardio.org/guidelineswww.escardio.org/guidelines
KONSIL KEDOKTERAN
INDONESIA
STANDAR KOMPETENSI DOKTER
KONSIL KEDOKTERAN INDONESIA
Indonesian Medical Council
Jakarta 2006
http://www.escardio.org/guidelineswww.escardio.org/guidelines
KASUS- A 1 2 3A 3B 4
KASUS- B 1 2 3A 3B 4
KASUS- C 1 2 3A 3B 4
KASUS- D 1 2 3A 3B 4
KASUS- E 1 2 3A 3B 4
Overview Ax,Px,Dx
Rujuk &
follow
up
Ax,Px,Dx
Terapi-I
Rujuk-
elective
Ax,Px,Dx
Terapi-I
Rujuk-
CITO
MANDIRI
&
TUNTAS
TINGKAT KEMAMPUAN:
Dr AW TAUFIQ, SpBTKV RSPAD
http://www.escardio.org/guidelineswww.escardio.org/guidelines
http://www.escardio.org/guidelineswww.escardio.org/guidelines
30% = 17 jt
WHO
Dr AW TAUFIQ, SpBTKV RSPAD
http://www.escardio.org/guidelineswww.escardio.org/guidelinesDr AW TAUFIQ, SpBTKV RSPAD
http://www.escardio.org/guidelineswww.escardio.org/guidelines
USA INDONESIA
population 330.000.000 237.600.000
CAD (30 persentil) 9.900.000 7.128.000
IMA (6 persentil) 1.980.000 1.425.600
mortality (30%) 594.000 427.680
pre hospital (15/30%) 118.800 85.536
readmission 1 y (35/70%) 633.600 456.192
Cath/PCI 1.210.110 871.279
CABG 356.730 256.846
JAMA.2011;305(17):1769-1776. doi:10.1001/jama.2011.55
PERSENTILE CAD
CAD
INFARK
MORTAL
Cath/PCI
CABG
1,000
30
6
23 1
CILEGON
392.341
11.770
2.354
785
392
589
1.177
392
Dr AW TAUFIQ, SpBTKV RSPAD
http://www.escardio.org/guidelineswww.escardio.org/guidelines
INSIDENSI CADPer Hari
CAD
INFARK
MORTAL
Cath/PCI
CABG
392,341
326
23 1
CILEGON
PENDUDUK:392.341
CAD: 11.770
INFARK: 2.354
MORTAL: 785
Pre RS: 392
Re admission: 589
PCI: 1.177
CABG: 392
Dr AW TAUFIQ, SpBTKV RSPAD
http://www.escardio.org/guidelineswww.escardio.org/guidelinesDr AW TAUFIQ, SpBTKV RSPAD
http://www.escardio.org/guidelineswww.escardio.org/guidelines
CAD 1-VD
2-VD
3-VD
LM
Dr AW TAUFIQ, SpBTKV RSPAD
http://www.escardio.org/guidelineswww.escardio.org/guidelines
Pembuntuan / penyumbatan Skema jantung : pembuluh koroner & bilik jantungTAUFIQ Collection
RSPAD
Pembuntuan / penyumbatan
Dr AW TAUFIQ, SpBTKV RSPAD
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