3-pathofisiologi -chest pain.pptx

8/18/2019 3-pathofisiologi -chest pain.pptx

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© 2012 Pearson Education, Inc.

PathophyisioloChest Pain


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Capaian Pembelajaran

1. Mahasiswa mampu mengidentifikasi gejala khas dan

penyebab nyeri dada2. Mahasiswa mampu menjelaskan etiologi nyeri dada

3. Mahasiswa mampu menjelaskan patofisiologi nyeri dad


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Pain

• pain is an uncomfortable sensory and emotional experien

both physiochemical and affectie components which serwarn the indiidual of either physical or psychological dam

• Pain is a complex unpleasant phenomenon composed of

experiences that include time! space! intensity! emotion!

and motiation

• Pain is an unpleasant or emotional experience originating

potential damaged tissue


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Pain category

1. "omatogenic pain is pain with cause #usually known$

localised in the body tissuea. nociceptie pain

b. neuropatic pain

2. Psychogenic pain is pain for which there is no known

physical cause but processing of sensitie information in

%&" is disturbed


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Physiology of Pain

• 'ransduction( &ociceptors

• 'ransmission( )*delta! % fiber • Perception

• Modulation


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Physiology of Pain

nociceptor "pinal cord +rain stem

'ransduction'ransmission

P

Modulation

Modu"timuli( %hemical mediator release

• 'issue damage

• ,nflamation

• "tronge stimuli potentially damage

Modulator

-

• P substance

• chatecholamine

• /pioid

• serotonin


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Physiology of Pain


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&europathic pain

• ,t occurs as a result of injury to or dysfunction of the ner

system itself! peripheral or central.• common causes of neuropathic pain in chest(

• "hingles #0erpes oster$

• %ommon symptoms( burning pain

• adicular pain

• Multiple sclerosis


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%hest Pain

4efinition

• Pain! pressure! tightness! or other discomfort originating radiating to the chest

• constitutes an important indicator of potentially serious ca

or cardioascular disorders.

• Pain( described as dull! heay! or crushing! "harp! stabb

or burning pain.


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/rigin

• Pain may originate from seeral different structures(

• within the chest(o the skin

o ibs

o intercostal muscles

o pleura

o esophagus

o 0eart

o 5ung

o )orta

o 4iaphragm

o thoracic ertebrae

• /utside the chest( lier! pancreas! stomach

• 'he pain may be transmitted by intercostal! sympathetic!

and phrenic neres.


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"ite of referred pain. )! 6ront. +! +ack #from Phipps! 5ong 7 8oods! 19:;$


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Pathophysiology of heart pain

• a part of isceral pain

• 'ypes * angina pectoris! myocardial infarction! pericardia• )ferent( unmyelinated % = fibres

• Mechanism(

1. rapid stretching of the capsule of such solid isceral organs #p

2. abrupt anoxia of cardiac muscles

3. inflammatory processes

>. necrosis of myocardium


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%haracteristic of angina

• it is dull! deep! not well defined! and differently described

patients• Pain is radiated to some area

• it induces strong autonomic reflex phenomena #much mo

pronounced than in pain of somatic origin$

1. diffuse sweating! asomotor responses! changes of arte

pressure and heart rate

2. an intense psychic alarm reaction *?angor animi ? *


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Pathophysiology of oesophageal pain

• a part of isceral pain

• )ferent( unmyelinated % = fibres• Mechanism(

1. direct action of chemical stimuli

2. inflammatory processes

3. abnormal distention and contraction of the hollow iscera mus


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%haracteristic of /esophageal pain

• it is dull! deep! not well defined! and differently described

patients• 'here are many isceral sensation that are unpleasant b

the leel of pain(

• feeling of disagreeable fullness or acidity of the stomach

• undefined and unpleasant thoracic or abdominal sensation

• "ub sternal burn pain


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Pathophysiology of muscle pain

• a part of somatic deep pain.

• it is common in rheumathology and sports medicine.• Muscles are relatiely insensitie to pain when elicited by

prick or knife cut! but oerlying fascia is ery sensitie to

•

3-pathofisiologi -chest pain.pptx

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