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NYERI DADA
BADAI BHATARA TIKSNADI, dr., SpJP, MM
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PEMBAHASAN
1. Pendekatan diagnosis pada Nyeri Dada
2. Tatalaksana awal pasien nyeri dada
3. Penyakit terkait gejala
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1. PENDEKATAN DIAGNOSIS NYERI
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NYERI DADA
5-20% of all EMG admissions
Benign & self-limited serious or life threatening
Establish accurate diagnosis effective treatment
Martínez-Sellés M, et al. Chest pain in the emergency department: incidence, clinical charac
risk stratification. Rev Esp Cardiol. 2008;61(9):953-9.
Ebell MH. Evaluation of chest pain in primary care patients. Point-Of-Care Guides. 2011;83(5
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DD/ NYERI DADA
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DD/ NYERI
DADA
Agostini-Miranda AA, Crown LA. An approach to the initial care of patients with chest pain in an emergenlocated in a non-cardiac center. amjmed. 2009;6(1):24-8.
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EPIDEMIOLOGI
Cayley WE. Diagnosing the cause of chest pain. Am Fam Physician. 2005;72 (10):2012
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ALUR DIAGNOSIS NYERI DADA
Anamnesis
• Karakteristik nyeri dada
• Riwayat penyakit
• Riwayat obat, family history , sosial
Pemeriksaan fisik• Inspeksi
• Sistem kardiovaskular
• Sistem respirasi
• Sistem GI
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ALUR DIAGNOSIS NYERI DADA
Investigasi / Penunjang
• EKG
• Pemeriksaan darah
• Toraks foto
• Ekokardiografi
• CT Scan
• V/Q scan
• Exercise test
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KARAKTERISTIK NYERI DADA
Provokes
Q
RadiateSeverity
Time
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HISTORY TAKING PHYSICAL FINDINGS
McConaghy JR. Outpatient diagnosis of acute chest pain in adults. Am Fam Physician. 2013;8
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HISTORY TAKING PHYSICAL FINDINGS
McConaghy JR. Outpatient diagnosis of acute chest pain in adults. Am Fam Physician. 2013;8
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ECG
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CXR
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LAB EXAM
CKMB
Troponin
ACSD-dim
PE
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CT-SCAN
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Tes treadmill
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2. TATALAKSANA AWAL NYERI D
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4/5/2016 copyright 2006 www.brainybetty.com
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3. PENYAKIT TERKAIT GEJALA
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SindromaKoroner AKut Kardiovask
Muskuloskeletal
PerikarditisakutParu
EmboliParu
GERD GITDiseksiaorta
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Sindroma
Koroner Akut
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CAD
Endothelial dysfunction
Risk Factors
Dyslipidemia , BP, DM, Insulin Resistance,
Platelets, Fibrinogen, etc
Adapted from
Dzau et al. Am Heart J. 199
plaque
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CAD
Endothelial dysfunction
Risk Factors
Dyslipidemia , BP, DM, Insulin Resistance,
Platelets, Fibrinogen, etc
Adapted from
Dzau et al. Am Heart J. 199
Myocardial
Ischemia
plaque
STABLE ANGINA
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CAD
Endothelial dysfunction
Risk Factors
Dyslipidemia , BP, DM, Insulin Resistance,
Platelets, Fibrinogen, etc
Adapted from
Dzau et al. Am Heart J. 199
Myocardial
Ischemia
plaque
STABLE ANGINA
UNSTABLE P
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Adapted from
Dzau et al. Am Heart J. 199
CAD
Endothelial dysfunction
Risk Factors
Dyslipidemia , BP, DM, Insulin Resistance,
Platelets, Fibrinogen, etc
Myocardial
Ischemia
Co
thro
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GERD
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Perikarditis
Akut
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Emboli Paru
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Diseksi Aorta
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THANK YOU