REFARAT “CRISIS HYPERTENSION” ARRANGED BY: Salman Saisar Hidayat 2011730095 PRESEPTOR : dr Ihsanil Husna, Sp.PD STASE ILMU PENYAKIT DALAM RSIJ CEMPAKA PUTIH PROGRAM STUDI KEDOKTERAN FAKULTAS KEDOKTERAN DAN KESEHATAN 1
REFARAT
“CRISIS HYPERTENSION”
ARRANGED BY:
Salman Saisar Hidayat 2011730095
PRESEPTOR :
dr Ihsanil Husna, Sp.PD
STASE ILMU PENYAKIT DALAM RSIJ CEMPAKA PUTIH
PROGRAM STUDI KEDOKTERAN
FAKULTAS KEDOKTERAN DAN KESEHATAN
UNIVERSITAS MUHAMMADIYAH JAKARTA
2016
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KATA PENGANTAR
AssalamualaikumWr. Wb.
Alhamdulillah, Puji syukur penyusun panjatkan kehadiran ALLAH SWT atas
terselesaikannya tugas Refarat “Krisis Hipertensi”.
Makalah refreshing ini disusun dalam rangka untuk dapat lebih mendalami dan
memahami mengenai “Krisis Hipertensi” . Tujuan khususnya adalah sebagai pemenuhan tugas
kepaniteraan Stase Ilmu Penyakit Dalam.
Semoga dengan adanya laporan kasus ini dapat menambah khasanah ilmu pengetahuan
dan berguna bagi penyusun maupun peserta didik lainnya.
Penyusun menyadari bahwa laporan kasus ini masih jauh dari kesempurnaan, oleh karena
itu penyusun sangat membutuhkan saran dan kritik untuk membangun laporan kasus yang lebih
baik di masa yang akan datang.
Terimakasih.
WassalamualaikumWr. Wb
Jakarta, Mei 2016
Penulis
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a. Definition
Hypertensive crises are defined as levels of systolic blood pressure >180 mmHg and/
or levels of diastolic blood pressure >120 mmHg and are mainly found in patients
with essential artery hypertension.
b. Epidemiology
In an Italian multicenter study of 1,546 patients with hypertensive crises, 13 % of
men and 9 % of women reported not taking antihypertensive drugs. Hypertensive
emergencies represented 25 % of crises. Approximately 25 % of adults with chronic
hypertension were unaware of their disease. In the US parallels the distribution of
essential hypertension with a twofold higher incidence in African–Americans than in
whites.
c. Classification
Hypertensive urgency is a situation with a severe increase in blood pressure without
progressive dysfunction of target organs.
Hypertensive emergencies are life threatening states because their outcome is
complicated by acute damages of target organs.
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d. Etiology
Undiagnosed or untreated hypertension is the most important risk factor to be crises
hypertension. Genetic factor, lifestyle, diet, acute physical stress, chronic
physiological stress can be the causes of hypertension. So the primary treatment is to
change the risk factor that can make hypertension.
e. Pathophysiology
Pathophysiology of hypertensive crises is still unclear. From the aspect of
pathophysiology, the disorder of systemic blood flow auto regulation on the level of
arterioles is considered to be a cause for both forms of hypertensive crisis.
f. Clinical manifestaions
Hypertensive urgency is a situation with severe increase in blood pressure without
progressive dysfunction of vital organs. The most common symptoms are headache,
dyspnea, nausea, vomiting, epistaxis, and pronounced anxiety.
Hypertensive emergencies include hypertensive encephalopathy, hypertensive acute
left ventricular relaxation associated with acute myocardial infarction or unstable
angina, aortic dissection, subarhnoic hemorrhage, ischemic stroke, and severe
preeclampsia or eclampsia.
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g. Supporting examinations
Recommended testing includes the following:
• Hematologic routine
• Blood glucose
• Total cholesterol serum
• Serum uric acid
• Creatinin serum
• Kalium serum
• Urinalisis
• Electrocardiogram
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h. Treatment
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References
• Monnet, Xavier, Paul E. Marik. 2015. What’s new with hypertensive crises?.
Intensive Care Med. 41:127–130
• Salkic, Sabina, Olivera Batic-Mujanovic, Farid Ljuca, Selmira Brkic. 2014.
Clinical Presentation of Hypertensive Crises in Emergency Medical Services.
Mater Sociomed. 26(1): 12-16
• Salkic, Sabina, Selmira Brkic, Olivera Batic-Mujanovic, Farid Ljuca, Almedina
Karabasic, Sehveta Mustafic. 2015. Emergency Room Treatment of Hypertensive
Crises. Med Arh, 69(5); 302-306
• Current Medical Diagnosis & Treatment. Systemic Hypertension. Sutters,
Michael.MD. 2016. 435-467
• American Journal of Emergency Medcine. The Relationship between vascular
inflammation and target organ damage in hypertensive crises. Karaback, Mustafa
MD. 2015; 497-500
• Jose Roesma. Krisis Hipertensi. Sudoyo, Idrus Alwi editor. Buku Ajar Ilmu
Penyakit Dalam Jilid II Edisi VI. Pusat penerbitan departemen penyakit dalam
FKUI.2014
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