OSCE BLOK 10

CONGESTIVE HEART FAILURE DUE TO VENTRIKEL SEPTAL DEFECT

1. ANAMNESIS
1. Anamnesis
Riwayat gestasi dan kelahiran : premature, kebiasaan dan
konsumsi ibu saat mengandung, cara kelahiran
Riwayat penyakit pasien : infeksi, dll
Riwayat penyakit keluarga : riwayat penyakit cardiovascular
Riwayat keperawatan : respon fisiologis terhadap defek (sianosis,
aktivitas terbatas)
Kaji adanya tanda-tanda gagal jantung, nafas cepat, sesak nafas,
retraksi, bunyi jantung tambahan (machinery mur-mur), edera
tungkai, hepatomegali, angina, palpitasi, sinkop.
Kaji adanya hipoksia kronis : Clubbing finger
Kaji adanya hiperemia pada ujung jari
Kaji pola makan, pola pertambahan berat badan
2. PEMERIKSAAN FISIK
Body weight
Body height
Orthopnea
Pale
Respiratory rate
Heart rate
Chest precordial bulging
Hyperactive precordium
A systolic thrill at the lower left sternal border
A grade 4/6 holostolic murmur at the lower left sternal border
An apical diastolic rumble
Pulmonary crackles
hepatomegaly
3. PEMERIKSAAN PENUNJANG
X-RAY
EKG
ECHO
4.

TREATMENT
Diuretic :furosemide
Vasodilator :Nitroglyserin
ACE Inhibitor :Kaptopril
Digoxin ;contractility of cardiac
Surgery :
Surgical closure is typically done before the child begins preschool.
Surgery is indicated if medications do not work in the first few moths or
years of life, especially if the child is not growing adequately even with
medications.

Surgery is more urgent if evidence of pulmonary hypertension has

developed.
The most used operation involves placing a Gore-Tex patch over the hole.
This prevents shunting (the movement of oxygenated blood from the left
to the right ventricle).