NYERI DADA

BADAI BHATARA TIKSNADI, dr., SpJP, MM

PEMBAHASAN

1. Pendekatan diagnosis pada Nyeri Dada

2. Tatalaksana awal pasien nyeri dada
3. Penyakit terkait gejala
1. PENDEKATAN DIAGNOSIS NYERI DADA
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 characteristics, and
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):603-5.
DD/ NYERI DADA
DD/ NYERI
DADA

Agostini-Miranda AA, Crown LA. An approach to the initial care of patients with chest pain in an emergency department
located in a non-cardiac center. amjmed. 2009;6(1):24-8.
EPIDEMIOLOGI

Cayley WE. Diagnosing the cause of chest pain. Am Fam Physician. 2005;72 (10):2012-21.
ALUR DIAGNOSIS NYERI DADA

Anamnesis
• Karakteristik nyeri dada
• Riwayat penyakit
• Riwayat obat, family history, sosial

Pemeriksaan fisik
• Inspeksi
• Sistem kardiovaskular
• Sistem respirasi
• Sistem GI
ALUR DIAGNOSIS NYERI DADA

Investigasi / Penunjang
• EKG
• Pemeriksaan darah
• Toraks foto
• Ekokardiografi
• CT Scan
• V/Q scan
• Exercise test
KARAKTERISTIK NYERI DADA
Provokes

Time Quality

Severity Radiates
 HISTORY TAKING & PHYSICAL FINDINGS

McConaghy JR. Outpatient diagnosis of acute chest pain in adults. Am Fam Physician. 2013;87(3):177-82.
 HISTORY TAKING & PHYSICAL FINDINGS

McConaghy JR. Outpatient diagnosis of acute chest pain in adults. Am Fam Physician. 2013;87(3):177-82.
ECG
CXR
LAB EXAM

ACS PE
CKMB D-dimer

Troponin
CT-SCAN
Tes treadmill
2. TATALAKSANA AWAL NYERI DADA
4/5/2016 copyright 2006 www.brainybetty.com 20
3. PENYAKIT TERKAIT GEJALA
 Muskuloskel Sindroma
etal Koroner AKut Kardiovaskular

Perikarditis Emboli
Paru akut
Paru

Diseksi
GERD GIT
aorta
 Sindroma
Koroner Akut
 CAD

Endothelial dysfunction

plaque

Risk Factors
Dyslipidemia , BP, DM, Insulin Resistance,
Platelets, Fibrinogen, etc

Adapted from
Dzau et al. Am Heart J. 1991;121:1244-1263
 CAD
Myocardial
Ischemia
STABLE ANGINA

Endothelial dysfunction

plaque

Risk Factors
Dyslipidemia , BP, DM, Insulin Resistance,
Platelets, Fibrinogen, etc

Adapted from
Dzau et al. Am Heart J. 1991;121:1244-1263
 CAD
Myocardial
Ischemia
STABLE ANGINA

Endothelial dysfunction

plaque

UNSTABLE PLAQUE

Risk Factors
Dyslipidemia , BP, DM, Insulin Resistance,
Platelets, Fibrinogen, etc

Adapted from
Dzau et al. Am Heart J. 1991;121:1244-1263
 CAD
Myocardial
Ischemia

Endothelial dysfunction

Coronary
thrombosis

Risk Factors
Dyslipidemia , BP, DM, Insulin Resistance,
Platelets, Fibrinogen, etc

Adapted from
Dzau et al. Am Heart J. 1991;121:1244-1263
GERD
Perikarditis
Akut
Emboli Paru
Diseksi Aorta
THANK YOU