Pemeriksaan Jantung

Penerbangan

PRODI KEDOKTERAN PENERBANGAN

FKUI
2020
PEMERIKSAAN

• ECG
• TREADMILL
• ABPM (AUTOMATIC BLOOD PRESSURE
MEASUREMENT)
• ECHOCARDIOGRAPH
• HOLTER MONITOR
ECG
• PENILAIAN →
• NORMAL
• TIDAK NORMAL
→ berikan saran
 • PENILAIAN
• END POINT OF TEST
• DURANTE/POST STRESS TEST
• HAEMODYNAMIC RESPONSE
TREADMILL • ECG RESPONSE
• PHYSICAL CONDITION (HIGH, GOOD,
AVERAGE, FAIR, LOW)
• AEROBIC CAPACITY
• FUNCTIONAL CLASSIFICATION (1,2,3)
Overview

• to clarify some minor ECG anomaly

• a standardized protocol such as the Bruce treadmill protocol
• The subject should be expected to complete at least three stages — nine minutes — of
the protocol or achieve an oxygen uptake equivalent to 11 metabolic equivalents (METs).
• optional→
• bicycle ergometry → do not have to bear their own weight, and there is no
imperative to maintain speed.
• bicycle protocol → the 20-Watt protocol. The subject is seated and the workload
increased from zero by 20 Watts every minute to the same symptom/heart-rate
endpoints.
BRUCE
PROTOCOLS
Bruce Protocols (sesuai aturan penerbangan)
Modified Bruce Protocol
Interpretation

• ST segment, the depression (or elevation) of which is measured at 60 ms after

the J point — the junction of the S wave and the ST segment.
• Its pattern needs to be examined closely at rest and in the early stages of
exercise, during the recording and especially during the early stages of
recovery
• the recovery ECG should be recorded for 10 minutes.
• Often 2 mm of plane ST segment depression is referred to as “positive” (i.e. for
coronary artery disease, other factors to be evaluated → walking time,
symptoms (if any) and pattern of change.
Karakteristik
tes yang
digunakan
untuk
mendiagnosis
CAD
ABPM (AUTOMATIC BLOOD PRESSURE
MEASUREMENT)

• PENILAIAN
• TINGGI BADAN
• BERAT BADAN
• HASIL
• Normal
• Tidak normal, → berikan saran
ECHOCARDIOGRAPH • PENILAIAN • IVS
• AORTA
• Thickness
• Root diameter
• Valve cusp motion • % Thickening
• LEFT ATRIUM • Motion Pattern
• Dimension • IVS/LUPW RATIO
• LA/Ao Ratio
• LEFT VENTRICLE
• MITRAL VALVE
• Dimension • Anterior Leaflet
• RIGHT VENTRICLE • Diastolic Motion
• Dimension
• Systolic Motion
• Fract-Shortening
• LPVW
• Posterior Leaflet
• Thickness • TRICUPID VALVE
• % Thickening • PULMONARY VALVE
• Motion Pattern
• PERICARDIAL EFFUSION
Assessed

• When an exercise recording is equivocal or abnormal, but The probability of

coronary artery disease is intermediate or high
 • PENILAIAN • SVE
HOLTER • Total Beats • Total
• Motion Pattern • Single
MONITOR • VE • Bigeminy
• Total • Maximum Cycle
• Single • Couplets
• Bigeminy • Runs
• Maximum Cycle • Longest
• Couplets • Fastest (average)
• Fastest (momentary)
• Runs
• Sinus Bradycardia
• Longest
• Total
• Fastest (average)
• Minima
• Fastest (momentary)
• Pause
• Max
• Prolongation
• Heart Rate (min, Average,
max)