ACUTE CORONARY

SYNDROM
AND STABEL ANGINA

Giovanni Caesar Maulana

2010211106
 THE TOPICS
N- S TE MI
3. NO
A PE CTOR IS
1 . A NG IN
STABIL
4. STEMI
A PE C TOR I S
2. A NG I N
A K S TA B I L
TID
 ANGINA PECTORIS
STABIL
ANGINA PECTORIS = Rasa Nyeri dada yang
diakibatkan iskemik miokardium

Dibagi 2 :
• Stable APE BEDANYE?
• Unstable
 INI BEDANYA
Unstable angina and
acute MI are also known
as acute coronary
syndromes and result
from specific
pathophysiologic
mechanisms, most
commonly rupture an
unstable atherosclerotic
plaque with subsequent
platelet aggregation and
thrombosis
EPIDEMIOLOGI
Global menunjukkan bahwa prevalensi angina
meningkat seiring dengan pertambahan usia Gradasi
baik pada pria maupun wanita. Angina pektoris
dialami oleh sekitar 4% pria dan 5% wanita
berusia 45-64 tahun dan angka ini meningkat
hingga 12% pada pria dan 10% pada wanita
berusia 65-84 tahun. Pada populasi berusia di
bawah 65 tahun, insidens angina pektoris
tanpa komplikasi pada wanita tampak sedikit
lebih tinggi dibandingkan pada pria.
ETIOLOGI

dysfunctional Loss of Normal

endothelium Antithrombotic
Properties
 FAKTOR RESIKO
In addition to the description of chest discomfort, a careful history
should uncover risk factors that predispose to atherosclerosis and
CAD, including cigarette smoking, dyslipidemia, hypertension,
diabetes, and a family history or premature coronary disease
GEJALA KLINIS
Angina is most often described as a
“pressure,” “discomfort,” “tightness,”
“burning,” or “heaviness” in the
chest.

Sometimes, a patient likens the sensation to

“an elephant sitting on my chest.”

While describing angina, the patient may

place a clenched f st over his or her sternum,
referred to as the Levine sign
GEJALA KLINIS
DIAGNOSIS 3. Pemeriksaan Laboratorium

1. Anamnesis
2. Pemeriksaan fisik

4. Px. Penunjang
DIAGNOSIS
Px. Penunjang

1. EKG
2. Stress Testing
3. Angiografi Kornoner
KOMPLIKASI

ACUTE CARDIAC EVENT

PATOGENESIS
FARMAKOLOGI
TATA LAKSANA
Pharmacologic agents are also the
first line of defense in the prevention
of anginal attacks. The goal of these
agents is to decrease the cardiac
workload and to increase myocardial
perfusion.

The three classes fo medications most

commonly used are β-adrenergic
blockers, organic nitrates, and calcium
channel blockers (Table 6-3).
FARMAKOLOGI
TATA LAKSANA
Medical Treatment to Prevent Acute Cardiac Events

Antiplatelet therapy
NON-FARMAKOLOGI
TATA LAKSANA
PROGNOSIS
 ACUTE CORONARY SYNDROM
Acute coronary syndromes (ACSs) are life-threatening conditions that can
punctuate the course of patients with coronary artery disease at any time.
These syndromes form a continuum that ranges from an unstable pattern of
angina pectoris of the development of a large acute myocardial infark (MI), a
condition of irreversible necrosis of heart muscle.
EPIDEMIOLOGI

The requency of ACS is staggering: more than 1.4 million people

are admitted to hospitals in the United States each year with these
conditions. Within the year after a first MI, 19% of men and 26%
of women will die.
KLASIFIKASI
ETIOLOGI

dysfunctional
endothelium

Plaq Rupture
PATOGENESIS
PATOGENESIS
PATOGENESIS
PATOGENESIS Gambaran PA
GEJALA KLINIS
Angina tak stabil :
1. Angina yang masih baru dalam 2
bulan cukup berat dan sering 3x
sehari
2. Semakin berat, sebelumnya angina
stabil, dan faktor prespitasi berkurang
3. Angina timbul pada saat istirahat

MI (Both) :
The discomfort experienced during an MI
resembles angina pectoris qualitatively but is
usually more severe, lasts longer, and may
radiate more widely.
 ANAMNESIS
GEJALA KLINIS DAN PX. FISIK
 ANAMNESIS
DIAGNOSIS DAN PX. FISIK

ACUTE CARDIAC EVENT

 PEMERIKSAAN
DIAGNOSIS LABORATORIUM
 PEMERIKSAAN
DIAGNOSIS LABORATORIUM
 PEMERIKSAAN
DIAGNOSIS PENUNJANG

1. EKG
 PEMERIKSAAN
DIAGNOSIS PENUNJANG

TAMBAHAN DIAGNOSIS :
IMAGING
 PEMERIKSAAN
DIAGNOSIS PENUNJANG

TAMBAHAN DIAGNOSIS :
IMAGING
DIAGNOSIS
DIAGNOSIS
KOMPLIKASI
TATA LAKSANA
 TATA
NON-STEMI
LAKSANA
STEMI TATA LAKSANA
STEMI TATA LAKSANA
STEMI TATA LAKSANA
STEMI TATA LAKSANA
PROGNOSIS
BERVARIASI
PROGNOSIS
BERVARIASI
PROGNOSIS
BERVARIASI
PROGNOSIS
BERVARIASI
SUMMARY
 Ilmu Penyakit Dalam UI Edisi 5
SOURCES 1

Pathophysiology of Heart
Disease Lily 6th ed
2

PERKI 2015
3

ESC Journal
4
THANK YOU!
Are there any clarifications?