Sindroma koroner akut

Definisi Sindroma koroner

akut
Kumpulan gejala yang berkaitan dengan obstruksi a. Koroner, dimana gejala
utamanya adalah nyeri dada, gejala lain: mual, muntah, diaforesis LIFE
THREATENING

Diagnosis ditegakkan bila (2 dari 3 indikator) kriteria WHO terpenuhi :

• Keluhan klinis  nyeri dada
• Gambaran khas EKG
• Peningkatan kadar enzim jantung (CK, CKMB, Troponin)
 Faktor risiko
✖ Non modifiable ✖ Modifiable risk
risk factor factor
1. Usia 1. Merokok
2. Jenis kelamin 2. Hipertensi
3. Ras 3. Kolesterol LDL
4. Obesitas
Patofisiologi Angina Stabil
dan SKA
Explore keluhan nyeri dada
 Explore keluhan nyeri dada
Onset
✖ Onset nyeri dada
✖ Pada STEMI  nyeri dada terberat

Provokasi
✖ Aktivitas
✖ Stress emosional
Evolusi dan Lokalisasi EKG pada STEMI
 Diagnosis STEMI

○ Clinically significant ST segment elevations:

■ at least two contiguous leads with ST-segment elevation 2.5mm in men < 40
y.o, 2mm in men > 40 y.o, or 2 mm (0.2 mV) in two contiguous precordial
leads
■ ≥ 1.5mm in women in leads V –V and/or 1mm in the other leads [in the
2 3

absence of left ventricular (LV) hypertrophy or left bundle branch block

LBBB)].
■ concomitant ST-segment elevation ≥ 0.5mm recorded in leads V7–V9 should
be considered as a means to identify posterior MI
 Spektrum
Sindroma Koroner Akut
STEMI
Fibrinolytic vs Primary PCI
Dosis Agen Fibrinolysis
Kontraindikasi Fibrinolysis
Alur Penanganan Pasien SKA
Alur Penanganan Pasien SKA
Kriteria Keberhasilan Fibrinolitik