Professional Documents
Culture Documents
Post PCI Care When To Refer
Post PCI Care When To Refer
Asymptomatic/stable
Progress !
SCAD ACS SCAD
Long-term outpatient Inpatient and
Long-term outpatient
management periprocedural management
stage
11
Rawat Ulang !
Why worsen The Condition?
• Stigma : CAD=’end’; (life style)
• Misperception :
• 1. Activity prohibited uncontrol risk factors; (measurable,
regular) (controlled risk factors)
• 2. No Sex (ok)
• 3. Drugs Damage the kidneys. (Protect the kidneys)
• 4. no symptoms = getting well No MD visit, stop
medication, no diet ( vice versa)
• 5. < water; (as needed)
ACS
AHF
Arrhythmia
Syock
Cardiac Syncope
Next Cardiovascular Event ?
Atherosclerosis Progress every time:
• Endothelial dysfunction (Chronic irreversible)
• Intake >output : Plaque accumulation
• Non Stent> dan stent <(DES) vessel
• Vulnerable plaque Prone to rupture
• Significant plaque Turbulence flow thrombus
• Triggering Factors; nonadherence, stress, infection, ect.
Acute Coronary Syndrome
• Substernal
• Squeezing, heaviness
• Radiation
• Progressive angina
1. More severe
2. More frequent
3. Longer in duration
4. Milder precipitating factors
• First onset angina minimal CCS III
• Resting angina > 20 menit
• Angina post Infarction
Heart failure
• Vascular problem Fixed it
• Pumping problem medication/device
• Pressure problem optimize management
Shock Cardiogenic
• Treat first than refer
• Vascular problem Fixed it
• Pumping problem medication/device
Arrhythmia
• Vascular related /iskemik Revascularization
• Heart failure related Optimal treatment
• Substrate/fixed defect eliminate/device
Complication: Risk vs Benefit !
Summary