Definition
Coronary heart disease (CHD) is mainly caused by the process of atherosclerosis (plaque buildup in blood vessels) which is a degenerative disorder, although influenced by many factors. Due to a degenerative disorder, then the life expectancy is growing Indonesia, it is clear that the incidence will increase. In addition he often cause sudden death and attacking the highly productive age CHD become an important disease
Symptoms and Signs
Typical ischemic chest pain (like pressure and heavy objects to the neck, right arm and back) can be caused by unstable angina pectoris (APS), unstable angina pectoris (APTS) or AMI (acute myocardial infarction Complaints of chest pain that requires serious attention has the following characteristics:
New chest pain that is felt (<1 month)
Changes in quality of chest pain, such as increased frequency or severity of chest pain, or chest pain that is felt at rest Chest pain unrelieved by rest or by sublingual nitrate administration
Changes in quality of chest pain, such as increased frequency or severity of chest pain, or chest pain that is felt at rest Chest pain unrelieved by rest or by sublingual nitrate administration
Other symptoms that may accompany the shortness of breath, feeling of floating and fainting (syncope). When you do a physical examination can be found hypertension, heart enlargement and abnormal heart sounds and heart murmur.
Governance
Treatment for coronary heart disease is general and specific. For general management of the most important are lifestyle changes that can control the risk factors that can aggravate the disease. Periodic cardiac examination is essential for patients who are at risk or not. Treatment was given to patients who already have symptoms of CHD. Provision of drugs vasodilators and thrombolytic very important in the period soon after the attack. To overcome the pain may be given medicines such as nitrates sublingual (administered under the tongue), nitroglycerin or morphine.
Generally tatalakasana is as follows;
A. Medikamentosa Medical
Nitrate
Beta blocker Beta blockers
Antagonis kalsium Calcium antagonists
Beta blocker Beta blockers
Antagonis kalsium Calcium antagonists
B. Revaskularisasi Revascularization
Thrombolytic. Effectively administered within <12 hours after the complaint of chest pain and age paien <75 years.
Thrombolytic. Effectively administered within <12 hours after the complaint of chest pain and age paien <75 years.
Invasive non-operative procedures. Can be performed primary percutaneous coronary intervention if performed <6 hours after the attack. Besides PCI performed when thrombolytic therapy fails. Surgery (coronary artery bypass (CABG)) CHD Risk Factors epidemiological studies have identified risk factors for CHD, namely: Smoking, any number of levels of total cholesterol and high LDL cholesterol Hypertension low HDL cholesterol levels Diabetes Mellitus Elderly In addition there also other factors associated with increased risk of CHD, the predisposing factors and conditional factors. Predisposing factors are factors that increase the risk of CHD caused by risk factors above. These factors include: obesity (BMI> 25 mg/m2)
Abdominal obesity (waist circumference> 94 cm for men and> 80 cm for women)
Less mobile habits / physical activity
Family history of CHD at a young age (<55 years for men and <65 years for women)
Ethnic / race specific
Psychosocial Factors
Risk factors conditionally associated with an increased risk of CHD independently although the causative effect is still not proven conclusively. These factors are:
High serum triglyceride levels
High serum homocysteine levels
High levels of lipoprotein a
Prothrombotic factors
Inflammatory marker
Additional examination
The first thing to do is install an EKG to see a typical picture of ischemia (lack of tissue oxygen supply) or infarction (tissue death). EKG is not only done when the patient complains of chest pain but can be used for early detection that can be worked breaks, daily activity time (Holter), or times of stress (exercise / drugs) are coupled with radiological examinations, laboratory examinations, especially to identify risk factors. Blood tests such as CK-MB (Creatine Kinase-MB) and troponin T carried out to see the presence of elevated levels of cardiac enzymes that indicate there has been IMA. Other checks that can be done is a radio nuclid echocardiography and myocardial imaging (RNMI) recess and physical stress or medications, to coronary arteriography and left ventricular angiography (AK & LVG).
Invasive non-operative procedures. Can be performed primary percutaneous coronary intervention if performed <6 hours after the attack. Besides PCI performed when thrombolytic therapy fails. Surgery (coronary artery bypass (CABG)) CHD Risk Factors epidemiological studies have identified risk factors for CHD, namely: Smoking, any number of levels of total cholesterol and high LDL cholesterol Hypertension low HDL cholesterol levels Diabetes Mellitus Elderly In addition there also other factors associated with increased risk of CHD, the predisposing factors and conditional factors. Predisposing factors are factors that increase the risk of CHD caused by risk factors above. These factors include: obesity (BMI> 25 mg/m2)
Abdominal obesity (waist circumference> 94 cm for men and> 80 cm for women)
Less mobile habits / physical activity
Family history of CHD at a young age (<55 years for men and <65 years for women)
Ethnic / race specific
Psychosocial Factors
Risk factors conditionally associated with an increased risk of CHD independently although the causative effect is still not proven conclusively. These factors are:
High serum triglyceride levels
High serum homocysteine levels
High levels of lipoprotein a
Prothrombotic factors
Inflammatory marker
Additional examination
The first thing to do is install an EKG to see a typical picture of ischemia (lack of tissue oxygen supply) or infarction (tissue death). EKG is not only done when the patient complains of chest pain but can be used for early detection that can be worked breaks, daily activity time (Holter), or times of stress (exercise / drugs) are coupled with radiological examinations, laboratory examinations, especially to identify risk factors. Blood tests such as CK-MB (Creatine Kinase-MB) and troponin T carried out to see the presence of elevated levels of cardiac enzymes that indicate there has been IMA. Other checks that can be done is a radio nuclid echocardiography and myocardial imaging (RNMI) recess and physical stress or medications, to coronary arteriography and left ventricular angiography (AK & LVG).
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