gagal jantung kronik

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GAGAL [ANTUNG KRON|KAleanora Wlolta S. P.Nurrakbmanlta AzlzaNor |oyanl|N|S| |N|S| Ketidaknanpuan jantung Memompa cukup oarab Menenuhi kebutuban metabollsme tububorwaro allure Kenanpuan jantung Memompa cukup oarab [lka tekanan pengisian jantung tinggi leblb oarl normal8ackwaro allure*Atau keouanya|N|S| |N|S|P|M|OLOG| P|M|OLOG|O > 500.000 kasus baru ol AS tlap tabunO 2007: 5 juta orang terserang gagal jantung|S|OLOG| |S|OLOG|Conlrucllllly Preloud AflerloudHeurl Rule X Slroke VolumeCurdluc oulpulugul )unlung Aflerloud Preloud CC Tolul luhununslslem perlfer Fllllng pressure Mekunlsme kompensuslI. Dllulusl venlrlkel2. Hlperlropl venlrlkel3. Akllfllus neurohumorul- Suruf slmpulls- Slsllm renln-unglolensln4. Renul mekunlsme (Relensl nulrlum/ulr)- Reubsorbl NA pudu proxlmul lubules- Anll dlurellc hormonPATO|S|OLOG| PATO|S|OLOG|Aktivitas Neurohumoral Aktivitas NeurohumoralMemperluhunkun lekunun duruh perfusl orgun vllul / koroner dlperluhunkunO Tekunun duruh (CC ) Plusmu noreplneprlne Plusmu renln Plusmu urglne vusopressln O uro receplor (Arcus Ao. Slnus curollcus) Pusul vusomolor (ulung Cluk)Suruf slmpulls * Vusokonlslrlksl (ufler loud )* Konlruklllllus mlokurd * Frekuensl (ebun . 02 dlbuluhkun )* Vuskonlrlksl renul (ekskresl Nulrlum. Alr )kongesll Perunun Renln Anglolensln Aldosleron Slsllm Perunun Renln Anglolensln Aldosleron Slsllmugul iunlungCC Anglolenslnogen (Hepur)FRSuruf slmpullsRenlnAnglolensln IAnglolensln converllngAnglolensln II enzyme (ACL) (Puru-puru)Vusokonslrlksl Vusokonslrlksl Aldosleron relenslvenous urlerloler NA & DRPreloud Aflerloud Preloudukum Starling ukum StarlingO Venous return / inflowO End diastolic volume(Left Ventricular End Diast. Volume )* Konstraksi miokard* CO / Stroke volume agal JantungCoStroke Vol.Tensi End Sist. vol.End Diast. vol.(ukum Starling)eart RateVasokonstriksiKontraksi ventrikelSaraf Simpatis Aliran darah renal(Perfusi)Renin(Renin-angiotensin aldosteron)Vasokontriksi Retensi NACardiad OutputRenin-angiotensin system Antidiuretic ormone Sympathetic nerous systemContrac-tilityeartrateVasoconstriction Circulating volumeArteriolar VenousMaintain blood pressureStroke volumeCardiac outputVenous return to heart( Preload)Peripheral edemaand pulmonary congestion(+)(+)(-)agal JantungKelelahan MiokardKontraksi VentrikelCOSindroma bendungan pada organ-organ (Backward Failure)ParuLiverinjal dll(Manifestasi Klinik)Kiri KananLeft sided CF Right sided CFDC kiri DC kananLeft backward F. Right backward failureAR|OvASULAR AR|OvASULAR ONT|NUUM ONT|NUUMKR|TR|A RAM|NGHAM KR|TR|A RAM|NGHAMKLAS||KAS| KLAS||KAS|olagnosls olagnosls dentification of Patients2 dentification of a 5tructuraI AbnornaIity onpIete history & P chocardiogran RadionucIide ventriIography hest radiography W|th o s,ndrome o[ decreosed exerc|se to|eronce2 W|th o s,ndrome o[ [|u|d retent|on.j W|th no s,mptoms or s,mptoms o[ onother cord|oc ornoncord|oc d|sorder vaIuation of ause of vaIuation of ause of VentricuIar Dysfunction VentricuIar DysfunctionO o. H|stor, ond Ph,s|co| Lxom|not|onO 5. Lo5orotor, 7est|ng complete blooo count, urlnalysls, serum electrolytes lncluolng calclum ano magneslum, ano blooo llplos as well as tests ot botb renal ano bepatlc tunctlon cbest raolograpb 2-leao electrocarologram 8NP - 2-amlno aclo polypeptloe tbat contalns a 7-amlno aclo rlng structure common to all natrluretlc peptloes carolac ventrlcles are tbe major source ot plasma 8NP plasma 8NP level greater tban 00 pg per mL supports a olagnosls ot abnormal ventrlcular tunctlon or symptomatlc Huropean Soclety ot arolology uropean Soclety ot arolologyTRAP| TRAP|GAGAL [ANTUNG KANAN GAGAL [ANTUNG KANANT|OLOG| T|OLOG|PATO|S|OLOG| PATO|S|OLOG|GAGAL [ANTUNG K|R| GAGAL [ANTUNG K|R|O ketloakmampuan jantung untukmengbasllkan arolac Output curabjantung yang aoekuat untuk pertusljarlngan.Gagal jantung klrlGagal jantung slstollk Gagal jantung olastollkGagal Gagal [antung [antung Slstollk SlstollkO ketloakmampuan jantung untukmengbasllkan curab jantung yang aoekuatuntuk pertusl jarlngan tubub aklbatpenurunan kontraktllltas otot jantungO Penyebab terserlng aoalab lntark mlokaro.www.tooooollory.co Copooy LoooVlo|oru loIor|Vlo|orultls, korulolopotlkootro|tllltos jootcoo G8tro|o volco GulportooslJoooooo vos|clor porlIor koslstoosl poooosooooo vootrl|olkorjo vootrl|ol |lrl ulportroIl lo|orulckootro|tllltos Gvolco o|olr ulostoll| vootrl|ol |lrl (proloou )Dllotosl jootcooJo|oooo otrlc |lrl lorIcsl olojol GA|tlvosl slsto koolo-ooolotoosloAItorloou voso|oostrl|sl slstol|8lsto soroI slpotls toro|tlvosllorIcsl olojol GA|tlvosl slsto koolo-ooolotooslolroloou Jo|oooo |opllor uoo vooo porc Fvoso|oostrl|sl F |roolollsoslJo|. olurostotl| > to|. Oo|otl| vos|clorJrooscuosl colroo |o lotorstlslol F ouoo lotorstlslol, oIcsl plocro,porl|orukoc. Jrooscuosl > |oc. Drolooso llIotl|loroobllltos opltol olvoolor |uoo olvoolor|uoo porculpo|solokootro|tllltos GGoool jootcoo |oooostlIloocrcooo porIcsl |o oto| uoo orooo lolokotoosl soulc uoo olr F pooloo|otoo vol.ploso 8 toooooo vos|clor porlIorGagal Gagal jantung jantung olastollk olastollkO gagal jantung aklbat oetek penglslanventrlkel yang olaklbatkan oleb kelalnantungsl olastollkO Penyebab utama - blpertrotl mlokaro yang ollnouksl oleb blpertensl oan lskemlkmlokarolum oengan ventrlkel remooellngwww.themeeallerv.oom Companv LoeoKemampuan ventrikel kiri untuk meneembane (.425,3.0) G'olume akhir diastolik ventrikel kiri normal1ekanan akhir diastolik ventrikel kiri 1ekanan vane meninekat ini direfleksikan kembali ke dalam sirkulasi pulmonalLdema paruipoksemia0aeal jantune koneestifTERMA KAS TERMA KAS