ANAMNESIS PASIEN NYERI KEPALA

SOCRATES

S : Side (Lokasi Nyeri) bilateral/unilateral?O :Onset (Mendadak/Perlahan-lahan)C : Characteristic (apakah nyeri berdenyut, menusuk, seperti

apa?R : Radiation ( Menjalar/Tidak?)A : Association ( Gangguan Penglihatan/ Fotofobia/ Mual,

Muntah/ Demam/Nyeri Leher/pingsan?)T : TIMING ( lama berlangsungnya nyeri)E : EXACERBATING ( faktor yang memperingan dan yang

memperberat)S : SEVERITY ( Apakah nyeri mengganggu aktivitas sehari-hari)

Nyeri kepala

Migren Cluster Tension headache

Nyeri kepala primer

Tension Migren Cluster

Bilateral, terasa penekanan (tegang)

Unilateral, nyeri berdenyut Terlokalisasi dimata

Ringan-sedang Sedang-berat berat

30 menit- I minggu 4-72 jam 15-90 menit

Tidak disertai mual atau muntah

Mual, muntahphotofobia

alkohol

Nyeri Kepala SekunderNyeri Kepala yang

mengancam jiwa• Perdarahan

subarahnoid• Perdarahan

ektradural• Perdarahan subdural• Perdarahan

intraserebral• Meningoenchepalitis• Cardiac chepalgia

Nyeri Kepala yang mengancam penglihatan

• Temporal arteritis• glaucoma

Reversible benign headache

• Sinusitis• Pos trauma nyeri

kepala• Nyeri kepala

kronik setelah terbentur

• cervicogenic

Faktor ResikoCAD

CAD Risk

• Conventional risk factors– Older age: Over age 45 years in men and over age

55 years in women– Family history of early heart disease– Race: Among persons with CAD, the cardiovascular

death rate for African Americans is reported to be particularly high; in Asians, low levels of high-density lipoprotein cholesterol (HDL-C), which are considered to be a risk factor for coronary heart disease, appear to be especially prevalent

CAD Risk

• Modifiable risk factors– High blood cholesterol levels (specifically, low-density

lipoprotein cholesterol [LDL-C])– High blood pressure– Cigarette smoking: Cessation of cigarette smoking constitutes

the single most important preventive measure for CAD– Diabetes mellitus [1]

– Obesity– Lack of physical activity– Metabolic syndrome– Mental stress and depression

• Developed 7 variable risk stratification tool that predicts the risk of death, reinfarction, or urgent revascularization at 14 days after presentation.

• Patient considered high risk if their TIMI risk score is ≥5 and low risk if the score is 0-4 .

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