Laporan Kasus II ACS STEMI

7/21/2019 Laporan Kasus II ACS STEMI

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LAPORAN KASUS

Seorang Pria Dengan Nyeri Dada Saat Bermain Bola

KELOMPOK VIII

030.09.133 LADY DIANA

030.09.135 LAKSMI PUTRI AYUKINANTI

030.09.137 LUSIANA JEANNETTE C

030.09.139 M. AGUNG SANTARA

030.09.141 MALVIN GIOVANNI

030.09.143 MARGO SEBASTIAN CHANDRA

030.09.147 MAYA LIANA

030.09.149 MELIA INDASARI

030.09.151 MELLY UTAMI

030.09.152 MEUTIA MAIRA RINDRA

030.09.153 MICHAEL !ONG

030.09.155 MOCHAMMAD RIKI MAULANA

030.09.157 MONICA RAHARJO

FAKULTAS KEDOKTERAN UNIVERSITAS TRISAKTI

JAKARTA

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%#, %'-',"' #$'&% *'&' +#'&'', %,:#+-%

7. E&#(' ),/+'% ?8@

T%&'+ &%#()+',,"' #&#(' ),/+'% (#,/%,&%+'-%+', '=' *'-%#, &''( +#'&'',

,$('. H' %,% (#,/%,&%+'-%+', *'-%#, %&'+ (#,/''(% +#'%,', *'&' ',),/

+',', /'/' /%,' '') $')(' &% -#+%'$ ),/+'%.

F% Pemeri*&aan La,oratori+m

P#(#$%+-'', N%'% N$(' H'-% P#(#$%+-'', K##$',/',

L#)+-% 5.000811.000>( 15.000>( M#,%,/+'

LDH 1158221 )> 550 )> M#,%,/+'

CPK 58100 )> 300 )> M#,%,/+'

CKMB F 24 )> 50 )> M#,%,/+'

T$*,%, T 8 P-%%:

C#-#$ F200 230 M#,%,/+'

LDL F100 17 M#,%,/+'

HDL 4080 35 M#,)$),

T$%/%-#$%&' 308200 10 N$('



• Le+*o&ito&i&

T#$'&%,"' *#,%,/+'', #)+-% ##$'*' '( -##' -#$',/', '+). D#$''

#)+-%-%- %,% #$/',),/ &'$% )'- '') %&'+,"' %,:'$+.

P#,%,/+'', #)+-%-%- %'-',"' #$'$% '&',"' %,:#+-% '') *'&' %-+#(%+ '+) "',/

%'-',"' (#,#'* -'(*'% 387 '$%.• LD$ -La.tate De(ydrogena&e/

LDH (#$)*'+', #,;%( "',/ #$&'*' &''( '(*#$ -#()' '$%,/', )).

P#,%,/+'', -#$)( #$'&% %+' #$&'*' +#$)-'+',>+#6$', -#.

8 LDH1 LDH2 J',),/ #$%$-%

8 LDH3 P'$) %(*' *',+$#'- *'-#,'

8 LDH4 LDH5 O $',/+' '%

P'&' M"6'$& I,:#6%,

8 LDH (#,#'* #% '(' &''( -#$)( &'$%*'&' CK

8 N%'% %,//% #$'&% 3855 '( -##' MCI

8 P#,%,/+'', LDH1 LDH2

• )reatinine Kina&e -)K/

M#$)*'+', -)') #,;%( "',/ &%'-%+', #$'/'% '$%,/', &', -#. CK )/' &%+#,'

-#'/'% CPK ?6$'%,%, *-*+%,'-#@. K,-#,$'-% #$%,//% #$&'*' *'&' ',),/

&', $',/+'. A&' 3 #,%- CK

8 MM O $',/+' ',),/

8 BB O'+ /'-$%,#-%,' $'6 /#,%)$%,'$" $'6

8 MB O ',),/

P#,%,/+'',,"' #$'$% '&',"' ("6'$& %,:'$6%, /'/' /%,' '+) $'&("#-%-

&', &%-$:% .• Tro'onin T

M#$)*'+', -'' -') #,;%( 6'$&%'6 $*,%, "',/ #$&'*' &''( ("6'$&%)(. P'&'

)()(,"' $*,%, T ('-% +)$',/ *-%%: &%',&%,/ &#,/', $*,%, I ,'(),

(#(%%+% -#,-%%:%'- "',/ #% %,//% -#%,//' ',"'+ &%*'+'%. K#$)-'+', (%+'$&

"',/ %&'+ #$') )'- '+', (#,%,/+'+', #,;%( %,% &''( -#$)( 183 '( -##'

-#$',/',.

P#,%,/+'', T$*,%, T

8 I,:'$+ M%+'$& A+)

8 P#$%-)$/%6' MCI

8 U,-'# A,/%,'

8 M"6'$&%%-

8 K#'%,', )+', ',),/

o C$,%6 R#,' '%)$#

o T$')(' '+) "',/ (#,/#,'%

o R'&("%-%- *"("-%%- &#$('("-%%-

• )(ole&terol

P#,%,/+'', +'&'$ +#-#$ #$'$% #$&'*' *#,)(*)+', +#-#$ #'- *'&'

*'-%#,. D''( ' %,% *'-%#, (#,'&% #$',6'( '+', (#,&#$%' '#$-+#$-%- '*'%'+#-#$ %&'+ &'*' &%+#' &#,/', '%+.



• LDL

LDL '') "',/ %'-' &%-#) +#-#$ '' '&'' +#-#$ "',/ &'*' (#(%6)

*#(#,)+', '#$-6#$-%-.

• $DL

HDL '') "',/ %'-' &%-#) +#-#$ '%+ '&'' +#-#$ "',/ &'*' (#,6#/'#$'&%,"' *#(#,)+', '#$-6#$-%-.

0% Pemeri*&aan Pen+n1ang#% Pemeri*&aan 2oto t(ora3

8 )TR 4 567 889 Normal

D'$% /'('$', CTR ? C'$&% T$' R'#@ &'*' &%%' '*'+' ',),/ &''(

+#'&'', ,$(' '') %&'+. N%'% ,$(',"' '&'' +)$',/ '') -'(' &#,/', 50.

J%+' #% &'$% 50 #$'$% ',),/ (#,/''(% *#(#-'$',.

8 Segmen Aorta dan P+lmonal 889 NormalH' %,% #$'$% *'-%#, %&'+ (#,/''(% +#'%,', *'&' +') ',),/ "',/ (#,/'$'

+# *'$)8*'$).

8 Tida* ada tanda8tanda ,end+ngan

H' %,% )/' (#,/%,&%+'-%+', #,&),/', 6'%$', )+',' *#,"#' &'$% ,"#$% &'&'

"',/ &'*' (#,/'$%+', *)' %&'+ '&',"' +#'%,', *'&' +##(*' +') ',),/.

D'$% '-% $'&%/% #$-#) &%-%(*)+', '=' *'-%#, #)( (#,/''(% /'/'

',),/. S#'/'%(',' "',/ +%' ') /'/' ',),/ '&'' #$(%,' &'$% -#)$) *#,"'+% ',),/.

2. P#(#$%+-'', EKG

H'-% *#(#$%+-'', EKG *'&' *'-%#, %,% '&'' -#'/'% #$%+)

Tiga Sandapan Standar



1. S',&'*', I

− $#+)#,-% ?,%'% ,$(' 08100>(#,%@ I,#$' R8R )(',"' %'' 13

+'+ +#6% '&% :$#+)#,-%,"' %'' 1500 &%'/% 13 "'%) 115>(#,% &%(','

#$('-)+ ta*i*ardi.

− I$'(' -%,)- N$(' +'$#,' /#(',/ P &%%+)% # +(*#+- RS

+#()&%', &%%+)% # /#(',/ T.− G#(',/ P G#(',/ P (#,',&'+', &#*'$%-'-% '$%)(. A(*%)&,"'

1(V ('-% ,$(' &#,/', &)$'-%,"' 004 &#%+ )/' ('-% ,$('

(#,',&'+', '=' '$%)( ('-% ,$('.

− I,#$' PR I,#$' PR (#,//'('$+', ='+) ()'% '=' &#*'$%-'-%

'$%)( -'(*'% '=' &#*'$%-'-% #,$%+#. D%-%,% %,#$' PR 012 &#%+ %''

,$('.

− G#(',/ G#(',/ (#,',&'+', &#*'$%-'-% -#*)( %,#$#,$%+#

&'$% +',', +# +%$% "',/ #$%' *'&' -',&'*', I 'VL V5 &', V. D%-%,%'(*%)&,"' 01(V -#%,//' ('-% ,$('. G#(',/ "',/ *'/%-

(#,',&'+', '&',"' %,:'$+ (%+'$&. G#(',/ "',/ *'/%- '')

/#(',/ -%/,%:%+', #% )'- &', #% &''( +$%#$%',"' %''

'. D)$'-% /#(',/ '$)- #% #-'$ &'$% 004 &#%+

. K#&''(', /#(',/ -#+)$',/8+)$',/,"' '$)- -#*#$%/' %,//%

/#(',/ R *'&' +(*#+- RS "',/ -'('

− I,#$' RS K(*#+- RS (#,',&'+', &#*'$%-'-% #,$%+# -#%,//'

%,#$' RS (#$)*'+', *#,/)+)$', #$'&'* ='+) &#*'$%-'-% #,$%+#.D%-%,% %,#$' RS 004 &#%+ %'' ,$('. I,#$' RS "',/ (##%% ,%'%

,$(' ?,%'% ,$(' 00801 &#%+@ (#,',&'+', '&',"' %*#$$:% #,$%+#.

− S#/(#, ST S#/(#, ST (#,//'('$+', ='+) ()'% '+%$ &#*'$%-'-%

#,$%+# -'(*'% '=' $#*'$%-'-% #,$%+#. D%-%,% #$&'*' de're&i &egmen

ST "',/ &'*' #$'&% *'&' ',/%,' %*%+' '') *'&' %,:'$+ /#(',/ ,,8.

D#*$#-% &'$% -#/(#, ST )/' %-' %() *'&' -',&'*', I %' -',&'*', "',/

#$'=',', ') &#,/', -',&'*', I ?"'%) -',&'*', 'VR (#,/''(% ##'-%

-#/(#, ST@ %,% &%-#) -#'/'% *#$)'', $#-%*$+'.



− G#(',/ T A$' /#(',/ T )()(,"' (#,/%+)% +(*#+- RS &',

(#,',&'+', $#*'$%-'-% &'$% #,$%+#. A(*%)& /#(',/ T &%-%,% %''

-#*#$%/' /#(',/ R -##)(,"' -#%,//' ('-% ,$('. P'&' '=' %,:'$+

/#(',/ T '+', (#,%,//% &', (#,"#(*% ?(#(),6'+> peaking @ &%(','&%-#) -#'/'% /#(',/ T %*#$'+). B##$'*' '( +#()&%', /#(',/

T '+', (#,/''(% %,#$-%. P#$)'', *'&' /#(',/ T ?T %*#$'+) '') T

%,#$-%@ (#,//'('$+', %-+#(%' (%+'$&%)( "'%) +)$',/,"' '%$', &'$' +#

(%+'$&%)(.

− I,#$' T I,#$' T (#,/)+)$ ='+) &'$% '=' &#*'$%-'-% #,$%+#

%,//' '+%$ $#*'$%-'-% #,$%+#. N$(',"' %,#$' T (#,")-), 40

&'$% %,#$' RR. D%-%,% %,#$' T 044 &#%+ ?,%'% ,$(' '+%8'+% 042

&#%+@ ('+' %,#$' :T meman1ang.

− A%- #+$ ',),/ A%- ',),/ &%#,)+', # -',&'*', I &', -',&'*',

IIIS',&'*', I R 3

S 82 1

S',&'*', III R 13

S 5 1

S#-)'% &#,/', 6'$' %),/ /&(',, '%- ',),/ %'' 9 ?*',' (#$'@

"'%) ('-% ,$(' &%(',' ,%'% ,$(' '%- ',),/ %'' &%','$' 830 -'(*'%

110. A%- "',/ ,$(' (#,',&'+', '=' %&'+ '&' %*#$$:% &'$% $)',/

',),/.

2. S',&'*', II



− $#+)#,-% I,#$' R8R %'' 14 +'+ +#6% -#%,//' :$#+)#,-%,"' %'' 1500

&%'/% 14 "'%) 107>(#,% "',/ (#,),)+', ta*i*ardi.− I$'(' -%,)- I$'(' -%,)- ,$(' &%(',' #$&'*' /#(',/ P &%%+)%

+(*#+- RS &', /#(',/ T.− G#(',/ P A(*%)& /#(',/ P "',/ #$%' %'' 2(V &%-#$'%

&#,/', &)$'-% 012 &#%+ "'%) ('-% &''( ''- ,$('.− I,#$' PR D%-%,% #$%' %,#$' PR %'' 012 &#%+ ('-% &''( ''-

,$('.− G#(',/ D%-%,% #$%' /#(',/ +#6% &#,/', '(*%)& 1(V "',/

%&'+ *'/%-.− I,#$' RS I,#$' RS &%-%,% 00 &#%+ ('-% &''( ''- ,$('.− S#/(#, ST D%-%,% #$%' ele;a&i &egmen ST. E#'-% -#/(#, ST

(#,',&'+', '&',"' 6#&#$' (%+'$&%)( ?injury@. C#&#$' (#,//'('$+',

+#$)-'+', (%+'$&%)( "',/ #% #-'$ &'$% %-+#(%' ,'(), &'*' #$-%:'$##$-%#. E#'-% -#/(#, ST (#$)*'+', ',&' "',/ &'*' &%',&'+', '='

#' #$'&% %,:'$+ -#'% &', '+', '(*'+ /'('$', %,:'$+ "',/ +(*% %'

%&'+ -#/#$' &%'+)+', %,#$#,-% #$'*#)%+ "',/ '/$#-%:.− G#(',/ T D%-%,% /#(',/ T -#'$' &#,/', '$' /#(',/ R ?,$('@

&#,/', '(*%)& "',/ ,$('.− I,#$' T I,#$' T &%-%,% %'' 04 &#%+ ('-% &''( ''- ,$('.

3. S',&'*', III

− $#+)#,-% I,#$' R8R %'' 14 +'+ '&% :$#+)#,-%,"' '&'' 1500 &%'/%

14 "'%) 107>(#,% "',/ (#,),)+', ta*i*ardi.



− I$'(' -%,)- I$'(' -%,)- ,$(' &%(',' #$&'*' /#(',/ P &%%+)%

+(*#+- RS &', /#(',/ T.

− G#(',/ P A(*%)& 2(V &#,/', &)$'-% 012 &#%+ '&% ('-% #$('-)+

&''( ''- ,$('.

− I,#$' PR D%-%,% #$%' %,#$' PR %'' 012 &#%+ ('-% &''( ''-

,$('.

− G#(',/ D%-%,% #$%' /#(',/ +#6% &#,/', '(*%)&# 15(V

"',/ (##%% ''- ,$(' &', &)$'-% 004 &#%+ "',/ ,$('. G#(',/

&%-%,% )+', /#(',/ "',/ *'/%- +'$#,' '(*%)&,"' +)$',/ &'$%

-#*#$%/' '(*%)& /#(',/ R.− I,#$' RS I,#$' RS &%-%,% 00 &#%+ ('-% &''( ''- ,$('.

− S#/(#, ST D%-%,% #$%' ele;a&i &egmen ST. E#'-% -#/(#, ST

(#,',&'+', '&',"' 6#&#$' (%+'$&%)( ?injury@.

− G#(',/ T D%-%,% /#(',/ T -#'$' &#,/', '$' /#(',/ R ?,$('@

&#,/', '(*%)& "',/ ,$('.

− I,#$' T I,#$' T &%-%,% %'' 03 &#%+ ('-% &''( ''- ,$('.

Tiga Sandapan Tambahan

4. S',&'*', 'VR

P'&' -',&'*', 'VR /#(',/ P +(*#+- RS &', /#(',/ T -#()'

(#,/''(% &#:#+-% ,#/'%: +'$#,' -)&) $%#,'-%,"' 8150 -#%,//' -#()' '+%%'-

%-$%+ ',),/ -#' #$/#$'+ (#,')% ##+$&'. S',&'*', 'VR %'-',"'

(#,),)+', /'('$', /#(',/ "',/ -',/' &''( -#%,//' %&'+ )-'

&%*#$%(',/+', &''( *#,%'%', +#(),/+%,', %,:'$+.

5. S',&'*', 'VL



− $#+)#,-% I,#$' R8R %'' 14 +'+ '&% :$#+)#,-%,"' '&'' 1500 &%'/%

14 "'%) 107>(#,% "',/ (#,),)+', ta*i*ardi.

− I$'(' -%,)- I$'(' -%,)- ,$(' &%(',' #$&'*' /#(',/ P &%%+)%

+(*#+- RS &', /#(',/ T. J)/' #$&'*' /#(',/ U.

− G#(',/ P ?(#,/''(% &#:#+-% ,#/'%:@ A(*%)& 1(V &#,/', &)$'-%

012 &#%+ '&% ('-% #$('-)+ &''( ''- ,$('.

− I,#$' PR D%-%,% #$%' %,#$' PR %'' 012 &#%+ ('-% &''( ''-

,$('.

− G#(',/ D%-%,% %&'+ #$%' /#(',/ .− I,#$' RS I,#$' RS &%-%,% 004 &#%+ ('-% &''( ''- ,$('.

− S#/(#, ST D%-%,% #$%' de're&i &egmen ST. D#*$#-% -#/(#, ST &'*'

#$'&% *'&' ',/%,' %*%+' '') *'&' %,:'$+ /#(',/ ,,8.

−

G#(',/ T D%-%,% #$%' gelom,ang T mengalami in;er&i. I,#$-%/#(',/ T (#,//'('$+', %-+#(%' (%+'$&%)(.

− G#(',/ U D%-%,% #$%' gelom,ang U ter,ali* "',/ (#,',&'+',

%-+#(%'. G#(',/ U '-',"' %&'+ #'- &%(',' /#(', U "',/ #$'%+

%'-' #$&'*' *'&' +#'&'', %-+#(%' '') %*#$$:%.

− I,#$' T I,#$' T &%-%,% %'' 024 &#%+ ('-% &''( ''- ,$('.

. S',&'*', 'V

− $#+)#,-% I,#$' R8R %'' 13 +'+ '&% :$#+)#,-%,"' '&'' 1500 &%'/%

13 "'%) 115>(#,% "',/ (#,),)+', ta*i*ardi.

− I$'(' -%,)- I$'(' -%,)- ,$(' &%(',' #$&'*' /#(',/ P &%%+)%

+(*#+- RS &', /#(',/ T.

− G#(',/ P A(*%)& 2(V &#,/', &)$'-% 012 &#%+ '&% ('-% #$('-)+

&''( ''- ,$('.

− I,#$' PR D%-%,% #$%' %,#$' PR %'' 02 &#%+ ('-% &''( ''-

,$('.

− G#(',/ D%-%,% #$%' /#(',/ +#6% &#,/', '(*%)&# 2(V "',/

(##%% ''- ,$(' &', &)$'-% 004 &#%+ "',/ ,$('. G#(',/ &%-%,%

)+', /#(',/ "',/ *'/%- +'$#,' '(*%)&,"' +)$',/ &'$% -#*#$%/'

'(*%)& /#(',/ R.



− I,#$' RS I,#$' RS &%-%,% 00 &#%+ ('-% &''( ''- ,$('.


(#,',&'+', '&',"' 6#&#$' (%+'$&%)( ?injury@.

− G#(',/ T D%-%,% /#(',/ T -#'$' &#,/', '$' /#(',/ R ?,$('@

&#,/', '(*%)& "',/ ,$('.

− I,#$' T I,#$' T &%-%,% %'' 04 &#%+ ('-% &''( ''- ,$('.

Enam Sandapan Prakordial

7. S',&'*', V1

− $#+)#,-% I,#$' R8R %'' 14 +'+ '&% :$#+)#,-%,"' '&'' 1500 &%'/%

14 "'%) 107>(#,% "',/ (#,),)+', ta*i*ardi.

− I$'(' -%,)- I$'(' -%,)- ,$(' &%(',' #$&'*' /#(',/ P &%%+)%

+(*#+- RS &', /#(',/ T.

− G#(',/ P ?&#:#+-% ,#/'%:@ A(*%)& 1(V &#,/', &)$'-% 012 &#%+

'&% ('-% #$('-)+ &''( ''- ,$('.

− I,#$' PR D%-%,% #$%' %,#$' PR %'' 012 &#%+ ('-% &''( ''-

,$('.

− G#(',/ D%-%,% %&'+ #$%' /#(',/ .− I,#$' RS I,#$' RS &%-%,% 004 &#%+ ('-% &''( ''- ,$('.


#$'&% *'&' ',/%,' %*%+' '') *'&' %,:'$+ /#(',/ ,,8.

− G#(',/ T D%-%,% #$%' gelom,ang T mengalami in;er&i. I,#$-%

/#(',/ T (#,//'('$+', %-+#(%' (%+'$&%)(.− I,#$' T I,#$' T &%-%,% %'' 04 &#%+ ('-% &''( ''- ,$('.

. S',&'*', V2



− $#+)#,-% I,#$' R8R %'' 14 +'+ '&% :$#+)#,-%,"' '&'' 1500 &%'/%

14 "'%) 107>(#,% "',/ (#,),)+', ta*i*ardi.

− I$'(' -%,)- I$'(' -%,)- ,$(' &%(',' #$&'*' /#(',/ P &%%+)%

+(*#+- RS &', /#(',/ T.

− G#(',/ P ?#$-%:' %:'-%+@ A(*%)& 1(V &#,/', &)$'-% 012 &#%+ '&%

('-% #$('-)+ &''( ''- ,$('.− I,#$' PR D%-%,% #$%' %,#$' PR %'' 02 &#%+ ('-% &''( ''-

,$('.

− G#(',/ D%-%,% %&'+ #$%' /#(',/ .− I,#$' RS I,#$' RS &%-%,% 00 &#%+ ('-% &''( ''- ,$('.


#$'&% *'&' ',/%,' %*%+' '') *'&' %,:'$+ /#(',/ ,,8.

− G#(',/ T D%-%,% /#(',/ T -#'$' &#,/', '$' /#(',/ R ?,$('@

&#,/', '(*%)& "',/ ,$('.

− I,#$' T I,#$' T &%-%,% %'' 03 &#%+ ('-% &''( ''- ,$('.

9. S',&'*', V3

−

$#+)#,-% I,#$' R8R %'' 13 +'+ '&% :$#+)#,-%,"' '&'' 1500 &%'/%13 "'%) 115>(#,% "',/ (#,),)+', ta*i*ardi.

− I$'(' -%,)- I$'(' -%,)- ,$(' &%(',' #$&'*' /#(',/ P &%%+)%

+(*#+- RS &', /#(',/ T.

− G#(',/ P A(*%)& 1(V &#,/', &)$'-% 012 &#%+ '&% ('-% #$('-)+

&''( ''- ,$('.

− I,#$' PR D%-%,% #$%' %,#$' PR %'' 01 &#%+ ('-% &''( ''-

,$('.

− G#(',/ D%-%,% #$%' /#(',/ &#,/', '(*%)& 05(V &',

&)$'-% 004 &#%+ ('-% &''( ''- ,$('.



− I,#$' RS I,#$' RS &%-%,% 004 &#%+ ('-% &''( ''- ,$('.


(#,',&'+', '&',"' 6#&#$' (%+'$&%)( ?injury@.

− G#(',/ T D%-%,% /#(',/ T -#'$' &#,/', '$' /#(',/ R ?,$('@

&#,/', '(*%)& "',/ ,$('.

− I,#$' T I,#$' T &%-%,% %'' 03 &#%+ ('-% &''( ''- ,$('.

10. S',&'*', V4

−

$#+)#,-% I,#$' R8R %'' 14 +'+ '&% :$#+)#,-%,"' '&'' 1500 &%'/%14 "'%) 107>(#,% "',/ (#,),)+', ta*i*ardi.

− I$'(' -%,)- I$'(' -%,)- ,$(' &%(',' #$&'*' /#(',/ P &%%+)%

+(*#+- RS &', /#(',/ T.

− G#(',/ P A(*%)& 1(V &#,/', &)$'-% 012 &#%+ '&% ('-% #$('-)+

&''( ''- ,$('.

− I,#$' PR D%-%,% #$%' %,#$' PR %'' 01 &#%+ ('-% &''( ''-

,$('.

− G#(',/ D%-%,% #$%' /#(',/ &#,/', '(*%)& 05(V &',

&)$'-% 004 &#%+ ('-% &''( ''- ,$('.− I,#$' RS I,#$' RS &%-%,% 004 &#%+ ('-% &''( ''- ,$('.


(#,',&'+', '&',"' 6#&#$' (%+'$&%)( ?injury@.

− G#(',/ T D%-%,% /#(',/ T -#'$' &#,/', '$' /#(',/ R ?,$('@

&#,/', '(*%)& "',/ ,$('.

− I,#$' T I,#$' T &%-%,% %'' 04 &#%+ ('-% &''( ''- ,$('.

11. S',&'*', V5

− $#+)#,-% I,#$' R8R %'' 14 +'+ '&% :$#+)#,-%,"' '&'' 1500 &%'/%

14 "'%) 107>(#,% "',/ (#,),)+', ta*i*ardi.



− I$'(' -%,)- I$'(' -%,)- ,$(' &%(',' #$&'*' /#(',/ P &%%+)%

+(*#+- RS &', /#(',/ T.

− G#(',/ P A(*%)& 1(V &#,/', &)$'-% 012 &#%+ '&% ('-% #$('-)+

&''( ''- ,$('.

− I,#$' PR D%-%,% #$%' %,#$' PR %'' 01 &#%+ ('-% &''( ''-

,$('.

− G#(',/ D%-%,% #$%' /#(',/ &#,/', '(*%)& 1(V &', &)$'-%

004 &#%+ ('-% &''( ''- ,$('.− I,#$' RS I,#$' RS &%-%,% 00 &#%+ ('-% &''( ''- ,$('.


(#,',&'+', '&',"' 6#&#$' (%+'$&%)( ?injury@.

− G#(',/ T D%-%,% /#(',/ T -#'$' &#,/', '$' /#(',/ R ?,$('@

&#,/', '(*%)& "',/ ,$('.− I,#$' T I,#$' T &%-%,% %'' 04 &#%+ ('-% &''( ''- ,$('.

12. S',&'*', V

− $#+)#,-% I,#$' R8R %'' 13 +'+ '&% :$#+)#,-%,"' '&'' 1500 &%'/%

13 "'%) 115>(#,% "',/ (#,),)+', ta*i*ardi.

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S#%'% S #&%$-. B)+) A'$ I() P#,"'+% D''(. 5 #&. J'+'$' I,#$,' P)%-%,/

2009. *.172587.

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S%('&%$'' M S#%'% S E&%$-. B)+) A'$ I() P#,"'+% D''(. 4 #&. J'+'$'

I,#$,' P)%-%,/ P)-' P#,#$%', I() P#,"'+% D''( 2007. *. 173589.

4. B%6+#" LS. B)+) S'+) P#(#$%+-'', %-%+ &', R%='"' K#-#'', B'#-. 5 #&.

J'+'$' P#,#$% B)+) K#&+#$', EGC 200.

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K#&+#$', EGC2004.

. !%&'' S. EKG P$'+%-. J'+'$' B%,'$)*' A+-'$' 2009.

7. T'#$ MS. S')8-'),"' )+) EKG "',/ ',&' *#$)+',. I, !'' AS P#$&', TIM

N)/$ A! #&%$-. 5 #&. J'+'$' EGC 2009. *.980 9 10285 13485 13 2098

37.

. M'"C%,%6 -'::. E-*'/#' -*'-(. A'%'# '

*>>===.('"6%,%6.6(>#'>#-*'/#'8-*'-(->DS0073. A66#--#& 21 M'"

2011.

9. D)/&'# DC L,/-$# G %## D. E-*'/#' -*'-(. A'%'# '

*>>===.,(.,%./>(#&%,#*)->#,6">'$%6#>00029.(. A66#--#& 21 M'"

2011.

10. B$=, CT. P#,"'+% A#$-+##$-%+ K$,#$. I, P$%6# SA !%-, LC #&%$-.P':%-%/% K,-#* K%,%- P$-#-8*$-#- P#,"'+%. #&. J'+'$' EGC 2005.

*.5081.

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E"-'# #&%$-. '$('+/% &', T#$'*%. 5 #&. J'+'$' B''% P#,#$% KUI

2007. *.32871.

http://www.mayoclinic.com/health/esophageal-spasms/DS00763

http://www.nlm.nih.gov/medlineplus/ency/article/000289.htm

http://www.nlm.nih.gov/medlineplus/ency/article/000289.htm

http://www.mayoclinic.com/health/esophageal-spasms/DS00763

Laporan Kasus II ACS STEMI

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