Makalah Kardiomiopati.doc

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MAKALAH

KARDIOMIOPATI

OLEH :

PRASGADIKA AZNURUTAMA

KELOMPOK 7

1



KATA PENGANTAR

Bismillahirrohmaanirrohiim.

Alham!lillah" s#$ala %!&i 'a$i Allah s#m#s(a alam )an$ (#lah

m#m'#ri*an rahma( an hia)ah+N)a *#%aa *i(a s#m!a s#hin$$a *ami a%a(

m#n)#l#sai*an ma*alah ini (#%a( %aa ,a*(!n)a. Ta* l!%a shola,a( s#r(a salam

s#mo$a s#nan(iasa (#r-!rahlim%ah*an *#%aa &!n&!n$an '#sar Na'i M!hamma

Shallallah! Alaihi /asallam" *#%aa *#l!ar$an)a" %ara saha'a(" (a'i0i( an

(a'i0im s#r(a a%a( sam%ai *#%aa *i(a s#la*! !ma(n)a hin$$a a*hir 1aman nan(i.

Ma*alah ini '#risi*an m#n$#nai %#ma%aran (#n(an$ 2Kariomio%a(i3 ma*alah ini

i s!s!n !n(!* (!&!an m#m'#ri*an %#n$a(ah!an (#n(an$ Kariomio%a(i *#%aa

%#m'a-a. P#%a(ah lama m#n$a(a*an 'ah,a (a* aa $ain$ )an$ (a* r#(a*" '#$i(!

%!la #n$an ma*alah )an$ (#lah is!s!n ini (#n(!n)a masih m#n)im%an *#salahan

an *#*!ran$an i sana+sini i*ar#na*an *!ran$ l!asn)a r#4#r#nsi a(a! 'ah*an

*!ran$ &#lin)a %#n!lis !n(!* m#nan$*a% is!+is! #(il ari s#'!ah 4#nom#na )an$

m!n-!l. Kar#nan)a" *ri(i* an saran )an$ m#m'an$!n san$a( i'!(!h*an 'a$i

%#r'ai*an %#n)!s!nan ma*alah+ma*alah s#lan&!(n)a.

P#n)!s!n

(Pras$ai*a An!r!(ama5

2



DAFTAR ISI

Ka(a %#n$an(ar.......................................................................................................6

Da4(ar Isi................................................................................................................

Bab I

8.8. La(ar '#la*an$................................................................................................9

8.6. R!m!san Masalah..........................................................................................7

8. T!&!an..............................................................................................................7

8..8T!&!an Um!m............................................................................................7

8..6T!&!an Kh!s!s...........................................................................................7

8. Man4aa(............................................................................................................7

Bab II

6.8 Ana(omi 4isiolo$i.............................................................................................;

6.6 D#4inisi............................................................................................................8

6. E(iolo$i............................................................................................................8;

6. Klasi4i*asi........................................................................................................6<

6.= Pa(o4isiolo$i.....................................................................................................68

6.9 /O>...............................................................................................................66

6.7 Mani4#s(asi.....................................................................................................6

6.; P#m#ri*saan Dia$nos(i*.................................................................................69

6.? P#na(a La*sanaan...........................................................................................<

6.8< Kom%li*asi...................................................................................................9

Bab III

.8 P#n$*a&ian.......................................................................................................;

.6 Dia$nosa..........................................................................................................8

3



. In(#r@#nsi P#r#n-anaan5.................................................................................6

. Im%l#m#n(asi...................................................................................................=9

.= E@al!asi...........................................................................................................=9

Bab IV

.8 K#sim%!lan......................................................................................................=7

.6 Saran................................................................................................................=;

Daftar pustaka.....................................................................................................=?

4



STIKES NGUDIA HUSADA MADURA

L R.E. Mar(aina(a" No. ?9?889" K#-. Ban$*alan" 9?889

SURAT PERSETUJUAN ARTIKEL PUBLIKASI ILMIAH

Can$ '#r(ana (an$an i'a,ah ini %#m'im'in$ (!$as a*hir:

Nama :

T#lah m#m'a-a an m#n-#rma(i nas*ah ar(i*#l %!'li*asi ilmiah )an$

m#r!%a*an rin$*asan(!$as PDKBPL:

Nama : Pras$ai*a A1n!r!(ama

NIM : 8=86<8<897

Pro$ram S(!i :S8K#%#ra,a(an

!!l : KARDIOMIOPATI

Nas*ah ar(i*#l (#rs#'!( la)a* an a%a( is#(!&!i !n(!* i%!'li*asi*an.

D#mi*ian %#rs#(!&!an ini i '!a(" s#mo$a a%a( i%#r$!na*an s#%#rl!n)a.

Ban$*alan"6< S#%(#m'#r

6<8=

P#m'im'in$

5

5



BAB I

! Latar B"#aka$%

K#hi!%an man!sia (a* l#%as ari )an$ naman)a *#s#ha(an " *#s#ha(an

han)a a%a( (#r&ai &i*a s#l!r!h *om%on#n m!lai ari s#l sam%ai #n$an ini@i!

'#r&alan s#s!ai ana(omi an 4isiolo$in)a" or$an )an$ '#*#r&a %alin$ %#n(in$ alam

(!'!h aalah o(a* an *#m!ian &an(!n$ *#na%a #mi*ian" *ar#na 4!n$si ari o(a*

aalah m#n$or$anisir s#m!a *#$ia(an )an$ aa alam (!'!h s#m#n(ara &an(!n$

m#m'#ri ma*an or$an s#l!r!h (!'!h *ar#na 4!n$sin)a s#'a$ai %#mom%a arah

*# s#l!r!h (!'!h.

Dalam %#m'ahasan *ali ini *i(a a*an m#n$!%as *#riomio%a(i imana i(!

aalah salah sa(! *#lainan &an(!n$. an(!n$ 'ahasa La(in" -or5 aalah s#'!ah

ron$$a" ron$$a or$an '#ro(o( )an$ m#mom%a arah l#,a( %#m'!l!h arah ol#h

*on(ra*si '#rirama )an$ '#r!lan$. Is(ilah *aria* '#rar(i '#rh!'!n$an #n$an

&an(!n$" ari *a(a C!nani -aria !n(!* &an(!n$. an(!n$ aalah salah sa(! or$an

man!sia )an$ '#r%#ran alam sis(#m %#r#aran arah. U*!ran &an(!n$ man!sia

*!ran$ l#'ih s#'#sar *#%alan (an$an. an(!n$ aalah sa(! o(o( (!n$$al )an$ (#riri

ari la%isan #no(h#li!m. an(!n$ (#rl#(a* i alam ron$$a (ora*i*" i 'ali* (!lan$

aa. S(r!*(!r &an(!n$ '#r'#lo* *# 'a,ah an s#i*i( *# arah *iri.

an(!n$ ham%ir s#%#n!hn)a is#l!'!n$i ol#h %ar!+%ar!" nam!n (#r(!(!%

ol#h s#la%!( $ana )an$ '#rnama %#ri*ari!m" )an$ (#r(#m%#l %aa ia4ra$ma.

La%isan %#r(ama m#n#m%#l san$a( #ra( *#%aa &an(!n$" s#an$*an la%isan l!arn)a

l#'ih lon$$ar an '#rair" !n(!* m#n$hinari $#s#*an an(ar or$an alam (!'!h

)an$ (#r&ai *ar#na $#ra*an m#mom%a *ons(an &an(!n$.

an(!n$ i&a$a i (#m%a(n)a ol#h %#m'!l!h+%#m'!l!h arah )an$ m#li%!(i

a#rah &an(!n$ )an$ m#ra(aa(ar" s#%#r(i i asar an i sam%in$. D!a $aris

%#m'#lah (#r'#n(!* ari o(o(5 %aa la%isan l!ar &an(!n$ m#n!n&!**an i mana

inin$ %#misah i an(ara s#ram'i F 'ili* &an(!n$. S#m#n(ara K#lainan 4!n$si

o(o( &an(!n$ #n$an %#n)#'a' )an$ (ia* i*#(ah!i an '!*an ia*i'a(*an ol#h

%#n)a*i( ar(#ri *oron#r" *#lainan &an(!n$ 'a,aan -on$#ni(al5" hi%#r(#nsi a(a!

%#n)a*i( *a(!%. Kariomio%a(i )an$ s#-ara har4iah '#rar(i %#n)a*i( mio*ari!m"

a(a! o(o( &an(!n$" i(anai #n$an hilan$n)a *#mam%!an &an(!n$ !n(!*

m#mom%a arah an '#r#n)!( s#-ara normal

6

http://id.wikipedia.org/wiki/Bahasa_Latin

http://id.wikipedia.org/wiki/Organ_(anatomi)

http://id.wikipedia.org/wiki/Darah

http://id.wikipedia.org/wiki/Pembuluh_darah

http://id.wikipedia.org/wiki/Bahasa_Yunani

http://id.wikipedia.org/wiki/Sistem_peredaran

http://id.wikipedia.org/wiki/Otot

http://id.wikipedia.org/w/index.php?title=Sternum&action=edit&redlink=1


http://id.wikipedia.org/wiki/Paru-paru

http://id.wikipedia.org/wiki/Perikardium

http://id.wikipedia.org/wiki/Diafragma

http://id.wikipedia.org/w/index.php?title=Atrium&action=edit&redlink=1

http://id.wikipedia.org/w/index.php?title=Ventrikel&action=edit&redlink=1

http://id.wikipedia.org/wiki/Bahasa_Latin

http://id.wikipedia.org/wiki/Organ_(anatomi)

http://id.wikipedia.org/wiki/Darah

http://id.wikipedia.org/wiki/Pembuluh_darah

http://id.wikipedia.org/wiki/Bahasa_Yunani

http://id.wikipedia.org/wiki/Sistem_peredaran

http://id.wikipedia.org/wiki/Otot



http://id.wikipedia.org/wiki/Paru-paru

http://id.wikipedia.org/wiki/Perikardium

http://id.wikipedia.org/wiki/Diafragma

http://id.wikipedia.org/w/index.php?title=Atrium&action=edit&redlink=1

http://id.wikipedia.org/w/index.php?title=Ventrikel&action=edit&redlink=1



!& Ru'usa$ Masa#a

8. A%a %#n$#r(ian *ariomio%a(i

6. A%a ma-am+ma-am *ariomio%a(i

. Ba$aimana #(iolo$i ari *ariomio%a(i

. Ba$aimana mani4#s(asi *linis ari *ariomio%a(i

=. Ba$aimana %#m#ri*saan %#n!n&an$ ari *ariomio%a(i

9. Ba$aimana -ara %#n$o'a(an ari *ariomio%a(i

7. Ba$aimana s(r!*(!r /#' O4 >a!(ion

!) Tu*ua$

!)! Tu*ua$ U'u'

8. Un(!* m#n$#(ah!i %#n$#r(ian *ariomio%a(i

6. Un(!* m#n$#(ah!i ma-am+ma-am *ariomio%a(i

. Un(!* m#n$#(ah!i -ara %#n$o'a(an *ariomio%a(i

!)!& Tu*ua$ Kusus

8. Un(!* m#n$#(ah!i #(iolo$i *ariomio%a(i

6. Un(!* m#n$#(ah!i mani4#s(asi *linis *ariomio%a(i

. Un(!* m#n$#(ah!i %#m#ri*saan %#n!n&an$ *ariomio%a(i

!+ Ma$faat

8. P#m'a-a a%a( m#mahami #4inisi" #(iolo$i" 4a*(or r#si*o s#(a %a(i4iolo$i

*ariomio%a(i

6. P#m'a-a *h!s!sn)a mahasis,a ilm! *#%#ra,a(an a%a( m#mahami

as!han *#%#ra,a(an (#rhaa% %asi#n *ariomio%a(i

. P#ra,a( a%a( m#n#ra%*an as!han *#%#ra,a(an )an$ (#%a( (#rhaa% %asi#n

#n$an *ariomio%a(i

7



BAB II

&! A$at,'- F-s-,#,%- *a$tu$%

an(!n$ m#r!%a*an s#'!ah or$an )an$ (#riri o(o(. >ara '#*#r&an)a

8m#n)#r!%ai o(o( %olos )ai(! i l!ar *#ma!an *i(a i%#n$ar!hi ol#h

s!s!nan sara4 o(onom5.K"r*a Fu$%s- *a$tu$% aalah m#n$a(!r is(ri'!si arah *# s#l!r!h 'a$ian (!'!h.

B#n(!* &an(!n$ m#n)#r!%ai &an(!n$ %isan$" '#sarn)a *!ran$ l#'ih s#'#sar

*#%alan (an$an %#mili*n)a. Ba$ian a(asn)a (!m%!l %an$*al &an(!n$5 an is#'!(

&!$a 'asis *oris. Di s#'#lah 'a,ah a$a* r!n-in$ )an$ is#'!( a%#*s *oris.

Letak jantung i alam ron$$a aa s#'#lah #%an *a@!m m#ias(in!m an(#rior5"

s#'#lah *iri 'a,ah ari %#r(#n$ahan ron$$a aa" ia(as ia4ra$ma" an

%an$*aln)a (#ra%a( i '#la*an$ *iri an(ara *os(a an I !a &ari i 'a,ah

%a%illa mama#.

Paa (#m%a( ini (#ra'a aan)a #n)!(an &an(!n$ )an$ is#'!( i*(!s *oris.

U*!rann)a *!ran$ l#'ih s#'#sar $#n$$aman (an$an *anan an '#ra(n)a *ira+*ira

6=<+<< $ram.

Lap-sa$ Ja$tu$%

Dinin$ &an(!n$ (#r!(ama (#riri ari s#ra(+s#ra( o(o( &an(!n$ )an$ (#rs!s!n s#-ara

s%iral an salin$ '#rh!'!n$an m#lal!i is*!s in(#r*ala(!s

La%isan &an(!n$ i(! s#niri (#riri ari P#ri*ari!m" Mio*ari!m" an

Eno*ari!m. B#ri*!( ini %#n&#lasan *#(i$a la%isan &an(!n$ )ai(!

Perikardium (Epikardium)

E%i '#rar(i 2i a(as3" -aria '#rar(i 2&an(!n$3" )an$ mana 'a$ian ini aalah s!a(!

m#m'ran (i%is i 'a$ian l!ar )an$ m#m'!n$*!s &an(!n$. T#riri ari !a la%isan :

8



8. P#ri*ar!im 4i'ros!m @is#ral5" m#r!%a*an 'a$ian *an(on$ )an$

m#m'a(asi %#r$#ra*an &an(!n$ (#ri*a( i 'a,ah s#n(r!m (#nini!m

ia4ra$ma" '#rsa(! #n$an %#m'!l!h arah '#sar m#r#*a( %aa s(#rn!m

m#lal!i li$am#n(!m s(#rno%#ri*arial.

6. P#ri*ar!im s#ros!m %ari#(al5" i'a$i m#n&ai !a 'a$ian" )ai(!P#ri*ari!m %ari#(alis m#m'a(asi %#ri*ar!im 4i'ros!m s#rin$ is#'!(

#%i*ari!m" an P#ri*ar!im 4is#ral )an$ m#n$an!n$ s#i*i( -airan )an$

'#r4!n$si s#'a$ai %#l!mas !n(!* m#m%#rm!ah %#r$#ra*an &an(!n$.

Miokardium

M)o '#rar(i o(o(" m#r!%a*an la%isan (#n$ah )an$ (#riri ari o(o( &an(!n$"

m#m'#n(!* s#'a$ian '#sar inin$ &an(!n$. S#ra(+s#ra( o(o( ini (#rs!s!n s#-ara

s%iral an m#lin$*ari &an(!n$. La%isan o(o( ini )an$ a*an m#n#rima arah ari

ar(#ri *oron#r.

Endokardium

Eno '#rar(i i alam" aalah la%isan (i%is #no(h#li!m" s!a(! &arin$an #%i(#l

!ni* )an$ m#la%isi 'a$ian alam s#l!r!h sis(#m sir*!lasi %#r#aran arah

Rua$%.Rua$% Ja$tu$%

B#r'i-ara m#n$#nai ana(omi &an(!n$ ma*a or$an &an(!n$ (#riri a(as r!an$"

)ai(! 6 r!an$ )an$ '#rinin$ (i%is is#'!( #n$an a(ri!m s#ram'i5" an 6 r!an$

)an$ '#rinin$ (#'al )an$ is#'!( #n$an @#n(ri*#l 'ili*5.

A(ri!m an @#n(ri*#l &an(!n$ ini masin$+masin$ a*an i%isah*an ol#h s#'!ah

*a(!%" s#an$*an sisi *anan an *iri &an(!n$ a*an i%isah*an ol#h s#'!ah s#*a(

)an$ inama*an #n$an s#%(!m.

S#%(!m a(a! s#*a( ini aalah s!a(! %ar(isi o(o( *on(in!# )an$ m#n-#$ah

%#r-am%!ran arah ari *#!a sisi &an(!n$.

P#misahan ini san$a( %#n(in$ *ar#na s#%ar!h &an(!n$ *anan m#n#rima an &!$a

m#mom%a arah )an$ m#n$an!n$ o*si$#n r#nah s#an$*an sisi &an(!n$

s#'#lah *iri aalah '#r4!n$si !n(!* m#mom%a arah )an$ m#n$an!n$ o*si$#n

(in$$i.

an(!n$ (#riri ari '#'#ra%a r!an$ &an(!n$ )ai(! a(ri!m an @#n(ri*#l )an$

masin$+masin$ ari r!an$ &an(!n$ (#rs#'!( i'a$i m#n&ai !a )ai(! a(ri!m *anan

*iri" s#r(a @#n(ri*#l *iri an *anan.

Atr-u'

B#ri*!( 4!n$si ari masin$+masin$ a(ri!m &an(!n$ (#rs#'!( )ai(! :

8. Atrium kanan '#r4!n$si s#'a$ai %#nam%!n$an r#s#r@oir5 arah )an$

r#nah o*si$#n ari s#l!r!h (!'!h. Darah (#rs#'!( m#n$alir m#lal!i @#na

*a@a s!%#rior" @#na *a@a in4#rior" s#r(a sin!s *oronari!s )an$ '#rasal ari

9



&an(!n$ s#niri. K#m!ian arah i%om%a*an *# @#n(ri*#l *anan an

s#lan&!(n)a *# %ar!. A(ri!m *anan m#n#rima arah #+o*si$#n ari (!'!h

m#lal!i @#na *a@a s!%#rior *#%ala an (!'!h 'a$ian a(as5 an in4#rior

@#na *a@a *a*i an aa l#'ih r#nah5. Sim%!l sinoa(rial m#n$irim*an

im%!ls )an$ m#n)#'a'*an &arin$an o(o( &an(!n$ ari a(ri!m '#r*on(ra*si#n$an -ara )an$ (#r*oorinasi s#%#r(i $#lom'an$. Ka(!% (ri*!s%i )an$

m#misah*an a(ri!m *anan ari @#n(ri*#l *anan" a*an (#r'!*a !n(!*

m#m'iar*an arah #+o*si$#n i*!m%!l*an i a(ri!m *anan m#n$alir *#

@#n(ri*#l *anan

6. Atrium kiri m#n#rima arah )an$ *a)a o*si$#n ari *#!a %ar! m#lal!i

'!ah @#na %!lmonalis. K#m!ian arah m#n$alir *# @#n(ri*#l *iri an

s#lan&!(n)a *# s#l!r!h (!'!h m#lal!i aor(a. A(ri!m *iri m#n#rima arah

'#ro*si$#n ari %ar!+%ar! m#lal!i @#na %ar!+%ar!. S#'a$ai *on(ra*si

i%i-! ol#h no# sinoa(rial *#ma&!an m#lal!i a(ri!m" arah m#l#,a(i *a(!%

mi(ral *# @#n(ri*#l *iri

V"$tr-k"#

B#ri*!( aalah 4!n$si @#n(ri*#l )ai(! :

8. Ventrikel kanan m#n#rima arah ari a(ri!m *anan an i%om%a*an *#

%ar!+%ar! m#lal!i ar(#ri %!lmonalis. #n(ri*#l *anan m#n#rima arah #+

o*si$#n s#'a$ai *on(ra* a(ri!m *anan. Ka(!% %ar! m#n!&! *# ar(#ri %ar!

(#r(!(!%" m#m!n$*in*an !n(!* m#n$isi @#n(ri*#l #n$an arah. S#(#lah

@#n(ri*#l %#n!h" m#r#*a *on(ra*. S#'a$ai *on(ra* @#n(ri*#l *anan"

m#n!(!% *a(!% (ri*!s%i an *a(!% %ar! (#r'!*a. P#n!(!%an *a(!%

(ri*!s%i m#n-#$ah arah ari !*!n$an *# a(ri!m *anan an %#m'!*aan

*a(!% %ar! m#m!n$*in*an arah m#n$alir *# ar(#ri %!lmonalis m#n!&! %ar!+%ar!.

6. Ventrikel kiri m#n#rima arah ari a(ri!m *iri an i%om%a*an *# s#l!r!h

(!'!h m#lal!i aor(a. #n(ri*#l *iri m#n#rima arah )an$ m#n$an!n$

o*si$#n s#'a$ai *on(ra* a(ri!m *iri. Darah m#l#,a(i *a(!% mi(ral *#

@#n(ri*#l *iri. Ka(!% aor(a m#n!&! aor(a (#r(!(!%" m#m!n$*in*an !n(!*

m#n$isi @#n(ri*#l #n$an arah. S#(#lah @#n(ri*#l %#n!h" an '#r*on(ra*si.

S#'a$ai *on(ra* @#n(ri*#l *iri" m#n!(!% *a(!% mi(ral an *a(!% aor(a

(#r'!*a. P#n!(!%an *a(!% mi(ral m#n-#$ah arah ari !*!n$an *# a(ri!m

*iri an %#m'!*aan *a(!% aor(a m#m!n$*in*an arah m#n$alir *# aor(a

an m#n$alir *# s#l!r!h (!'!h.

S-k#us Ja$tu$% Da$ S-st"' P"r"/ara$ Dara Ja$tu$%

Si*l!s &an(!n$ (#rmas!* alam 'a$ian ari 4isiolo$i &an(!n$ i(! s#niri. an(!n$

*#(i*a '#*#r&a s#-ara '#rs#lan$+s#lin$ '#r*on(ra*si !n(!* m#n$oson$*an isi

&an(!n$ an &!$a '#r#la*sasi alam ran$*a m#n$isi arah *#m'ali. S

i*l!s &an(!n$ (#riri a(as periode sistol *on(ra*si an %#n$oson$an isi5 an &!$a

periode diastol r#la*sasi an %#n$isian &an(!n$5.

A(ri!m an @#n(ri*#l m#n$alami si*l!s sis(ol an ias(ol (#r%isah. Kon(ra*si

10



(#r&ai a*i'a( %#n)#'aran #*si(asi m#*anism# lis(ri* &an(!n$5 *# s#l!r!h &an(!n$.

S#an$*an r#la*sasi (im'!l s#(#lah r#%olarisasi a(a! (aha%an r#la*sasi ari o(o(

&an(!n$.

P"r"/ara$ Dara Ja$tu$%

P#r#aran &an(!n$ i(! (#riri ari %#r#aran arah '#sar an &!$a %#r#aran arah

*#-il. Darah )an$ *#m'ali ari sir*!lasi sis(#mi* ari s#l!r!h (!'!h5 mas!* *#

a(ri!m *anan m#lal!i @#na '#sar )an$ i*#nal s#'a$ai @#na *a@a.

Darah )an$ mas!* *# a(ri!m *anan '#rasal ari &arin$an (!'!h" (#lah iam'il O6+

n)a an i(am'ahi #n$an >O6.

Darah )an$ mis*in a*an o*si$#n (#rs#'!( m#n$alir ari a(ri!m *anan m#lal!i

*a(!% *# @#n(ri*#l *anan" )an$ m#mom%an)a *#l!ar m#lal!i ar(#ri %!lmonalis *#

%ar!. D#n$an #mi*ian" sisi *anan &an(!n$ m#mom%a arah )an$ mis*in o*si$#n

*# sir*!lasi %ar!.

Di alam %ar!" arah a*an *#hilan$an >O6+n)a an m#n)#ra% O6 s#$ar s#'#l!m

i*#m'ali*an *# a(ri!m *iri m#lal!i @#na %!lmonalis.

Darah *a)a o*si$#n )an$ *#m'ali *# a(ri!m *iri ini *#m!ian m#n$alir *# alam

@#n(ri*#l *iri" 'ili* %om%a )an$ m#mom%a a(a! m#noron$ arah *# s#m!s sis(im

(!'!h *#-!ali %ar!.

ai" sisi *iri &an(!n$ m#mom%a arah )an$ *a)a a*an O6 *# alam sir*!lasi

11



sis(#mi*. Ar(#ri '#sar )an$ m#m'a,a arah m#n&a!hi @#n(ri*#l *iri aalah aor(a.

Aor(a '#r-a'an$ m#n&ai ar(#ri '#sar an m#narahi '#r'a$ai &arin$an (!'!h.

Katup.Katup Ja$tu$%.

Ka(!' &an(!n$ ini (#riri ari )ai(! :

Katup Trikuspidalis

Ka(!% (ri*!s%ialis '#raa ian(ara a(ri!m *anan an @#n(ri*#l *anan. Bila *a(!%

ini (#r'!*a" ma*a arah a*an m#n$alir ari a(ri!m *anan m#n!&! @#n(ri*#l *anan.

Ka(!% (ri*!s%i '#r4!n$si m#n-#$ah *#m'alin)a aliran arah m#n!&! a(ri!m

*anan #n$an -ara m#n!(!% %aa saa( *on(ra*si @#n(ri*#l. S#s!ai #n$an

naman)a" *a(!% (ri*!s%i (#riri ari a!n *a(!%.

Katup Pulmonal

S#(#lah *a(!% (ri*!s%i (#r(!(!%" arah a*an m#n$alir ari alam @#n(ri*#l *anan

m#lal!i (r!n*!s %!lmonalis. Tr!n*!s %!lmonalis '#r-a'an$ m#n&ai ar(#ri

%!lmonalis *anan an *iri )an$ a*an '#rh!'!n$an #n$an &arin$an %ar! *anan

an *iri. Paa %an$*al (r!n*!s %!lmonalis (#ra%a( *a(!% %!lmonalis )an$ (#riri

ari a!n *a(!% )an$ (#r'!*a 'ila @#n(ri*#l *anan '#r*on(ra*si an m#n!(!% 'ila

@#n(ri*#l *anan r#la*sasi" s#hin$$a m#m!n$*in*an arah m#n$alir ari @#n(ri*#l

*anan m#n!&! ar(#ri %!lmonalis.

Katup Bikuspid (Bikuspidalis).

Ka(!% 'i*!s%i a(a! katup '-tra# m#n$a(!r aliran arah ari a(ri!m *iri m#n!&!

@#n(ri*#l *iri. S#%#r(i *a(!% (ri*!s%i" *a(!% 'i*!s%i m#n!(!% %aa saa( *on(ra*si

@#n(ri*#l. Ka(!% 'i*!s%i (#riri ari !a a!n *a(!%.

Katup Aorta. Ka(!% aor(a (#riri ari a!n *a(!% )an$ (#ra%a( %aa %an$*al

aor(a. Ka(!% ini a*an m#m'!*a %aa saa( @#n(ri*#l *iri '#r*on(ra*si s#hin$$a

arah a*an m#n$alir *#s#l!r!h (!'!h. S#'ali*n)a *a(!% a*an m#n!(!% %aa saa(@#n(ri*#l *iri r#la*sasi" s#hin$$a m#n-#$ah arah mas!* *#m'ali *#alam

@#n(ri*#l *iri.

Dan m#n$#nai f-s-,#,%- *a$tu$% i(! (#riri ari :

8. Sis(#m %#n$a(!ran &an(!n$.

6. Sistem kelistrikan jantung .

. Si*l!s &an(!n$.

. Bunyi jantung .

=. Cura jantung .

12



F-s-,#,%-

Ana(omis Jisiolo$is O(o( an(!n$

Ti%# o(o( &an(!n$ !(ama: o(o( a(ri!m" o(o( @#n(ri*#l" an s#ra'!( o(o( #*si(a(ori*

an *on!*si *h!s!s. O(o( &an(!n$ s#%#r(i o(o( l!ri* an &!$a s!a(! sinsi(i!m*ar#na (#ra%a( is*!s in(#r*ala(!s" m#r!%a*an s!a(! m#m'ran s#l )an$

m#misah*an masin$+masin$ s#l o(o( &an(!n$ '#r!%a a#rah $#la% )an$ m#n)ilan$

s#ra'!( o(o( &an(!n$.

Paa s#(ia% is*!s in(#r*ala(!s m#m'ran s#ln)a salin$ '#r$a'!n$ sa(! sama lain

m#m'#n(!* 2(a!( '#rh!'!n$an3 $a% &!n-(ions5 )an$ %#rm#a'l#" )an$

m#m!n$*in*an i4!si ion+ion )an$ ham%ir s#%#n!hn)a '#'as '#r$#ra* alam

-airan in(ras#l s#%an&an$ s!m'! lon$i(!inal s#ra'!( o(o( &an(!n$ s#hin$$a

%o(#nsial a*si a%a( '#r&alan ari s#l *# s#l" m#l#,a(i is*!s in(#r*ala(!s.

an(!n$ (#riri a(as !a sinsi(i!m sinsi(i!m a(ri!m an sinsi(!m @#n(ri*#l. A(ri!man @#n(ri*#l i%isah*an ol#h &arin$an 4i'rosa )an$ m#n$#lilin$i %#m'!*aan

*a(!% a(rio@#n(ri*!l#r A+5.

Po(#nsial a*si ihan(ar*an m#lal!i &arin$an 4i'rosa l#,a( sis(#m han(aran *h!s!s

)an$ is#'!( '#r*as A+. P#m'a$ian o(o( &an(!n$ m#n&ai !a sinsi(i!m

4!n$sional a*an m#n)#'a'*an a(ri!m '#r*on(ra*si s#saa( s#'#l!m *on(ra*si

@#n(ri*#l" )an$ %#n(in$ 'a$i #4#*(i@i(as %om%a &an(!n$. G!)(on" 6<<;5

Po(#nsial A*si %aa O(o( an(!n$

Po(#nsial a*si )an$ '#rlan$s!n$ l#'ih lama i(im'!l*an ol#h %#m'!*aan !a

*anal" *anal -#%a( na(ri!m an *anal *alsi!m+na(ri!m *anal lam'a( *alsi!m5.

K#(i*a *anal lam'a( *alsi!m (#r'!*a" s#'a$ian '#sar ion *alsi!m an ion na(ri!m

m#n$alir an mas!* *# s#ra'!( o(o( &an(!n$" s#hin$$a (#r&ai #%olarisasi" l#'ih

lan&!(" ion *alsi!m )an$ '#rasal ari r#(i*!l!m sar*o%lasmi* in(ras#l )an$ mas!*

s#lama 4as# %#na(aran m#m'an$*i(*an %ros#s *on(ra*si o(o(.

S#$#ra s#s!ah %o(#nsial a*si (im'!l" %#rm#a'ili(as m#m'ran o(o( &an(!n$

(#rhaa% ion *ali!m m#n!r!n" s#hin$$a m#n!r!n*an %#n$#l!aran ion *ali!m

s#lama (#r&ain)a %#na(aran %o(#nsial a*si.

Bila *anal lam'a( *alsi!m+na(ri!m (#r(!(!%" %#rm#a'ili(as m#m'ran !n(!* *ali!m

a*an m#nin$*a( an (#r&ai %#n$#l!aran ari s#ra'!( s#hin$$a (#r&ailah is(iraha(

r#%olarisasi5. G!)(on" 6<<;5

13



&!& D"f-$-s- Kar/-,'-,pat-

K#lainan 4!n$si o(o( &an(!n$ #n$an %#n)#'a' )an$ (ia* i*#(ah!i

an '!*an ia*i'a(*an ol#h %#n)a*i( ar(#ri *oron#r" *#lainan &an(!n$ 'a,aan-on$#ni(al5" hi%#r(#nsi a(a! %#n)a*i( *a(!%. Kariomio%a(i )an$ s#-ara

har4iah '#rar(i %#n)a*i( mio*ari!m" a(a! o(o( &an(!n$" i(anai #n$an

hilan$n)a *#mam%!an &an(!n$ !n(!* m#mom%a arah an '#r#n)!( s#-ara

normal. Konisi s#ma-am ini -#n#r!n$ m!lai #n$an $#&ala rin$an"

s#lan&!(n)a m#m'!r!* #n$an -#%a(. Paa *#aaan ini (#r&ai *#r!sa*an a(a!

$an$$!an mio*ari!m" s#hin$$a &an(!n$ (ia* mam%! '#r*on(ra*si s#-ara

normal. S#'a$ai *om%#nsasi" o(o( &an(!n$ m#n#'al a(a! hi%#r(ro4i an ron$$a

&an(!n$ m#m'#sar. B#rsama #n$an %ros#s %#m'#saran ini" &arin$an i*a(

'#r%roli4#rasi an m#n$in4il(rasi o(o( &an(!n$. Miosi( &an(!n$ *ariomiosi(5

m#n$alami *#r!sa*an an *#ma(ian" a*i'a(n)a a%a( (#r&ai $a$al &an(!n$"

ari(mia an *#ma(ian m#naa*. Ol#h *ar#na i(! *ariomio%a(i ian$$a%

s#'a$ai %#n)#'a' !(ama mor'ii(as an mor(ili(as *ario@as*!lar.

K#'an)a*an *ariomio%a(i (#r&ai s#'a$ai a*i'a( *om%li*asi

%#n)a*i( ar(#ri *oron#r )an$ m#n)#'a'*an (#rs!m'a(n)a aliran arah *# o(o(

&an(!n$. K#lainan ini m#n$#nai 8 ari 8<< oran$ %asi#n" 'iasan)a la*i+la*i i

a(as !m!r 9= (h. Paa %asi#n )an$ l#'ih (!a 'iasan)a l#'ih 'an)a* (#r&ai

%aa %#r#m%!an. S#m#n(ara i(!" *ariomio%a(i '!*an s#'a$ai a*i'a( %#n)a*i(

ar(#ri *oron#r -!*!% &aran$ an (o(al i#ri(a ol#h =<.<<< %asi#n i USA.

T#(a%i *#lainan ini s#rin$ i&!m%ai %aa oran$ m!a an m#r!%a*an alasan

!(ama !n(!* (rans%lan(asi &an(!n$. K#'an)a*an *#lainan ini is#'a'*an

4a*(or $#n#(is an -#n#r!n$ i&!m%ai alam *#l!ar$a.

Ma0a'.'a0a' Kar/-,'-,pat-

P#m'a$ian *ariomio%a(i '#rma-am+ma-am" '#rasar*an %aa

#(iolo$i" %a(olo$i" $#n#(i*a" *lini*" 'io*imia" 4!n$si h#moinami* an

s#'a$ain)a" (#(a%i (ia* aa sa(! %!n )an$ m#m!as*an *ar#na 'an)a*

(!m%an$ (inih. P#m'a$ian *ario+mio%a(i )an$ 'an)a* ian!( saa( ini aalah

m#n!r!( Goo,in )an$ '#rasar*an *#lainan s(r!*(!r an 4!n$si

14



%a(o4isiolo$i5" i5 h)%#r(ro%hi- -ariom)o%a(h) H>M5" ii5 ila(#

-ariom)o%a(h) D>M5" iii5 r#s(ri-(i@# -ariom)o%a(h).

15



(a'#l 8. %#r'anin$an *ariomio%a(i

H-p"rtr,p- R"str-kt-f D-#atas-

E&#-(ion Jra-(ion

normal ==59< 6==< <

L#4( #n(ri-!lar

Dias(oli-

Dim#nsion

normal ==mm5

S#rin$*ali

m#n!r!n9< mm 9< mm

L#4( #n(ri-!lar/all Thi-*n#ss

M#nin$*a(s#-ara n)a(a

Normal a(a! m#nin$*a( M#n!r!n

A(rial Si1# m#nin$*a( M#nin$*a(" a%a( masi4 M#nin$*a(

al@!lar

R#$!r$i(a(ion

R#$!r$i(asi

mi(ral

R#$!r$i(asi mi(ral an

(ri*!s%i

Paa #*om%#nsasi

mi(ral r#$!r$i(asi"

(aha% lan&!( (#r&ai

r#$!r$i(asi (ri*!s%i

>ommon Jirs(

S)m%(oms

EQ#r(ional

in(ol#ran-#

ma) ha@# -h#s(

%ain

EQ#r(ional in(ol#ran-#EQ#r(ional

in(ol#ran-#

>on$#s(i@#

S)m%(oms

D)s%n#a saa(

a*(i4i(as 4isi*

G#&ala *on$#s(i *anan

s#rin$*ali m#l#'ihi *iri

Kon$#s(i *iri

s#'#l!m *anan"

*#-!ali %aa !sia

m!a l#'ih s#rin$

*on$#s(i *anan

Ris* 4or

Arrh)(hmia

Ta*iari(mia

@#n(ri*#l an

a(rial 4i'rilasi

Ari(mia @#n(ri*#l san$a(

&aran$ *#-!ali

sar*oiosis" 'lo*

*on!*si %aa

sar*oiosis an

amiloiosis" a(ri!m

4i'rilasi

Ta*iari(mia

@#n(ri*#l" 'lo*

*on!*si %aa

%#n)a*i( -ha$as"

$ian( -#ll

m)o-ari(is" an

4amilial" a(ri!m

16



H-p"rtr,p- R"str-kt-f D-#atas-

4i'rilasi

1 G#&ala *on$#s(i %!lmon#r *iri : )s%n#a saa( a*(i4i(as 4isi*" or(ho%n#a" %aroQ)smal no-(!rnal

)s%n#a. G#&ala *on$#s(i @#na sis(#mi* *anan : is(#nsi a'om#n an h#%ar" ##ma %#ri4#r.

So!r-# : J#rri JJ. 6<<7. Pra-(i-al G!i# (o (h# >ar# o4 (h# M#i-al Pa(i#n( 7(h #. Mos')" An

Im%rin( o4 Els#@i#r. Phila#l%hia.

Kar/-,'-,pat- H-p"rtr,p-

Kariomio%a(i hi%#r(ro%i KH5 i*#nal &!$a s#'a$ai idiopati!

ypertropi! su"aorti! stenosis a(a! asymmetri! septal ypertropy

i#4inisi*an s#'a$ai hi%#r(ro%i ari mio*ari!m an %#ni%isan s#%(!m

in(#r@#n(ri*!lar i'anin$*an #n$an inin$ '#'as ari @#n(ri*#l *iri

asim#(ris s#%(al hi%#r(ro%i5 #n$an !*!ran r!an$an @#n(ri*#l *iri )an$

normal a(a! s#i*i( m#n$#-il (an%a aan)a hi%#r(#nsi ma!%!n s(#nosis

aor(a.

Kariomio%a(i hi%#r(ro4i* m#mili*i l#'ih ari 7= nama lain s#%#r(i

T#ar#s is#as#" Bro-*s is#as#" as)mm#(ri-al h)%#r(ro%hi-

-ariom)o%a(h)" h)%#r(ro%hi- o's(r!-(i@# -ario+mio%a(h)" iio%a(hi-

h)%#r(ro%hi- -ariom)o%a(h)" iio%a(hi- h)%#r(ro%hi- s!'aor(i- s(#nosis"

4amilial m)o-arial is#as#" nam!n #mi*ian )an$ i%a*ai /HO aalah

ypertropi! !ardiomyopaty.

Kariomio%a(i hi%#r(ro4i* ia%a(*an i s#l!r!h !nia" *#&aian

*!ran$ l#'ih sama an(ara %ria an ,ani(a" (#(a%i '#r'#a %aa #(nis a(a!

ras (#r(#n(! 'an)a* %aa oran$ #%an$5" %alin$ 'an)a* %aa oran$ m!a

!sia 6<+< (ah!n" nam!n '#r@ariasi ari 9 '!lan sam%ai l#'ih 9< (ah!n.

Paa %o%!lasi !m!m i%#r*ira*an %r#@al#nsin)a 8 : =<<. T#ra%a( !a

4i(!r !(ama ari KH )ai(! 85 hi%#r(ro%i @#n(ri*#l *iri )an$ asim#(ris"

s#rin$*ali (#ra%a( %aa s#%(!m in(#r@#n(ri*!lar" 65 (#*anan aliran

@#n(ri*#l *iri )an$ inamis" )an$ '#rh!'!n$an #n$an m#n)#m%i(n)a

ar#a s!'aor(a s#'a$ai *ons#*!#nsi ari misis(oli* a%%osi(ion ari *a(!%

mi(ral an(#rior m#la,an s#%(!m )an$ hi%#r(ro%i. >on(ohn)a systoli!

anterior motion SAM5 ari *a(!% mi(ral. Pa(o4isiolo$is a'normali(asn)a

17



(ia* %aa sis(oli* nam!n %aa 4!n$si ias(oli*" #n$an *ara*(#ris(i*

m#nin$*a(n)a *#*a*!an %aa o(o( &an(!n$ )an$ m#n$alami hi%#r(ro%i.

Hal ini m#n$a*i'a(*an m#nin$*a(n)a (#*anan %#n$isian ias(oli*. Pola

hi%#r(ro%i ari KH '#r'#a #n$an )an$ (#rliha( %aa hi%#r(ro%i s#*!n#r

misaln)a hi%#r(#nsi5. K#'an)a*an %asi#n m#m%!n)ai @ariasi %aa

*#(#'alan s#%(!m @#n(ri*#l )an$ (ia* %ro%orsional *#(i*a i'anin$*an

#n$an inin$ )an$ '#'as. Pasi#n lainn)a m!n$*in m#m%#rliha(*an

is%ro%orsi ari a%#Q a(a! inin$ '#'as @#n(ri*#l *iri" an han)a 8<

%asi#n )an$ m#mili*i *#(#rli'a(an *ons#n(ris ari @#n(ri*#l. Paa

'#'#ra%a ana*" *om%r#si sis(oli* s#$m#n in(ramio*arial ari ar(#ri

*oron#r a%a( m#n$a*i'a(*an is*#mia an *#ma(ian.

Kar/-,'-,pat- R"str-kt-f

Kara*(#ris(i* !(ama ari *ariomio%a(i r#s(ri*(i4 KR5 aalah

4!n$si )an$ a'normal ari ias(oli*" )an$ is#'a'*an *#*a*!an inin$

@#n(ri*#l an ham'a(an %#n$isian @#n(ri*#l s#hin$$a m#n!r!nn)a

@ol!m# ias(oli*" nam!n *#(#'alan mio*ari!m @#n(ri*#l *iri normal

an 4!n$si ias(oli* &!$a normal" 'iasan)a s#*!n#r i*ar#na*an

in4ilrasi ari mio*ari!m.

Kar/-,'-,pat- D-#atas-

Kariomio%a(i ila(asi KD5 m#m%!n)ai *ara*(#ris(i* %#nin$*a(an

@ol!m# sis(oli* an ias(oli* @#n(ri*#l *iri )an$ i(anai #n$an

(#rila(asin)a *#!a @#n(ri*#l (#r!(ama @#n(ri*#l )an$ *iri" &aran$ )an$

*anan" )an$ '#ra*i'a( m#n!r!nn)a *on(ra*(ili(as mio*ari!m s#hin$$a

m#n!r!n*an -!rah &an(!n$.

18



&!) Et-,#,%-


P#n)#'a' KH (ia* i*#(ah!i" i!$a is#'a'*an ol#h *#lainan

4a*(or $#n#(i*" 4amilial" ran$san$an *a(#*olamin" *#lainan %#m'!l!h arah

*oron#r *#-il" *#lainan )an$ m#n)#'a'*an is*#mi mio*ar" *#lainan

*on!*si a(rio@#n(ri*!l#r an *#lainan *ola$#n. Kariomio%a(i hi%#r(ro%i

m#m%!n)ai !a '#n(!* '#rasar*an ons#( an %#r(im'an$an $#n#(i*"

)ai(!:

8. B#n(!* 4amilial" 'iasan)a i ia$nosa %aa %asi#n )an$ '#r!sia

m!a an $#n+n)a (#r%#(a*an %aa *romosom 8. s#'!ah *onisi

a!(osomal ominan )an$ is#'a'*an m!(asi salah sa(! ari 8< $#n

)an$ m#mili*i #n-oin$ %ro(#in ari sar*om#r &an(!n$.

6. B#n(!* s%orai*" 'iasan)a m!n-!l %aa %asi#n )an$ '#r!sia

#,asa.


E(iolo$i ari KR (#r'a$i m#n&ai 6 *#lom%o*" %#r(ama

)ai(! iio%a(i*" *#'an)a*an %asi#n )an$ i*lasi4i*asi*an m#n&ai

KR m#m%!n)ai m!(asi %aa $#n !n(!* (ro%onin I" an KR

'iasan)a salin$ (!m%an$ (inih #n$an KH %aa *as!s 4amilial.

B#n(!* )an$ *#!a )ai(! s#*!n#r *ar#na %#n)a*i( %#n)a*i(

s#%#r(i:

8. In4il(ra(i4 an s(ora$# isor#rs

a. Am)loiosis" m#r!%a*an %#n)a*i( sis(#mi* (#rs#rin$ )an$

m#n)#'a'*an KR.

'. Gl)-o$#n s(ora$# is#as#

-. Sar-oiosis

. H#mo-hroma(osis

6. S-l#ro#rma

. Raia(ion

. Eno-arial 4i'ro#las(osis

19



=. Enom)o-arial 4i'rosis

9. ToQi- #44#-(s o4 an(hra-)-lin#

7. >ar-inoi h#ar( is#as#" m#(as(a(i- -an-#rs

;. Dia'#(i- -ariom)o%a(h)

?. Eosino%hili- -ariom)o%a(h) L44l#r0s #no-ari(is5


8. Iio%a(i*" m#r!%a*an (i%# )an$ %alin$ s#rin$" %aa %#m#ri*saan

s#-ara his(olo$i m#m%#rliha(*an hi%#r(ro%i miosi( an 4i'rosis

in(#rs(i(ial.

6. Jamilial

a. H#r#o4amilial n#!rom!s-!lar is#as#

'. Ventri!ular dysplasia m#r!%a*an '#n(!* KD )an$ !ni* #n$an

*ara*(#ris(i* %#n$$an(ian %ro$r#si4 ari inin$ @#n(ri*#l *anan

#n$an &arin$an ai%osa. S#rin$ ih!'!n$*an #n$an ari(mia

@#n(ri*#l" (#(a%i %#r&alanan *linisn)a '#r@ariasi.

. To*si*

a. Al-oholism 8= sam%ai < *as!s i N#$ara 'ara(5

'.>o'al(" l#a" %hos%hor!s" -ar'on monoQi#" m#r-!r)"

oQor!'i-in" a!nor!'i-in" m#r-!r)" an(imon)" $ol"

-hromi!m.

-. >o-ain#" h#roin" or$ani- sol@#n(s 2$l!# sni44#r0s h#ar(35

. An(ir#(ro@iral a$#n(s 1io@!in#" ianosin#" 1al-i(a'in#5

#. Ph#no(hia1in#s

. M#(a'oli* a. >olla$#n @as-!lar is#as# SLE" rh#!ma(oi ar(hri(is"

%ol)ar(#ri(is5" #rma(om)osi(is

'. P#ri%ar(!m (rim#s(#r *#(i$a ari *#hamilan a(a! 9 '!lan

%os(%ar(!m5

-. N!(risi '#ri+'#ri" #4isi#nsi s#l#ni!m" #4isi#nsi *arni(in"

#4isi#nsi (iamin5

20



. A-rom#$al)" os(#o$#n#sis im%#r4#-(a" m)Q##ma"

(h)ro(oQi-osis" ia'#(#s" H)%o-al-#mia

#. H#ma(olo$i #.$." si-*l# -#ll an#mia" h#mo-hroma(osis5

4. P#n)a*i( $in&al (aha% a*hir %aa h#moial)sis

$. Am)loi

h. H#a( s(ro*#

=. In4#*si!s

a. Pos(m)o-ari(is

'. @ir!s h!man imm!no#4i-i#n-) @ir!s" -oQsa-*i#@ir!s B5"

ri-*#((sial" m)-o'a-(#rial" (oQo%lasmosis" (ri-hinosis" >ha$as0

is#as#" 'a-(#rial.

9. Konisi sis(#mi* s#%#r(i is*#mia mio*ari!m" hi%#r(#nsi an

*#lainan *a(!% &an(!n$.

7. Irraiasi

;. Prolon$# (a-h)-aria

?. Ta*o(s!'o -ariom)o%a(h) s#*!n#r *ar#na s(r#ss '#ra( a(a! la(ihan

4isi* )an$ '#rl#'ihan5.

&!+ K#as-f-kas-

Bila *ariomio%a(i i *lasi4i*asi*an '#rasar*an #(iolo$i ma*a i*#nal

'#n(!* asar )ai(! :

8. Ti%# %rim#r" a%a'ila (#ra%a( %#n)a*i( %aa &an(!n$ #n$an %#n)#'a' )an

$ (ia* i*#(ah!i. T#rmas!* ialamn)a is(ilah iio%a(i* *ariomio%a(i" 4a

milial *ariomio%a(i an 4i'rosis #nomio*ari!m.

6. Ti%# s#*!n#r" a%a'ila i(#m!*an %#n)a*i( mio*ari!m #n$an %#n)#'a'

)an$ a%a(i*#(ah!i" (#rmas!* 'ila '#rh!'!n$an #n$an %#n)a*i( )an$

m#n$ai(*an s)s(#mor$an lain. S#an$*an 'ila *lasi4i*asi '#rasar*an

*linis an %a(o4isiolo$i" ma*a*ariomio%a(i i'a$i m#n&ai ila(asi"

r#s(i*(i4 an hi%#r(ro4i*.

21



&!2 Pat,f-s-,#,%-

Kariomio%a(i Dila(asi m#n$a*i'a(*an is4!n$si %aa @#n(ri*#l *iri an *anan

s#hin$$a *#*!a(an *on(ra*si &an(!n$ m#n!r!n )an$ a*an is#r(ai %#n!r!nan*aria* o!(!(. P#n!r!nan *aria* a!(%!( a%a( '#ra*i'a( %aa '#'#ra%a hal

)ai(! :

8. P#n!r!nan >O a*an m#nin$*a(*an %r#loa s#hin$$a *on$#s(i4 %ar!

&!$a m#nin$*a( )an$ m#n)#'a'*an arah r#si! i @#n(ri*#l *anan

'#rl#'ihan. Kar#na arah r#si! i arah '#rl#'ihan ma*a (#*anan i

@#n(ri*#l *anan &!$a m#nin$*a( s#hin$$a aliran arah i a(ri!m *anan

(#r$an$$!" aliran 'ali* @#na *a@a s#r(a @#na h#%a(i*a m#n&ai

(#rham'a( )an$ '#r#4#* %aa %#nin$*a(an (#*anan %ar(ial an s(a(is

arah i @#na %or(al. S(asis arah )an$ '#raa i @#na %or(a lama

*#lamaan m#n)#'a'*an @#na i h#%ar s#ma*in m#m'#sar s#hin$$a

(#r&ailah h#%a(om#$ali. H#%a(om#$ali )an$ (#r&ai %aa *li#n #n$an

*ariomio%a(i ila(asi a*an m#n$*i'a(*an m#n!r!nn)a 4!n$si h#%ar

s#'a$ai %#m'#n(!* %ro(#in %lasma )an$ m#n$a(!r %#r%inahan

(#*anan osmo(i* *oloi ari -airan in(ras#l!l#r *# #*s(ras#l!l#r.

T#r$an$$!n)a %#r%inahan >IS *# >ES a*an m#n$a*i'a(*an

(#r&ain)a asi(#s.

6. P#n!r!nan >O a*an ii*!(i %#n!r!nan s!%lai arah an O*si$#n *#

(!'!h s#hin$$a s!%lai an *#'!(han arah s#ra o*si$#n )an$

i%#rl!*an (!'!h m#n&ai (ia* s#ima'n$ an %#r4!si &arin$an m#n&ai

(#r$an$$! )an$ '#ram%a* %aa *#l#mahan an *#l#lahan %aa *li#n.

K#l#mahan an *#l#lahan )an$ ialami *li#n m#n)#'a'*an in(ol#ransi

a*(i@i(as s#hin$$a *li#n immo'ilisasi. Immo'ilisasi )an (#rlal! lama

a*an m#n$a*i'a(*a %#n#*anan )an$ m#n#(a% a%a a#rah )an$

"m#non&ol s#hin$$a sir*!lasi &arin$an %aa ar#a (#rs#'!( a*an

(#rham'a( an (#r&ai hi%o*sia &arin$an )an$ &i*a i'iar*an a*an

(#r&ai $an$$!an %aa in(#$ri(as *!li(.

. P#n!r!nan >O m#n$a*i'a(*an arah r#si! %aa @#n(ri*#l *iri

'#r(am'ah s#hin$$a (#*anan alam @#n(ri*#l *iri an a(ri!m *iri a*an

m#nin$*a(. P#nin$*a(an (#*anan @#n(ri*#l *anan an a(ri!m *iri a*an

m#n$ham'a( arah ari %ar!+%ari! s#hin$$a (#*anan *a%il#r %ar! a*an

22



m#nin$*a( m#l#'ihi (#*anan osmo(i* *oloi %aa &arin$an. Darah )an$

(#rhama'( a*an m#n&ai (rans!a( in(#r(isisal al@#olar )an$ a*an

'#ram%a* s#sa* %aa *li#n.

. Paa %#n!r!nan >O m#n$a*i'a(*an s!%lai arah *# $in&al m#n!r!n

s#hin$$a %#r4!si $in&al &!$a m#n!r!n )an$ a*an is#r(ai %#n!r!nan

4il(rasi $lom#l!r!s. Hal+hal (#rs#'!( m#n)#'a'*an @aso*on(ri*asi

%#m'!l!h arah $in&al s#hin$$a alos(#ron m#nin$*a(. P#nin$*a(an

alos(#ron an r#(#nsi na(ri!m a*an m#n)#''a*an !#ma.

=. P#n!r!nan >O ii!*(i ol#h %#n!r!nan s!%lai arah *# o(a*. i*a s!%lai

arah *# o(a* m#n!r!n m#n)#'a'*an %#r4!si i o(a* a(a! s#r#'ral

(#r$an$$! )an$ a%a( '#ra*i'a( %aa %#r!'ahan s(a(!s m#n(al.

&!3 4O5

4O5 Kar/-,'-,pat-

23

Disfungsi

ototMK :

1.

genetis

2. Arteri

oroner

3. !nfesi "o#sa"ie

$irus %

4.

a&o'o&

5. ()at anti

aner

*o#oru)i"in

*an

*aunoru)i"in

Mutasi

+rotein

saro,er

yaitu

tro+onin-

*an ,yosin

/ rantai

)erat

asoan *ara' ti*a,e,a*ai e otot

jantung

era*angan

otot jantung

aut

,ioar*itis

,e,+eruat

)ere,)angnya

,ioar*itis

arena

turunnya

resistensi

in*i$i*u atau

,ungin

,enja*i

+re*is+osisi

*esiensi nutrisi

Merusa

,ioar*iu

, se"ara

autA&e&

ti*a

atif

M :

enurunan

+erfusi

jaringan

ar*io+u&,o

ner

Me,+er&e,

a' otot

jantung !na,asi

,ioar*iti

sKerusaan

+roteinsaro,er

otot jantung

i+osi

a

Kerusaan

jantung

ronis

i+ose,i

a ,ioar*

Disfungsi

otot

jantung

Kardiomio

pati



24

fusi

+&eura

angguan

es+ansi

+aru

MK :

angguan

+o&a na+as

Cardiac

Output

↓

Kegaga&an

$entrie&

iri

MK :

!nto&eransi

ati$itas

-era+i

AA

( :

Mua& -a'anan

$entrie& anan

i+er)i&iru)

in

-a'anan

$ena +orta

MK: risio

erusaan

integritas u&it

$o&u,e

atriu,

anan

angguan

A&iran *ara'

e 'e+ar

MK :Ke&e)i'an

$o&u,e

"airan↓ %i&iru)in

teronjugasi

*e,a

erifer

-a'anan

)a&i

$ena

Kegaga&an

$entrie& Kanan

'i+ertens

i

+u&,ona&

-eanan atriu,

iri

*e,a +aru

angguan *ifusi

(2 ;(

2

MK :

Kerusaan

ertuaran

as

Kar*io,io+ati

*i&atasi

Kar*io,io+ati

'i+ertro+i

Kar*io,io+ati

restritif

Di&atasi $entrie&

iri

< engisian

$entrie&

↓ =o&u,e

$entrie&

i+ertro $entrie&

teruta,a se+tu,

$entrie&

eningatan

$o&u,e $entrie&

iri > anan

Din*ing jantung

au *an ti*a

"uu+ &entur untu

terisi *ara'



&!6 Ma$-f"stas- K#-$-s


Mani4#s(asi ari KH san$a( '#r@ariasi" 'an)a* %asi#n asim%(oma(i*

a(a! sim%(oma(i* rin$an an %#r(ama *ali i#@al!asi *ar#na 'isin$ &an(!n$.

T#(a%i sa)an$n)a mani4#s(asi %#r(ama *ali ari %#n)a*i( a%a( '#r!%a

*#ma(ian m#naa*" s#rin$*ali m!n-!l %aa ana*+ana* an r#ma&a 8=+=

(ah!n )an$ asim%(oma(i*" %aa saa( is(iraha( a(a! m#la*!*an a*(i@i(as

rin$an" s#%#r(i$an)a s#lama a(a! s#s!ah a*(i@i(as '#ra(. Ja*(or risi*o

*#ma(ian m#naa* aalah !sia m!a" %#n#'alan inin$ @#n(ri*#l *iri

)an$ h#'a(" ri,a)a( *#l!ar$a %osi(i4 an (a*i*ari @#n(ri*#l non+s!s(ain#

%aa r#*aman EKG 6 &am. P#n)#'a' *#ma(ian m#naa* m#li%!(i

(a*iari(mi @#n(ri*#l" 'raiari(mi" (a*i*ari s!%ra@#n(ri*#l" is*#mi mio*ar"

%#nin$*a(an o's(r!*si &al!r *#l!ar @#n(ri*#l *iri m#naa*" is4!n$si

ias(oli*" hi%o(#nsi )an$ iin!*si ol#h la(ihan" a*(i@asi 'aror#4l#*s

@#n(ri*#l #n$an hi%o(#nsi.

Paa %asi#n )an$ m#mili*i $#&ala" *#l!han !(ama )an$ %alin$ s#rin$ )ai(!

rasa s#sa* na4as" i*ar#na*an m#nin$*a(n)a *#*a*!an ari inin$

@#n(ri*#l *iri" )an$ m#n$$an$$! %#n$isian @#n(ri*#l an m#n$a*i'a(*an

m#nin$*a(n)a (#*anan ias(oli* @#n(ri*#l *iri an a(ri!m *iri" $#&ala

lainn)a (#rmas!* n)#ri aa (ia* *has an$ina )an$ (#r&ai saa(

'#ris(iraha( an '#ra*hir '#'#ra%a &am (an%a *#nai*an #n1im &an(!n$"

%al%i(asi" *#l#lahan" $an$$!an *#saaran" %!sin$" %in$san a(a! ham%ir

%in$san.

G#&ala )an$ aa (ia* '#rh!'!n$an #n$an aan)a a(a! '#ra(n)a #ra&a(

o's(r!*si aliran *#l!ar @#n(ri*#l. K#'an)a*an %asi#n #n$an o's(r!*si

aliran *#l!ar @#n(ri*#l m#m%#rliha(*an !a a(a! (i$a im%!ls %r#-orial"

#n)!( ar(#ri *aro(is )an$ m#nin$*a( -#%a( *ar#na aan)a early systoli!

eje!tion arah ari @#n(ri*#l an s!ara &an(!n$ *##m%a(. P#m#ri*saan 4isi*

ia%a(*an im%!ls *aro(i 'is4#ri#ns %#nin$*a(an -#%a( ii*!(i ro%

misis(oli*5 s#-ara '#r$an(ian" ii*!(i ol#h $#lom'an$ l#'ih lam'a(.

an(!n$ s#i*i( m#m'#sar. Paa im%!ls a%i*al ia%a(*an systoli! trust

)an$ *#ras" an (#ra'a S sis(oli* a(rial )an$ *#rass)s(oli- (hrill5 %aa

25



< %asi#n. Bisa ia%a(*an h#%a(om#$ali )an$ *#'an)a*an %aa 'a)i

i'anin$*an ana* )an$ l#'ih '#sar. Tana !(ama ari KH o's(r!*(i4

aalah aan)a m!rm!r sis(oli*" )an$ '#rsi4a( *asar" '#r'#n(!*

in(an'#rlian" an 'iasan)a m!n-!l s#(#lah s!ara &an(!n$ %#r(ama" *ar#na

#&#*si a,al (ia* (#rhalan$i %aa a,al sis(ol.

M!rm!r (#r#n$ar %alin$ 'ai* %aa 'a(as s(#rnal *iri 'a,ah an &!$a %aa

a%#Q" imana s#rin$*ali '#r*!ali(as holosis(oli* an m#ni!%" hal ini

i*ar#na*an mi(ral r#$!r$i(asi )an$ 'iasan)a (#ra%a( %aa KH o's(r!*(i4.

Gam'ar 8. Kariomio%a(i hi%#r(ro%i*

Kar/-,'-,pat- R"str-kt-f G#&ala *linis ari *ariomio%a(i r#s(ri*(i4 sama #n$an $#&ala $#&ala )an$

aa %aa $a$al &an(!n$ *iri an *anan" )ai(!:

8. E#ma" asi(#s" h#%a(om#$ali" is(#nsi @#na l#h#r.

6. K#l#lahan an *#l#mahan i*ar#na*an m#n!r!nn)a -!rah &an(!n$.

. 'isa (#ra%a( K!ssma!l0s si$n.

. s#rin$ (#ra%a( m!rm!r r#$!r$i(asi.

=. im%!ls a%i*al )an$ *!a(.

9. s#rin$ (#r#n$ar s!ara &an(!n$ *#(i$a %aa a,al ias(oli*.


Pasi#n #n$an *ariomio%a(i ila(asi KD5 s#-ara !m!m m#m%!n)ai

$#&ala *linis )an$ (ia* &#las an (i'a+(i'a ia%a(i $#&ala $a$al &an(!n$

*on$#s(i4. m!la+m!la (#ra%a( 'a(!* *ar#na *on$#s(i %ar!" )s%n#a %aa

*#r&a rin$an" *#l#mahan an anor#*sia )an$ m#m'!r!* s#-ara '#r(aha%

alam hi(!n$an '!lan sam%ai (ah!n. Aa*alan)a ia%a(i ari(mia a(ri!m

26

http://usebrains.files.wordpress.com/2008/09/picture1.png



4i'rilasi an ari(mia @#n(ri*#l5 )an$ m#nah!l!i $a$al &an(!n$. Bila

*#aaan '#r(am'ah '#ra(" *!li( m#n&ai in$in an %!-a(" @ol!m# nai an

(#*anan nai '#r*!ran$" (a*i*aria" (#*anan @#na &!$!laris m#nin$*a("

h#%a(om#$ali an ##ma *a*i 'isa ia%a(i. Bisin$ %ansis(oli* 'isa

ia%a(i" *ar#na ins!4isi#nsi *a(!% (ri*!s%i an *a(!% mi(ral m#s*i%!n

san$a( &aran$. %aa lima%!l!h %#rs#n ana* a%a( i(#m!*an #mam alam

'!lan s#&a* (#ra%a( $#&ala $a$al &an(!n$" an 8<+6< m#mili*i $#&ala

n#!rolo$is *#&an$" *#(#rlam'a(an %#r(!m'!han5 an $as(roin#s(inal

m!n(ah" n)#ri %#r!(5. $#&ala a%a( i(#m!*an %aa lima%!l!h %#rs#n saa(

'a)i an 6= %aa masa *!ran$ ari 6 &am. B#'#ra%a %asi#n m#mili*i

@#n(ri*#l *iri )an$ (#rila(asi '#'#ra%a '!lan sam%ai (ah!n s#'#l!m

aan)a $#&ala. Aan)a an$ina %#-(oris san$a( &aran$ (#r&ai" &i*a aa ma*a

*#m!n$*inan '#rh!'!n$an %#n)a*i( &an(!n$ is*#mi*. Sin*o% *ar#na

ari(mia" #m'oli" an *#ma(ian m#naa* a%a( (#r&ai m#s*i%!n san$a(

&aran$.

&!7 P"'"r-ksaa$ D-a%$,st-k


El#*(ro*ario$ram s#rin$*ali m#n!n&!**an aan)a hi%#r(ro%i

@#n(ri*#l *iri #n$an a(a! (an%a #%r#si s#$m#n ST an in@#rsi $#lom'an$

T" $#lom'an$ V )an$ l#'ar an alam s#%#r(i (#rliha( %aa mio*ar in4ar*

)an$ lama. K#'an)a*an %asi#n m#m%#rliha(*an aan)a ari(mia" 'ai*

a(ri!m s!%ra@#n(ri*!l#r (a*i*aria a(a! a(rial 4i'rilasi5 ma!%!n @#n(ri*#l

@#n(ri*#l (a*i*ari5" s#lama am'!la(or) Hol(#r5 moni(orin$. Nam!n %aa

6= %#n#ri(a (an%a o's(r!*si aliran *#l!ar @#n(ri*#l *iri" $am'aran

#l#*(ro*ario$ra4i a%a( normal.

Gam'aran ro#n($#n (horaQ a%a( normal" m#s*i%!n m!n$*in

(#ra%a( %#nin$*a(an rin$an sam%ai s#an$ ari 'a)an$an &an(!n$"

!m!mn)a m#n$$am'ar*an %#m'#saran a(ri!m. Dasar ia$nosa ari KH

aalah #n$an m#n$$!na*an e!o!ardiogram *ar#na a%a(

m#n$$am'ar*an *#(#'alan !*!ran @#n(ri*#l an 4!n$si sis(oli*" )an$

m#m%#rliha(*an hi%#r(ro%i @#n(ri*#l *iri )an$ asim#(ris (#r!(ama

27



m#n$#nai s#%(!m in(#r@#n(ri*#l" s#rin$*ali #n$an s#%(!m 8" a(a! l#'ih

ari *#(#'alan inin$ '#'as @#n(ri*#l *iri 'a$ian %os(#rior. S#%(!m a%a(

m#m%#rliha(*an $am'aran )an$ (ia* la1im '#r!%a 2$ro!n+$lass3

a%%#aran-#" )an$ m!n$*in '#rh!'!n$an #n$an s(r!*(!r s#l!lar )an$

a'normal an 4i'rosis mio*ar. SAM ari *a(!% mi(ral i(#m!*an %aa

s#s#oran$ #n$an o's(r!*si aliran *#l!ar an %#n!(!%an *a(!% aor(a )an$

ini. Paa KH" -a@i(as @#n(ri*#l *iri 'iasan)a '#r!*!ran *#-il" #n$an

$#ra*an inin$ %os(#rior )an$ #igorous (#(a%i m#n!r!nn)a s#%(al

#Q-!rsion. B#n(!* )an$ &aran$ ari KH" m#m%!n)ai *ara*(#ris(i*

hi%#r(ro%i a%i*al" )an$ 'iasan)a '#rh!'!n$an #n$an $#lom'an$ n#$a(i4 T

ra*sasa %aa #l#*(ro*ario$ram EKG5 an m#m%!n)ai $am'aran -a@i(as

@#n(ri*#l *iri )an$ '#r'#n(!* 2s%a# sha%#3 %aa an$io$ra%h) an

'iasan)a m#m%!n)ai ons#( *linis )an$ &ina*. Raion!-li# s-in(i$ra%h)

#n$an (halli!m 6<8 s#rin$*ali m#n#m!*an '!*(i aan)a #4#* %#r4!si

mio*ar m#s*i%!n %aa %asi#n )an$ asim%(oma(i*. m#s*i%!n *a(#(#r

&an(!n$ (ia* i%#rl!*an alam m#nia$nosa KH nam!n a%a( i(#m!*an

%#r'#aan (#*anan sis(oli* %aa o's(r!*si aliran *#l!ar @#n(ri*#l *iri 'ila

(#ra%a( o's(r!*si.

Gam'ar 6. Pan#l A m#n!n&!**an 4ram# s#lama ias(oli*. Da%a( (#rliha( m#nin$*a(n)a

*#(#'alan s#%(!m" %an#l B m#n!n&!**an 4ram# s#lama sis(oli*. S)s(oli- an(#rior mo(ion

ari *a(!% mi(ral m#n)#'a'*an o's(r!*si ari @#n(ri*#l *iri.


28



Gam'aran E>G san$a( '#r@ariasi" a%a( m#m%#rliha(*an

$#lom'an$ T )an$ %romin#n" @ol(a$# VRS s#lal! normal" s#$m#n ST )an$

#%r#si an $#lom'an$ T )an$ in@#rsi" l#'ih s#rin$ m#n!n&!**an LBBB

l#4( '!nl# 'ran-h 'lo-*s5 ari%aa RBBB" m#n!r!nn)a @ol(a$# #n$an

%#r!'ahan $#lom'an$ ST+T (#r!(ama %aa am)loiosis5" an @ariasi )an$

l!as ari isri(mia (#r!(ama %aa %#n)a*i( in4il(ra(i45" #@iasi *#*iri" an

a(rial 4i'rilasi. Ro#n($#n (horaQ s#rin$*ali m#n!n&!**an aan)a *on$#s(i

@as*!l#r %!lmon#r an *ariom#$ali s#an$ (ana+(ana $a$al &an(!n$5.

E-ho-ario$ram m#r!%a*an %#m#ri*saan )an$ %#n(in$ !n(!*

m#n)in$*ir*an #(iolo$i ari $#&ala+$#&ala )an$ (#ra%a( %aa %asi#n" an

!n(!* m#nilai #ra&a( %#n$isian an (#*anan @#n(ri*#l" an a%a(

m#m%#rliha(*an m#nin$*a(n)a *#(#'alan inin$ an m#ni%isn)a *a(!%

(#r!(ama %aa %asi#n am)loiosis5" %aa #-ho-ario$ram a%a( (#rliha(

%#m'#saran *#!a a(ri!m s#an$*an *#!a @#n(ri*#l normal #n$an

4!n$si sis(oli* )an$ '#r!'ah !'ah" im#nsi #n ias(oli* @#n(ri*#l *iri an

*anan normal" s#an$*an 4ra-(ion @#n(ri*#l *iri 'iasan)a normal a(a!

'#r*!ran$. >T an MRI san$a( m#m'an(! alam m#m'#a*an ia$nosa

i4#r#nsial KR )an$ %alin$ %#n(in$ )ai(! %#ri*ari(is *ons(ri*(i4 PK5

#n$an m#nilai *#(#'alan ari %#ri-ari!m %aa PK *#(#'alan

%#ri-ari!m = mm5. Ka(#(#risasi &an(!n$ m#r!%a*an hal )an$ %#n(in$

!n(!* m#n$i#n(i4i*asi*an %aram#(#r h#moinami* an !n(!* m#la*!*an

'io%si #nomio*arial. i*a san$a( s!li( !n(!* m#m'#a*an an(ara KR an

PK ma*a s#rin$*ali ila*!*an %#m'#ahan #*s%lorasi an %#ri*ar#*(omi

#m%iris.

P#r'#aan an(ara KR an PK ari *a(#(#risasi &an(!n$ aalah:8. P#ri*ari(is *ons(ri*(i4 'iasan)a m#li'a(*an *#!a @#n(ri*#l an

m#n$hasil*an %la(#! ari %#nin$*a(an (#*anan %#n$isian @#n(ri*#l.

a. P>/P sama an(ara (#*anan a(ri!m *anan an (#*anan a*hir

ias(oli* @#n(ri*#l *anan.

'. T#*anan sis(oli* ar(#ri %!lmon#r =< mmH$.

-. T#*anan a*hir ias(oli* @#n(ri*#l *anan l#'ih '#sar ari%aa

s#%#r(i$a (#*anan sis(oli* @#n(ri*#l *anan.

29



6. *ariomio%a(i r#s(ri*(i4 l#'ih m#n$$an$$! @#n(ri*#l *iri ari%aa

@#n(ri*#l *anan.

a. P>/P l#'ih '#sar ari (#*anan a(ri!m *anan

'. T#*anan sis(oli* ar(#ri %!lmon#r =< mmH$


8. la'ora(ori!m

a. La&! #na% arah

'. -r#a(inin# *inas# %#na%isan m!s*!lar is(ro%i5

-. r#nal 4!n-(ion (#s(

. li@#r 4!n-(ion (#s(

#. !&i 4!n$si (iroi

4. @iral s#rolo$i

6. Ron($#n (horaQ

a. P#m'#saran &an(!n$ masi4

'. E#ma in(#rs(i(ial %!lmon#r

-. Khas %aa ro#n($#n sil!#( &an(!n$ m#m'#sar" *aan$ masi4 an

&an(!n$ '#r'#n(!* 2'o(ol air3 #4!si %#ri*ari!m.

. E>G

a. Hi%#r(ro%i @#n(ri*#l *iri #n$an %#r!'ahan $#lom'an$ ST+T

&!m%ai %aa =< %#n#ri(a 'a)i.

'. Khas" $#lom'an$ T ra(a a(a! in@#rsi #n$an ST #%r#si.

-. S!m'! VRS in4#rior %aa ;= %#n#ri(a.

. Ri$h( '!nl# 'ran-h 'lo-* RBBB5 or LBBB

#. P#r!'ahan $#lom'an$ P )an$ m#n$ini*asi*an a'normali(as

a(ri!m *iri" 4irs(+#$r## A 'lo-*4. A'normali(as *on!*si a(rio@#n(ri*!lar sin!s (a*i*ari" a(rial

4i'rilasi" P>" *on(ra*si a(ri!m %r#ma(!r" @#n(ri*#l (a*i*ari"

@#n(ri*#l ari(mia" s!%ra@#n(ri*#l isri(mia5

. E-ho-ario$ram" m#n!n&!**an %#m'#saran r!an$ &an(!n$ %aa =<

%#n#ri(a an 6= %#n#ri(a m#mili*i EJ )an$ r#nah is4!n$si

sis(oli*5 #n$an $lo'al a*in#sia. Kri(#ria ia$nos(i* aalah 'ila

30



4ra*si #&#*si <.=" $ra!tional sortening 6=" an @ol!m# a*hir

ias(oli* @#n(ri*#l *iri 886.

=. Do%%l#r" a%a( m#m#ri*sa inami*a #&#*si @#n(ri*#l *iri an

m#m%!n)ai $am'aran *has %#n!r!nan *#-#%a(an an %#r-#%a(an

%!n-a* %aa saa( is(iraha( ma!%!n la(ihan 4isi*.

9. Ka(#(#risasi &an(!n$: %#nin$*a(an (#*anan a*hir ias(oli* @#n(ri*#l

*iri a(a! *anan" -!rah &an(!n$ s#-ara !m!m normal a(a! m#n!r!n

(#(a%i (ia* si$ni4i*an %aa saa( a*(i4i(as 4isi*. An$io$ra%h)

m#m%#rliha(*an hi%o*in#(i* @#n(ri*#l *iri i4!s )an$ (#rila(asi"

s#rin$*ali #n$an aan)a mi(ral r#$!r$i(asi.

7. Bio%si #nomio*arial (ia* i%#rl!*an %aa KD iio%a(i* a(a!

4amilial" nam!n a%a( '#r$!na !n(!* m#n-ari %#n)#'a' )an$ a%a(

io'a(i -on(ohn)a sar-oiosis" h#mo-hroma(osis5 an ia$nosa

#4ini(i4 -on(ohn)a am)loiosis5 ari KD" nam!n 'io%si s#-ara

!m!m m#m%!n)ai -a*!%an ia$nos(i* )an$ r#nah" r#si*o %#r4orasi

an *#ma(ian s#hin$$a m#m'a(asi %#n$$!naann)a.

Gam'ar 9. E-ho-ario$ram KD. an(!n$ normal i s#'#lah *iri an

KD i s#'#lah *anan. Da%a( (#rliha( m#in$*a(n)a r!an$ @#n(ri*#l *iri#n$an inin$ )an$ (i%is.

&!8 P"$ata#aksa$aa$


P#na(ala*sanan i(!&!*an !n(!* m#m%#r'ai*i *!ali(as hi!% #n$an -ara

m#n$!ran$i *#l!han an *om%li*asi" m#m'a(asi $#&ala an m#m%#rlam'a(

%ro$r#si4i(as %#n)a*i( an m#n-#$ah *#ma(ian m#naa*. T#ra%i (#rhaa%

31



*ariomio%a(i hi%#r(ro%i aalah #n$an s#-ara lan$s!n$ m#n$halan$i #4#*

ari *a(#*olamin )an$ a%a( m#n$a*i'a(*an #*sas#r'asi o's(r!*si ari

aliran @#n(ri*#l *iri an m#n$hinari '#r'a$ai a$#n )an$ a%a(

m#m%#r'!r!* o's(r!*si -on(ohn)a @asoila(or a(a! i!r#(i*5.

8. Kar#na *#ma(ian m#naa* s#rin$*ali m!n-!l s#lama a(a! s#(#lah

m#la*!*an a*(i4i(as 4isi*" ma*a olahra$a )an$ '#rsi4a( *om%#(i(i4

har!s ihinari.

6. Diso%)rami# (#lah i$!na*an !n(!* m#n!r!n*an *on(ra*(ili(as

@#n(ri*#l *iri" o's(r!*si aliran *#l!ar" ari(mi @#n(ri*#l an ari(mia

s!%ra@#n(ri*#l. i sam%in$ i(! &!$a m#mili*i #4#* ino(ro%i* n#$a(i4

s#hin$$a m#n$!ran$i $rai#n s!'aor(i*" i'#ri*an #n$an osis Q

8<<+<< m$hari. Nam!n #mi*ian iso%)rami# a%a(

m#m%#r%#n#* ,a*(! *on!*si no!s a(rio@#n(ri*!l#r s#hin$$a

m#nin$*a(*an *#-#%a(an @#n(ri*#l s#lama 4i'rilasi a(rial %aro*sismal.

. W+'lo-*#rs '#rman4aa( !n(!* m#n$!ran$i #n)!( &an(!n$"

m#n$!ran$i an$ina #n$an %#n!r!nan *#'!(!han o*si$#n mio*ar

an m#n!r!n*an o's(r!*si aliran *#l!ar @#n(ri*#l s#lama la(ihan

4isi*" *#(i*a r#4l#* sim%a(#(i* m#nin$*a(" m#m%#r'ai*i %#n$isian

ias(oli* @#n(ri*#l *iri #n$an m#m%#r%an&an$ ,a*(! ias(oli* an

m#nin$*a(*an %#n$isian %asi4 @#n(ri*#l" #4#* an(iari(mi" m#n$!ran$i

'#'an @#n(ri*#l *iri. O'a( %ilihan aalah %ro%anolol #n$an osis

89<+6< m$hari" *aan$+*aan$ i%#rl!*an osis l#'ih (in$$i 9<

m$hari5. Al(#rna(i4 lain m#(o%rolol an a(#nolol. Nam!n" W+'lo-*#rs

(ia* (#rliha( a%a( m#lin!n$i ari *#&aian *#ma(ian m#naa*.

. Amioaron #4#*(i4 !n(!* m#n$a(asi (a*iari(mi @#n(ri*#l anm#n!r!n*an 4r#*!#nsi ari ari(mia s!%ra@#n(ri*#l. Di!$a

m#*anism# *#r&an)a aalah m#lal!i #4#* 'rai*ari" m#m%#r'ai*i

4!n$si ias(oli* an #4#* ino(ro%i* n#$a(i4. Amioaron han)a

i$!na*an %aa %asi#n KH )an$ (ia* m#m'ai* #n$an %#n)#*a(

'#(a an %#n$ham'a( sal!ran *alsi!m" *ar#na '#r%o(#nsi

m#m%#r'!r!* h#moinami* a(a! *#aaan *linis %aa s#'a$ian

%asi#n. Dosis 9<< m$hari s#lama = hari lal! << m$hari alam

32



osis (#r'a$i alam = hari '#ri*!(n)a. Un(!* %#n-#$ahan *#ma(ian

m#naa* i$!na*an osis 8<<+<< m$hari.

=. >al-i!m -han#l 'lo*#r i$!na*an %aa KH *ar#na '#rsi4a( ino(ro%i*

n#$a(i4 an *rono(ro%i* n#$a(i4 s#r(a m#m%#r'ai*i *om%lians

ias(oli* r#la*sasi an %#n$isian @#n(ri*#l5" m#n$!ran$i is*#mia

mio*ar" m#n!r!n*an (#*anan ias(oli* )an$ m#nin$*a("

m#nin$*a(*an (ol#ransi a*(i4i(as 4isi* an %aa '#'#ra%a *#aaan

a%a( m#n!r!n*an #ra&a( *#%arahan ari o's(r!*si aliran *#l!ar.

Golon$an %#n$ham'a( sal!ran *alsi!m )an$ i%a*ai aalah

@#ra%amil Q ;< m$ sam%ai Q 6< m$ %#r hari. #ra%amil

i*a(a*an m#m%#r'ai*i *#l!han an$ina l#'ih 'ai* ari%aa %#n)#*a(

'#(a" s#lain i(! '#rsi4a( an(iari(mi an m!n$*in m#m%#r'ai*i

*#lainan m#(a'olism# *alsi!m )an$ i!$a s#'a$ai %#n)#'a' KH.

S#'a$ai al(#na(i4 a%a( i%a*ai il(ia1#m" s#an$*an %#n$$!naan

ni4#i%in masih *on(ro@#rsial.

9. Lar!(an salin in(ra@#na &!$a a%a( i'#ri*an s#'a$ai (am'ahan

(#rhaa% %ro%anolol a(a! @#ra%amil %aa %asi#n #n$an $a$al

&an(!n$ *roni* >HJ5.

7. Paa '#'#ra%a %asi#n ila*!*an %#n$$an(ian *a(!% mi(ral. Ini

ila*!*an %aa *#aaan r#r!r$i(asi mi(ral '#ra( *ar#na %rola%s *a(!%

mi(ral" o's(r!*si mi+-a@i() *ar#na ins#rsi a'normal m!s*!l!s

%a%ilaris %aa a!n *a(!% mi(ral an(#rior.

;. T#ra%i %#m'#ahan m)o(om)+m)#-(om)5 &!$a iini*asi %aa

%asi#n #n$an $#&ala )an$ h#'a( )an$ (ia* a%a( ia(asi #n$an

(#ra%i m#is an o's(r!*si aliran *#l!ar @#n(ri*#l *iri s#i*i(n)a =< mm H$5 saa( sis(ol #n$an hi%#r(ro4i s#%(!m )an$ h#'a(.9

P#m'#ahan a%a( m#r#a*an *#l!han %aa X %asi#n. T#(a%i r#si*o

*#ma(ian m#naa* *ar#na ari(mia (ia* '#r!'ah #n$an

%#m'#ahan. Tina*an %#m'#ahan !n(!* KH %#r(ama *ali

ila*!*an (ah!n 8?=;. Saa( ini %ros#!r )an$ %alin$ 'an)a* i%a*ai

aalah m)o(om)+m)#-(om) s#%(!m @#n(ri*#l s!a(! 'a$ian 'asal

s#%(!m s#*i(ar 6+= $ram5 ir#s#*si l#,a( s!a(! aor(o(omi a(a!

33



mio(omi s#%(!m )ai(! s!a(! insisi i'!a( %aa ar#a ana(omi )an$

sama (#(a%i &arin$an (ia* i*#l!ar*an. T!&!an in(#r@#nsi '#ah

aalah m#n$hilan$*an o's(r!*si aliran *#l!ar @#n(ri*#l *iri an

m#n!r!n*an (#*anan sis(oli* @#n(ri*#l *iri.

?. Im%lan( #4i'rilla(or san$a( aman an #4#*(i4 !n(!* i$!na*an %aa

%asi#n )an$ m#m%!n)ai *#m!n$*inan (#r&ain)a ari(mia @#n(ri*#l.

P#n$$!na*ann)a san$a( ir#*om#nasi*an %aa %asi#n #n$an

ri,a)a( h#n(i &an(!n$ a(a! @#n(ri*#l (a*i*ari s%on(an )an$ m#n#(a%.

Pa-! &an(!n$ !al+-ham'#r )an$ %#rman#n #n$an in(#r@al PR )an$

%#n#* (#lah ila%or*an a%a( m#m%#r'ai*i $#&ala an m#n!r!n*an

o's(r!*si aliran *#l!ar %aa '#'#ra%a %asi#n #n$an $#&ala '#ra("

*#m!n$*inan #n$an m#r!'ah %ola ari #%olarisasi @#n(ri*#l an

*on(ra*si" %#r'ai*an $#&ala 'iasan)a (#rliha( s#(#lah 9+86 min$$!"

(#(a%i %#r!'ahan s#lan&!(n)a (#rliha( sam%ai sa(! (ah!n '#ri*!(n)a"

nam!n %aa %#n$!*!ran o'&#*(i4 %a-! &an(!n$ (#rs#'!( (ia*

m#m%#rliha(*an %#r'ai*an )an$ si$ni4i*an ari *a%asi(as la(ihan

4isi*.

8<. An(i'io(i* %ro4ila*sis !n(!* 'a*(#rial #no*ari(is %aa %ros#!r

%#m'#ahan.

88. Hinari %#n$$!naan i$i(alis" i!r#(i*" ni(ra(" @asoila(or an

ar#n#r$i- a$onis(s. O'a(+o'a( #n$an #4#* ino(ro%i* %osi(i4 s#%#r(i

i$o*sin" #%in#4rin" o'!(amin an amrinon har!s ihinari.

P#ma*aian i!r#(i* %aa KH masih *on(ro@#rsial *ar#na #4#*

%#n!r!nan %r#loa a%a( m#n$#*sas#r'asi o's(r!*si aliran *#l!ar"

nam!n #mi*ian i!r#(i* i*om'inasi #n$an %#n)#*a( '#(a a(a!@#ra%amil a%a( m#n$!ran$i *on$#s(i %ar! %aa $a$al &an(!n$

*on$#s(i4 s#hin$$a m#m%#r'ai*i *#l!han s#sa*.

86. Hinari %#n$$!naan al*ohol m#s*i%!n alam &!mlah )an$ s#i*i("

*ar#na a%a( m#n$a*i'a(*an m#nin$*a(n)a o's(r!*si aliran *#l!ar

@#n(ri*#l *iri.

34




8. Tia* aa (#ra%i )an$ #4#*(i4 !n(!* *ariomio%a(i r#s(ri*(i4.

K#ma(ian 'iasan)a is#'a'*an $a$al &an(!n$ a(a! ari(mia" ol#h

*ar#na i(! (#ra%i i(!&!*an !n(!* m#n$on(rol $a$al &an(!n$

#n$an %#m'a(asan as!%an na(ri!m" %#m'#rian i!r#(i* an

%#nan$anan ari(mia )an$ %o(#nsial l#(al. T#(a%i %#rha(ian har!s

i'#ri*an !n(!* m#n$hinari %#n!r!nan %r#loa !n(!*

m#n$hinari %#n!r!nan -!rah &an(!n$ l#'ih &a!h.

6. i*a 4!n$si sis(oli* normal" ma*a %#n$$!naan i$i(alis har!s

ihinari *ar#na #4#*n)a '#r!%a %roari(mia.

. Un(!* m#m%#r(ahan*an irama sin!s l#'ih i!(ama*an

%#ma*aian amioaron.

. Paa *#aaan h#mo*roma(osis a%a( i(an$ani #n$an

#4#roQamin# an %hl#'o(omi#s '#r!lan$ !n(!* m#n!r!n*an

#%osi( '#si" %aa Ja'r)0s is#as# a%a( i'#ri*an in4!s

$ala*(osa !n(!* m#ns(im!lasi #n1im )an$ (#ra%a( #4isi#nsi

s#hin$$a m#m'an(! m#m%#r'ai*i 4!n$si &an(!n$. (#ra%i

*or(i*os(#roi a%a( i'#ri*an %aa %#n)a*i( sar*oiosis.

*or(i*os(#roi an o'a( si(o(o*si* a%a( m#nin$*a(*an s!r@i@al

%aa %asi#n #n$an #osino%hili- -ariom)o%a(h).

=. P#n$$!naan an(i*oa$!lan ir#*om#nasi*an !n(!* m#n$!ran$i

r#si*o #m'oli ari &an(!n$.

9. P#n$$!naan im%lan %a-! &an(!n$ ir#*om#nasi*an %aa

*#aaan imana (#ra%a( a'normali(as *on!*si )an$ si$ni4i*an

s#-ara *linis an r#4ra*(#r (#rhaa% m#i*am#n(osa.7. S#'a$ai lan$*ah (#ra*hir" (rans%lan(asi &an(!n$ har!s

i%#r(im'an$*an %aa %asi#n #n$an $#&ala r#4ra*(#r %aa

*ariomio%a(i r#s(ri*(i4 iio%a(i* a(a! 4amilial. T#(a%i

%ro$nosisn)a '!r!* %aa am)loiosis an sar-oiosis" *ar#na

%#n)a*i( ini m#m%!n)ai *#-#n#r!n$an !n(!* *#m'ali %aa

&an(!n$ )an$ i(rans%lan(asi*an.

35




P#r'ai*an s#-ara s%on(an a(a! s(a'ilisasi a%a( m!n-!l %aa

s#*i(ar s#%#r#m%a( %asi#n #n$an KD. K#ma(ian is#'a'*an $a$al

&an(!n$" (a*iari(mia @#n(ri*#l a(a! 'ra)ari(mia @#n(ri*#l. P#ma*aian

an(i*oa$!lan har!s i%#r(im'an$*an &i*a (#ra%a( *#m!n$*inan #m'oli

sis(#mi*. S(anar (#ra%i !n(!* $a$al &an(!n$ aalah r#s(ri*si na(ri!m"

A>E inhi'i(or" i!r#(i*" an i$i(alis m#n$hasil*an %#r'ai*an $#&ala.

Paa KD s#*!n#r )an$ is#'a'*an *ar#na hi%#r(#nsi a(a! %#n)a*i(

*a(!%" %#n!r!nan a4(#rloa %alin$ 'ai* #n$an m#nam'ah*an

h)rala1in# a(a! ni(ra( (#rhaa% s(anar r#$im#n (#ra%i $a$al &an(!n$

*on$#s(i4. B#r'a$ai %#n#li(ian m#n!n&!**an 'ah,a *om'inasi ari

an$io(#nsin II r#-#%(or an(a$onis #n$an A>E inhi'i(or l#'ih #4#*(i4

i'anin$*an %#ma*aian mono(#ra%i.

Paa %asi#n #n$an $a$al &an(!n$ *on$#s(i4 4!n$sional *#las I

an Le$t Ventrikel Eje!tion %ra!tion =" %#nam'ahan 6= m$

s%ironola*(on (#rhaa% s(anar r#$im#n $a$al &an(!n$ *on$#s(i4 (#lah

m#n!r!n*an (in$*a( mor(ali(as s#'#sar <. B#'#ra%a %asi#n #n$an

KD )an$ %aa saa( 'io%si m#n!n&!**an aan)a in4lamasi mio*ari!m

har!s i(#ra%i #n$an o'a(+o'a(an im!nos!%r#si4. P#n$$!naan al*ohol

har!s ihinari *ar#na '#rsi4a( (o*si* 'a$i &an(!n$" s#'a$aimana &!$a

%#n$$!naan -al-i!m -han#l 'lo*#r an NSAID. o'a( an(iari(mia

s#'ai*n)a ihinari !n(!* m#n$hinari %roari(mia" *#-!ali i'!(!h*an

!n(!* m#n$a(asi %aa ari(mia )an$ s#ri!s.

Paa sa(! ari (i$a %asi#n #n$an *#(#rlam'a(an *on!*si

in(ra@#n(ri*!l#r s#%#r(i LBBB a(a! RBBB5" %#masan$an %a-! &an(!n$ 'i@#n(ri*!l#r resyn!roni&ation terapy5 a*an m#m%#r'ai*i $#&ala"

m#n!r!n*an ,a*(! ra,a( ina% an m#n!r!n*an mor(ali(as. P#masan$an

im%lan( -ario@#r(#r+#4i'rilla(or san$a( '#r$!na %aa %asi#n #n$an

ari(mia @#n(ri*!l#r. Trans%lan(asi &an(!n$ har!s i%#r(im'an$*an %aa

%asi#n )an$ r#4ra*(#r (#rhaa% m#i*am#n(osa a(a! %asi#n #n$an KD

iio%a(i*.

36



&!9 K,'p#-kas-

8. Ga$al &an(!n$

M#r!%a*an %#n)a*i( )an$ %alin$ !m!m (#r&ai %aa D>M. T#r&ai *#(i*ao(o( &an(!n$ (ia* -!*!% *!a( !n(!* m#mom%a arah )an$ -!*!% !n(!*

s#l!r!h (!'!h" m#n)#'a'*an ##ma i %ar!+%ar! an a(a! &arin$an

%#ri4#r. B#'#ra%a oran$ m#mili*i %#n)a*i( )an$ s(a'il an *onisi )an$

a$a* s#i*i( '!r!*. S#m#n(ara )an$ lain m#mili*i $#&ala '#r!'ah+!'ah

)an$ is#'!( $a$al &an(!n$. Hal ini m#m%#n$ar!hi *#!a sisi &an(!n$ *iri

an *anan5 m#n)#'a'*an $#&ala s#sa* na4as" ##ma (!n$*ai" '#n!n$an

@#na &!$!laris an %#r!( (#rasa %#n!h.

6. A(rial 4i'rilla(ion AJ5 4i'rilasi a(ri!m

M#r!%a*an *#lainan irama &an(!n$ )an$ %alin$ s#rin$ %aa D>M. D#n)!( &an(!n$ ir#$!l#r an -#%a(" m#n)#'a'*an rasa '#r#'ar+#'ar"

m#nin$*a(*an na%as )an$ %#n#* s#sa* na4as. Hal (#rs#'!( a%a(

'#r*ai(an #n$an $#&ala )an$ s#ma*in m#m'!r!* a(a! %#r*#m'an$an ari

'#*!an arah #m'oli. Risi*o ari '#*!an (#rs#'!( ia(asi #n$an

%#m'#rian ,ar4arin )an$ i$!na*an !n(!* m#n$#n-#r*an arah &i*a

(#r&ai 4i'rilasi a(ri!m.

. B#*!an arah Throm'o#m'oli

Paa D>M" aliran arah )an$ m#l#,a(i &an(!n$ l#'ih lam'a( ari

'iasan)a. Hal ini m#n)#'a'*an '#*!an arah (#r'#n(!* i &an(!n$. i*a '#*!an arah (#rs#'!( (#rl#%as ari &an(!n$ an i*!( alam sir*!lasi" ma*a

a%a( m#n)#'a'*an *#r!sa*an o(a* s(ro*#. Paa D>M #n$an

%#m'#saran &an(!n$" i%#rl!*an %#n$o'a(an #n$an ,ar4arin

an(i*oa$!lan" !n(!* m#n-#$ah %#m'#n(!*an '#*!an arah.

. K#lainan irama rh)(hm ari(mia :

Hal (#rs#'!( s#-ara !m!m m#n)#'a'*an %!sin$" s#sa* na4as" %al%i(asi an

a%a( &!$a asim(oma(i*. B#'#ra%a *#lainan irama )an$ a%a( (#r&ai %aa

D>M :

8. E*(o%i* @#n(ri*!lar

Kaan$+*aan$ aa 8 #n)!( (am'ahan i l!ar #n)!( &an(!n$.

Tia* m#m#rl!*an %#n$o'a(an" (ia* '#r'aha)a" an a%a(

i(#m!*an %aa oran$ normal.

6. #n(ri*!lar (a*i*aria

M#r!%a*an #n)!( &an(!n$ )an$ san$a( -#%a(. B#r*ai(an #n$an

%#n!r!nan ras(is ari (#*anan arah an $#&ala ari %!sin$ s#sa*

37



na4as a(a! 'ah*an %in$san. Ta%i a%a( &!$a asim(oma(i*. Da%a(

'#r#s%on (#rhaa% o'a( a(a! I>D im%lan(a'l# -ario@#n(#r

#4i'rilla(or.

. #n(ri-!lar 4i'rilla(ion J5 4i'rilasi @#n(ri*#l

aran$ (#r&ai. K#lainan )an$ '#ra( an s#ri!s ari a*(i@i(as #l#*(ri*

irama &an(!n$. Da%a( m#n)#'a'*an *ola%s an 'ah*an *#ma(ian

&i*a (ia* is#m'!h*an.

=. S!#n #a(h *#ma(ian m#naa*

T#r&ai *ar#na ari(mia )an$ '#ra( a(a! %#r*#m'an$an '#*!an arah )an$

'#sar. O'a(+ o'a(an an a(a! I>D a%a( m#n$!ran$i risi*o ini.

9. H#ar( 'lo-*

i*a sis(#m *on!*si #l#*(ri*al &an(!n$ alam &an(!n$ $a$al !n(!*

'#r4!n$si #n$an 'ai*" &an(!n$ a*an m#n&ai (#rlal! lam'a(. i*a (#r&ai

%anan$an ma(a (#rasa $#la% (ia* saar" ma*a i%#rl!*an %a-#ma*#r.

7. E4#* sam%in$ ari %#n$o'a(an" m#li%!(i :

8. hi%o(#nsi

6. %anan$an $#la% an %in$san

. r#a*si l!%!s *!m%!lan $#&ala '#r!%a 'in(i*+'in(i* m#rah %aa*!li( an ar(ri(is5

. %!sin$

=. $an$$!an %#n-#rnaan.

38



BAB III

)! P"$%ka*-a$

P"$%u'pu#a$ Data

85 Da(a D#mo$ra4i

An$*a *#&aian *ariomio%a(i ila(asi aalah 6 Y (#r&ai %aa la*i+la*i

an (#r&ai %aa !sia %#r(#n$ahan. I$na(a@i-i!s #( al" 8??=:?8?5

65 Ri,a)a( K#s#ha(an

a5 Ri,a)a( K#s#ha(an S#*aran$

Um!mn)a *li#n a(an$ #n$an *#l!han aan)a s#sa*. S#sa )an$

irasa*an '#r(am'ah 'ila ila*!*an a*(i@i(as an (i!r (#rl#n(an$ an

'#r*!ran$ 'ila iis(iraha(*an an m#ma*ai 6+ 'an(al. S#sa* irasa*an

%aa a#rah aa an s#%#r(i (#r(inih '#na '#ra(. S*ala s#sa* <+

an irasa*an s#rin$ %aa sian$ an malam hari.

'5 Ri,a)a( P#n)a*i( Dah!l!

Ka&i aan)a K#lainan a!(oim!n" Hi%#r(#nsi sis(#mi*" A!(oan(i'oi

)ai(! antimyo!ardial anti"odies" Pros#s in4#*si in4#*si 'a*(#ri@ir!s5"

Gan$$!an m#(a'oli* #4isi#nsi (hiamin# an s-!r@)5" $an$$!an

im!ni(as l#!*imia5" K#hamilan an *#lainan %os( %ar(!m" (oQi-

%ros#s al*ohol an -h#mo(#ra%i5" %ros#s in4il(rasi am)loiosis an

*an*#r5

-5 Ri,a)a( *#s#ha(an *#l!ar$a

Ka&i aan)a an$$o(a *#l!ar$a lin$*!n$an )an$ m#m%!n)ai %#n)a*i(

m#n!lar in4#*si s#%#r(i TB an h#%a(i(is. Ka&i aan)a ri,a)a( %#n)a*i(

hi%#r(#nsi" &an(!n$ an ia'#(#s m#li(!s i *#l!ar$a" 'ila aa

-an(!m*an alam $#no$ram.

5 Pola A*(i@i(as S#hari+hari

N!(risi *li#n i*a&i aan)a *ons!msi $aram" l#ma*" $!la an *a4#in an

&#nis ma*anan. Kli#n m!n$*in a*an m#rasa ha!s an min!m '#rl#'ihan

<<<+=<<< mL5 a*i'a( s#*r#si alos(#ron. Aan)a %#n!r!nan a*(i@i(as

an a*(i@i(as s#hari+harin)a ADL5 a*i'a( aan)a l#mah" l#(ih an

39



aan)a is%n#!. Is(iraha( (#r$an$$! a*i'a( is%n#! an s#rin$ (#r'an$!n

%aa malam hari !n(!* #liminasi BAK.

5 P#m#ri*saan Jisi*

a5 Sis(#m P#rna4asan

Dis%n#! saa( '#ra*(i@i(as" Paro*simal No*(!rnal Dis%n#!" (i!r

sam'il !!* a(a! #n$an '#'#ra%a 'na(al" Ba(!* #n$an (an%a

%#m'#n(!*an s%!(!m" ri,a)a( %ar! *ronis" %#n$$!naan 'an(!an

%#rna4asan o*si$#n an m#i*asi5" na4as an$*al"(a*i%n#!"

%#n$$!naan o(o( a*s#sori %#rna4asan.'!n)i na4as m!n$*in (ia*

(#r#n$ar" #n$an *ra*#ls 'asilar an m#n$i.

'5 Sis(#m Kario@as*!lar

Dis(#nsi @#na &!$!laris" %#m'#saran &an(!n$" aan)a n)#ri aa"

s!ara s an s %aa a!s*!l(asi &an(!n$ "(#*anan arah normal(!r!n"

(a*i*ari" isri(mia 4i'ril a(ri!m" 'lo* &na(!n$ ll5nai %#ri4#r

m!n$*in '#r*!ran$"%#r!'ahan #n)!(an a%a( (#r&ainai s#n(ral

m!n$*in *!a(" %!n$$!n$ *!*! %!-a( a(a! siano(i* #n$an %#n$isian

*a%il#r lam'a(.

-5 Sis(#m P#n-#rnaan

Ka&i aan)a %#nin$*a(an '#ra( 'aan s#-ara si$ni4i*an" m!al an

m!n(ah" anor#Qia" aan)a n)#ri a'om#n *anan a(as" h#%a(om#$ali

an asi(#s

5 Sis(#m M!s*!los*#l#(al

K#l#lahan" *#l#mahan" sa*i( %aa o(o( an *#hilan$an *#*!a(an

(on!s o(o(.

#5 Sis(#m P#rs)ara4anKa&i aan)a rasa %#nin$" %#r!'ahan %rila*!" %#n!r!nana *#saaran

an isori#n(asi

45 Sis(#m P#r*#mihan

Ka&i aan)a no*(!ria an %#n!r!nanan '#r*#mih" !rin# '#r,arna

$#la%" %#n$$!naan an *#aaan *a(#(#risasi .

$5 Sis(#m In(#$!m#n

40



Pi((im$ ##ma %aa 'a$ian (!'!h 'a,ah" an *!li( (#ra'a in$in"

aan)a *#'ir!an" %!-a(" a'!+a'! an siano(i* " an aan)a *!li( )an$

l#-#(.

=5 Da(a %si*olo$is

Ka&i aan)a *#-#masan" $#lisah an *ons#% iri an *o%in$ *li#n a*i'a(

%#n)a*i(" *#%riha(inan 4inansial an hos%i(alisasi.

95 Da(a sosial

P#rl! i*a&i (#n(an$ %#rs#%si *li#n (#rhaa% irin)a s#h!'!n$an #n$an

*onisi s#*i(arn)a" h!'!n$an *li#n #n$an %#ra,a(" o*(#r an (im

*#s#ha(an lainn)a. Biasan)a *li#n a*an i*!( s#r(a alam a*(i@i(as sosial

a(a! m#nari* iri a*i'a( aan)a is%n#!" *#l#mahan an *#l#lahan.

75 Da(a s%iri(!al

Ka&i (#n(an$ *#)a*inan a(a! %#rs#%si *li#n (#rhaa% %#n)a*i(n)a

ih!'!n$*an #n$an a$ama )an$ ian!(n)a.. Biasan)a *li#n a*an m#rasa

*#s!li(an alam m#n&alan*an i'aahn)a.

;5 Da(a P#n!n&an$

a5 P#m#ri*saan La'ora(ori!m

'adiologi: Paa 4o(o ron($#n aa" (#rliha( aan)a *ariom#$ali"

(#r!(ama @#n(ri*#l *iri. !$a i(#m!*an aan)a '#n!n$an %ar! an

#4!si %l#!ra

Elektrokardiogra$i: i(#m!*an aan)a sin!s (a*i*aria" ari(mia a(rial

an @#n(ri*#l" *#lainan s#$m#n ST an $#lom'an$ T an $an$$!an

*on!*si in(ra@#n(ri*!lar. Kaan$+*aan$ i(#m!*an @ol(as# VRS

)an$ r#nah" a(a! $#lom'an$ V %a(olo$is" a*i'a( n#*rosis mio*ar.

Ekokardiogra$i : Tam%a* @#n(ri*#l *iri m#m'#sar" is4!n$si@#n(ri*#l *iri" an *#lainan *a(!% mi(ral ,a*(! ias(oli*" a*i'a(

-om%li#n-# an (#*anan %#n$isian )an$ a'normal.

Bila (#ra%a( ins!4isi#nsi (ri*!s%i" %#r$#ra*an s#%(!m m#n&ai

%arao*sal. ol!m# a*hir ias(oli* an a*hir sis(oli* m#m'#sar an

%aram#(#r 4!n$si %om%a @#n(ri*#l" 4ra*si #&#*si EJ5 m#n$!ran$.

P#n!(!%an *a(!% mi(ral (#rlam'a( an %#n!(!%an *a(!% aor(a 'isa

(#r&ai l#'ih ini ari normal. Trom'!s @#n(ri*#l *iri a%a(

41



i(#m!*an #n$an %#m#ri*saan 6D+#*o*ario$ra4i" &!$a an#!risma

@#n(ri*#l *iri a%a( isin$*ir*an #n$an %#m#ri*saan ini.

Raion!*l#ar: %aa %#m#ri*saan raion!*l#ar (am%a* @#n(ri*#l *iri

is#r(ai 4!n$sin)a )an$ '#r*!ran$.

Sadapan jantung : %aa saa%an &an(!n$ i(#m!*an @#n(ri*#l *iri

m#m'#sar s#r(a 4!n$sin)a '#r*!ran$" r#$!r$i(asi mi(ral an a(a!

(ri*!s%i" -!rah &an(!n$ '#r*!ran$ an (#*anan %#n$isian

in(ra@#n(ri*!lar m#nin$$i an (#*anan a(ri!m m#nin$*a(.

Bila (#ra%a( %!la $a$al @#n(ri*#l *anan" (#*anan a*hir ias(oli*

@#n(ri*#l *anan" a(ri!m *anan an #sa*an @#na s#n(ralis a*an

(in$$i. D#n$an an$io$ra4i @#n(ri*#l *iri a%a( isin$*ir*an ana

n#!risma @#n(ri*#l s#'a$ai %#n)#'a' $a$al &an(!n$.

)!& D-a%$,sa

85 P#n!r!nan -!rah &an(!n$ '#rh!'!n$an #n$an %#r!'ahan *on(ra*(ili(as

mio*arial%#r!'ahan ino(ro%i*" %#r!'ahan 4r#*!#nsi"irama an

*on!*si lis(ri*" %#r!'ahan s(r!-(!ral mis *#lainan *a(!%" an#!rism#

@#n(ri-!lar 5

65 A*(i@i(as in(ol#ran '#rh!'!n$an #n$an *#(ia*s#im'an$an an(ara

s!%lai o*si$#n*#'!(!han" *#l#mahan !m!m" (irah 'arin$

lamaimmo'ilisasi.

5 K#l#'ihan @ol!m# -airan '#rh!'!n$an #n$an m#n!r!nn)a la&! 4il(rasi

$lom#r!l!s m#n!r!nn)a -!rah &an(!n$ 5 m#nin$*a(n)a %ro!*si

ADH an r#(#nsi na(ri!m air.

5 R#si*o (in$$i *#r!sa*an %#r(!*aran $as '#rh!'!n$an #n$an

%#r!'ahan m#m'ran *a%il#r+al@#ol!s"-n(oh

%#n$!m%!lan%#r%inahan -airan *#alam ar#a in(#rs(i(ialal@#oli 5

=5 R#si*o (in$$i *#r!sa*an in(#$ri(as *!li( '#rh!'!n$an #n$an (irah

'arin$ lama" ##ma" %#n!r!nan %#r4!si &arin$an.

95 K!ran$n)a %#n$#(ah!an m#n$#nai *onisi" %ro$ram %#n$o'a(an

'#rh!'!n$an #n$an *!ran$ %#mahaman*#salahan %#rs#%si (#n(an$

h!'!n$an 4!n$si &an(!n$%#n)a*i($a$al.

42



)!) I$t"r:"$s- (P"r"$0a$aa$;

In(#r@#nsi P#r#n-anaan *#%#ra,a(an aalah m#n)!s!n r#n-ana (ina*an

*#%#ra,a(an )an$ ila*sana*an !n(!* m#nan$$!lan$i masalah #n$an

ia$nosa *#%#ra,a(an )an$ (#lah i(#n(!*an #n$an (!&!an (#r%#n!hin)a

*#'!(!han %asi#n.P#ra,a(an %aa *li#n #n$an *ariomio%a(i sama #n$an

%asi#n #n$an $a$al &an(!n$ I$na(a@i-i!s #( al" 8??=: ?8?5 M#n!r!( Do#n$o#s"

alih 'ahasa I Ma# Kariasa" 6<<<:7965 aalah:

a. P#n!r!nan -!rah &an(!n$ '#rh!'!n$an #n$an %#r!'ahan *on(ra*(ili(as

mio*arial%#r!'ahan ino(ro%i*" %#r!'ahan 4r#*!#nsi"irama an *on!*si

lis(ri*" %#r!'ahan s(r!-(!ral mis *#lainan *a(!%" an#!rism# @#n(ri-!lar 5

T!&!an : >!rah &an(!n$ (ia* m#n!r!n

Kri(#ria hasil :

+ M#n!n&!**an (ana @i(al )an$ a%a( i(#rima isri(mia (#r*on(rol

a(a! hilan$ 5

+ M#n!n&!*an (ana $a$al &an(!n$ mis: %aram#(#r h#moinami* alam

'a(as normal" hal!aran rin# a#*!a( 5

+ M#n!n&!**an %#n!r!nan #%iso# i%sn#a

+ M#n!n&!**an %#n!r!nan #%iso# an$ina

+ I*!r s#r(a alam a*(i@i(as )an$ m#n$!ran$i '#'an *#r&a &an(!n$

I$t"r:"$s- Ras-,$a#

85 A!s*!l(asi nai a%i-al : *a&i

4r#*!#nsi" irama &an(!n$

o*!m#n(asi*an isri(mia 'ila

(#rs#ia (#l#m#(ri 5.

65 >a(a( '!n)i &an(!n$

5 Pal%asi nai %#ri4#r 5 Pan(a! TD

=5 Ka&i *!li( (#rhaa% %!-a( an

sianosis

95 Pan(a! hal!aran !rin#" -a(a

%#n!r!nan hal!aran an

*#%#*a(an*ons#n(rasi

75 Ka&i %#r!'ahan %aa s#nsori"

-on(oh l#(ar$i" 'in$!n$"

8. Biasan)a (#r&ai (a*hi*ari

m#s*i%!n %aa saa( is(iraha( 5

!n(!* m#n$*om%#nsasi %#n!r!nan

*on(ra*(ili(as @#n(ri-!lar. Disri(mia

@#n(ri-!lar )an$ (ia* r#s%onsi@#

(#rhaa% o'a( i!$aan#!risma

@#n(ri-!lar.

6. S8 an S6 m!n$*in l#mah *ar#na

m#n!r!nn)a *#r&a %om%a. Irama

$allo%s !m!m S an S 5

ihasil*an s#'a$ai aliran arah *#

alam s#ram'i )an$ is(#nsi.

. P#n!r!nan -!rah &an(!n$ a%a(

43



isori#n(asi" -#mas an #%r#si

;5 A(!r %osisi s#mi r#*!m'#n %aa

(#m%a( (i!r a(a! *!rsi

?5 Tin$$i*an *a*i" hinari (#*anan

%aa 'a,ah l!(!(

8<5 P#ri*sa n)#ri (#*an '#(is"

m#n!r!nn)a nai %#al"

%#m'#n$*a*an" *#m#rahan lo-al

a(a! %!-a( %aa #*s(r#imi(as

885 Kola'orasi %#m'#rian o*si$#n

(am'ahan #n$an *an!la

nasalmas*#r s#s!ai ini*asi865 Kola'orasi %#m'#rian o'a( :

• Di!r#(i* : -on(oh 4!ros#mi

lasiQ5" asam #(a*rini* E#-rin5

"'!m#(ami B!m#Q5"

s%ironola(on Ala*(on5.

• asoila(or : -on(oh ni(ra(

ni(ro+!r" isoril5" ar(#rioila(or"

-on(oh hirala1in A%r#solin#5"

*om'inasi o'a(" -on(oh %ra1osin

Mini%%r#s5

• Di$o*sin LanoQin 5

• >a%(o%ril >a%o(#n 5" lisino%ril

Prini@il 5" #nala%ril aso(#- 5

• Mor4in S!l4a(

• Trans!ili1#rs#a(i4

• An(i*oa$!lan" -on(oh h#%arin

osis r#nah" ,ar4arin >o!main

5

85 Kola'orasi %#m'#rian -airan I"

%#m'a(asan &!mlah (o(al s#s!ai

ini*asi. Hinari -airan $aram

85 Kola'orasi %an(a!$an(i #l#*(roli(.

m#n!n&!**an m#n!r!nn)a nai

raial" %o%li(#al" orsalis %#is an

%os(i'ial. Nai m!n$*in -#%a(

hilan$ a(a! (ia* (#ra(!r!n(!*

i%al%asi an %!ls!s al(#rnan

#n)!( *!a( lain an #n)!(

l#mah 5 m!n$*in aa.

. Paa GK ini" s#an$ an *ronis

TD a%a( m#nin$*a( s#h!'!n$an

#n$an SR. Paa GK lan&!(

(!'!h (ia* mam%! la$im#n$*om%#nsasi an hi%o(#nsi

(ia* a%a( normal la$i

=. P!-a( m#n!n&!**an m#n!r!nn)a

%#r4!si %#ri4#r s#*!n#r (#rhaa%

(ia* a#*!a(n)a -!rah &an(!n$"

@aso*ons(ri*(si an an#mia.

Sianosis a%a( (#r&ai s#'a$ai

r#4a*(oriGK. Ar#a )an$ sa*i(

s#rin$ '#r,arna 'ir! a(a! '#lan$

*ar#na %#nin$*a(an *on$#s(i4 @#na.

9. Gin&al '#r#s%on !n(!* m#n!r!n*a

-!rah &an(!n$ #n$an m#nahan

-airan an na(ri!m. Hal!aran !rin#

'iasan)a m#n!r!n s#lama s#hari

*ar#na %#r%inahan -airan *# &arin$an (#(a%i a%a( m#nin$*a(

%aa malam hari s#hin$$a -airan

'#r%inah *#m'ali *# sir*!lasi 'ila

%asi#n (i!r.

7. Da%a( m#n!n&!**an (ia*

a#*!a(n)a %#r4!si s#r#'ral

s#*!n#r (#rhaa% %#n!r!nan -!rah

&an(!n$.

44



8=5 Kola'orasi EKG an %#r!'ahan

4o(o aa.

895 Kola'orasi"%#m#ri*saan

l'ora(ori!m" -on(oh BUN"

*r#a(inin. P#m#ri*saan 4!n$si ha(i

AST" LDH 5.

PTAPTTP#m#ri*saan *oa$!lasi

;. Is(iraha( 4isi* har!s i%#r(ahan*an

s#lama GK a*!( a(a! r#4a*(ori

!n(!* m#m%#r'ai*i #4isi#nsi

*on(ra*si &an(!n$ an m#n!r!n*an

*#'!(!han *ons!msi o*si$#n

mio*ar an *#r&a '#rl#'ihan

?. M#n!r!n*an s(asis @#na an a%a(

m#n!r!n*an insi#n

(hrom'!s%#m'#n(!*an #m'ol!s

8<. M#n!r!nn)a -!rah &an(!n$.

B#n!n$an s(asis @#na an (irah

'arin$ lama m#nin$*a(*an r#si*o

(rom'o4l#'i(is

88. M#nin$*a(*an s#iaan o*s#$#n

!n(!* *#'!(!hanmio*ar m#la,an

#4#* hi%o*siais*#mia.

86. Kola'orasi %#m'#rian o'a(

• Ti%# an osis i!r#(i- (#r$an(!n$

%aa #ra&a( $a$al &an(!n$ an

4!n$si $in&al. P#n!r!nan %r#loa

%alin$ 'an)a* i$!na*an alam

m#n$o'a(i %asi#n #n$an -!rah

&an(!n$ r#la(i4 normal i(am'ah

#n$an $#&ala *on$#s(i. Di!r#(i*

'li* r#a'sor'si i!r#(i-" s#hin$$a

m#m%#n$ar!hii r#a'sor'si na(ri!m

an air.

• asoila(or i$!na*an !n(!*

m#nin$*a(*an -!rah &an(!n$"

m#n!r!n*an @ol!m# sir*!lasi

@asoila(or 5 an (ahanan @as*!l#r

sis(#mi* ar(#rioila(or 5" &!$a

*#r&a @#n(ri*#l.

45



• M#nin$*la(*an *#*!a(an *on(ra*si

mio*ar an m#m%#rlam'a(

4r#*!#nsi &an(!n$ #n$an

m#n!r!n*an *on!*si an

m#m%#rlama %#rio# r#4a*(ori %aa

h!'!n$an A !n(!* m#nin$*a(*an

#4isi#nsi-!rah &an(!n$.

• Inhi'i(or H>E a%a( i$!na*an

!n(!* m#n$on(rol $a$al &an(!n$

#n$an m#n$ham'a( *on@#rsi

an$io(#nsin alam %ar! an

m#n!r!n*an @aso*ons(ri*si" SR

an (#*anan arah.

• P#n!r!nan (ahan @as*!l#r an

aliran 'ali* @#na m#n!r!n*an *#r&a

mio*ar. M#n$hilan$*an -#mas

an m#n$is(iraha(*an si*l!s !m%an

'ali* -#mas%#n$#l!aran

*a(#*olamin-#mas.

• M#nin$*a(*an is(iraha(r#la*sasi

an m#n!r!n*an *#'!(!han

o*s#$#n an *#r&a mio*ar.

>a(a(an : Aa on (rial0 oral )an$

analo$ #n$an amrinon ino-or 5

a$#n ino(ro%i* %osi(i4" is#'!(milrinon )an$ a%a( -o-* !n(!*

%#n$$!naan &an$*a %an&an$.

• Da%a( i$!na*an s#-ara

%ro4ila*sis!n(!* m#n-#$ah

%#m'#n(!**an (hrom'!s#m'oli

%aa aan)a 4a-(or r#si*o s#%#r(i

s(asis @#na"(irah 'arin$" isri(mia

46



&an(!n$ an ri,a)a( #%iso#

(rom'oli* s#'#l!mn)a.

8. Kar#na aan)a %#nin$*a(an

(#*anan @#n(ri*#l *iri" %asi#n (ia*

a%a( m#n(ol#ransi %#nin$*a(an

@ol!m# -airan %r#loa 5. Pasi#n

GK &!$a m#n$#l!ar*an s#i*i(

na(ri!m )an$ m#n)#'a'*an r#(#nsi

-airan an m#nin$*a(*an *#r&a

mio*ar.

8. P#r%inahan -airan an %#n$$!naan i!r#(i- a%a(

m#m%#n$ar!hi #l#*(rolo(

*h!s!sn)a *ali!m an *loria 5

)an$ m#m%#n$ar!hi irama &an(!n$

an *on(ra*(ili(as.

8=. D#%r#si s#$m#n ST an a(arn)a

$#lom'an$ T a%a( (#r&ai *ar#na

%#nin$*a(an *#'!(!han o*si$#n

mio*ar" m#s*i%!n (a* aa

%#n)a*i( ar(#ri *oron#r. Jo(o aa

a%a( m#n!n&!**an %#m'#saran

&an(!n$ an %#r!'ahan *on$#s(i4

%!lmonal.

89. %#nin$*a(an"BUNKr#a(inin"m#n!n

&!**an hi%#r4!n$si$a$al$in&al.ASTLDH a%a( m#nin$*a(

s#h!'!n$an #n$an *on$#s(i ha(i

an m#n!n&!**an *#'!(!han !n(!*

o'a( #n$an osis l#'ih *#-il )an$

i#(o*si*asi ol#h ha(i. M#n$!*!r

%#r!'ahan %aa %ros#s *oa$!lasi

a(a! *##4#*(i4an (#ra%i

47



an(i*oa$!lan.

a. A*(i@i(as in(ol#ran '#rh!'!n$an #n$an *#(ia*s#im'an$an an(ara s!%lai

o*si$#n*#'!(!han" *#l#mahan !m!m" (irah 'arin$ lamaimmo'ilisasi.

T!&!an : A*(i@i(as (#r%#n!hi

Kri(#ria hasil :

+ B#r%ar(isi%asi %aa a*(i@i(as )an$ iin$in*an"

+ M#m#n!hi *#'!(!han %#ra,a(an iri s#niri.

+ M#n-a%ai %#nin$*a(an (ol#ransi a*(i@i(as )an$ a%a( i!*!r" i'!*(i*an

ol#h m#n!r!nn)a *#l#mahan an *#l#lahan

+ Tana @i(al alam 'a(as normal s#lama a*(i@i(as.

I$t"r:"$s- Ras-,$a#

48



8. P#ri*sa (ana @i(al s#'#l!m

an s#s!ah s#$#ra a*(i@i(as"

*h!s!sn)a 'ila %asi#n

m#n$$!na*an @asoila(or"

i!r#(i-" %#n)#*a( '#(a.

6. >a(a( r#s%on *ario%!lmonal

(#rhaa% a*(i@i(as" -a(a(

(a*i*ari" isri(mia" i%sn#a"

'#r*#rin$a(" %!-a(.

. Ka&i %r#si%i(a(or%#n)#'a'

*#l#mahan -on(oh

%#n$o'a(an" n)#ri" o'a(.

. E@al!asi %#nin$*a(an

in(ol#ran a*(i@i(as.

=. B#ri*an 'an(!an alam

a*(i@i(as %#ra,a(an iri

s#s!ai ini*asi. S#lin$i

%#rio# a*(i@i(as #n$an

%#rio# is(iraha(.

9. Kola'orasi %ro$ram

r#ha'ili(asi &an(!n$a*(i@i(as.

85 Hi%o(#nsi or(os(a(i* a%a( (#r&ai #n$an

a*(i@i(as *ar#na #4#* o'a( @asoilasi 5"

%#r%inahan -airan i!r#s(i* 5 a(a!

%#n$ar!h 4!n$si &an(!n$.

65 P#n!r!nan*#(ia*mam%!an mio*ari!m

!n(!* m#nin$*a(*an @ol!m# s#*!n-!%

s#lama a*(i@i(as" a%a( m#n)#'a'*an

%#nin$*a(an s#$#ra %aa 4r#*!#nsi &an(!n$

an *#'!(!han o*si$#n" &!$a %#nin$*a(an

*#l#lahan an *#l#mahan.

5 K#l#mahan aalah #4#* sam%in$ '#'#ra%a

o'a( '#(a 'lo-*#r" (rans!ili1#r an

s#a(i4 5. N)#ri an %ro$ram %#n!h s(r#ss

&!$a a%a( m#m#rl!*an #n#r$i an

m#n)#'a'*an *#l#mahan.

5 Da%a( m#n!n&!**an %#nin$*a(an

#*om%#nsasi &an(!n$ ari%aa *#l#'ihan

a*(i@i(as.

=5 P#m#n!han *#'!(!han %#ra,a(an iri

%asi#n (an%a m#m%#n$ar!hi s(r#ss

mio*ar*#'!(!han o*si$#n '#rl#'ihan.

95 P#nin$*a(an '#r(aha% %aa a*(i@i(as

m#n$hinari *#r&a &an(!n$*ons!msi

o*si$#n '#rl#'ihan. P#n$!a(an an

%#r'ai*an 4!n$si &an(!n$ i'a,ah s(r#ss" 'ila is4!n$si &an(!n$ (ia* a%a(

m#m'ai* *#m'ali.

'. K#l#'ihan @ol!m# -airan '#rh!'!n$an #n$an m#n!r!nn)a la&! 4il(rasi

$lom#r!l!s m#n!r!nn)a -!rah &an(!n$ 5 m#nin$*a(n)a %ro!*si ADH an

r#(#nsi na(ri!m air.

T!&!an : @ol!m# -airan alam 'a(as normal a#*!a(

Kri(#ria hasil :

49



+ M#n#mons(rasi*an @ol!m# -airan s(a'il #n$an *#s#im'an$an mas!*an

an %#n$#l!aran"

+ B!n)i na4as '#rsih&#las

+ Tana @i(al alam r#n(an$ )an$ a%a( i(#rima

+ B#ra( 'aan s(a'il

+ Ta* aa ##ma

+ M#n)a(a*an %#mahaman (#n(an$%#m'a(asan -airan ini@i!al.

I$t"r:"$s- Ras-,$a#

8. Pan(a! hal!aran !rin#" -a(a( &!mlah

an ,arna saa( hari imana i!r#sis(#r&ai.

6. Pan(a!hi(!n$ *#s#im'an$an

%#mas!**an an %#n$#l!aran s#lama 6

&am.

. P#r(ahan*an !!* a(a! (irah 'arin$

#n$an %osisi s#mi4o,l#r s#lama 4as#

a*!(.. Tim'an$ '#ra( 'aan (ia% hari.

=. Ka&i is(#nsi l#h#r an %#m'!l!h

%#ri4#r. Liha( ar#a (!'!h #%#n#n !n(!*

##ma #n$an(an%a %i((in$ -a(a

aan)a ##m (!'!h !m!m anasar*a 5.

9. U'ah %osisi #n$an s#rin$.

Tin$$i*an *a*i 'ila !!*. Liha(

%#rm!*aan *!li(" %#r(ahan*an (#(a%

*#rin$ an '#ri*an 'an(alan s#s!ai

ini*asi.

7. A!s*!l(asi '!n)i na4as" -a(a(

%#n!r!nan ana(a! '!n)i (am'ahan.

>on(oh *r#*#ls" m#n$i. >a(a( aan)a

%#nin$*a(an is%n#a" (a*i%n#a" or(o%n#a"

8. Hal!aran !rin# m!n$*in s#i*i(

an %#l*a( *h!s!sn)a s#lama s#hari 5*ar#na %#n!r!nan %#r4!si $in&al. Posisi

(#l#n(an$ m#m'an(! i!r#sis : s#hin$$a

hal!aran !rin# a%a( i(in$*a(*an %aa

malams#lama (irah 'arin$.

6. T#ra%i i!r#(i- a%a( is#'a'*an

ol#h *#hilan$an -airan (i'a+(i'a

'#rl#'ihan hi%o@ol#mia 5 m#s*i%!n##maasi(#s masih aa.

. Posisi (#l#n(an$ m#nin$*a(*an

4il(rasi $in&al an m#n!r!n*an %ro!*si

ADH s#hin$$a m#nin$*a(*an i!r#sis.

. P#nin$*a(an 6"= *$ m#n!n&!**an

*!ran$ l#'ih 6 L -airan. S#'ali*n)a

i!r#(i- a%a( m#n$a*i'a(*an -#%a(n)a

*#hilan$an%#r%inahan -airan an

*#hilan$an '#ra( 'aan.

=. R#(#nsi -airan '#rl#'ihan a%a(

imani4#s(asi*an ol#h %#m'#n!n$an

@#na an %#m'#n(!*an ##ma. E#ma

%#ri4#r m!lai %aa *a*ima(a *a*i a(a!

ar#a #%#n#n 5 an m#nin$*a( s#'a$ai

50



i%sn#a no-(!rnal %aro*sismal" 'a(!*

%#rsis(#n.

;. S#lii*i *#l!han i%sn#a #*(r#m (i'a+

(i'a" *#'!(!han !n(!* 'an$!n ari

!!*" s#nsasi s!li( '#rna4as" rasa %ani*

a(a! r!an$an s#m%i(.

?. Pan(a! TD an >P 'ila aa 5.

8<. Ka&i 'isin$ !s!s. >a(a( *#l!han

anor#*sia" m!al" is(#nsi a'om#n an

*ons(i%asi.

88. B#ri*an ma*anan )an$ m!ah

i-#rna. Porsi *#-il an s#rin$.

86. U*!r lin$*ar a'om#n s#s!ai

ini*asi.

8. Doron$ !n(!* m#n)a(a*an %#rasaan

s#h!'!n$an #n$an %#m'a(asan.

8. Pal%asi h#%a(om#$ali. >a(a(

*#l!han n)#ri a'om#n *!aran *anan

a(asn)#ri (#*an.

8=. >a(a( %#nin$*a(an l#(har$i"

hi%o(#nsi an *ram o(o(.

89. Kola'orasi %#m'#rian o'a( s#s!ai

ini*asi : i!r#(i-" (hia1i an (am'ahan

*ali!m .

87. P#m'a(asan na(ri!m s#s!aiini*asi.

8;. Kons!l #n$an ahli i#(.

8?. Kola'orasi 4o(o (ora*

*#$a$alan %alin$ '!r!*. E#ma %i((in$

aalah $am'aran s#-ara !m!m han)a

s#(#lah r#(#nsi s#i*i(n)a = *$ -airan.

P#nin$*a(an *on$#s(i @as-!lar

s#h!'!n$an s#n$an $a$al &an(!n$

*anan 5 s#-ara n)a(a m#n$a*i'a(*an

##ma &arin$an sis(#mi*.

9. P#m'#n(!*an ##ma" sir*!lasi

m#lam'a(" $an$$!an %#mas!*an n!(risi

an imo'ilisasi(irah 'arin$ lama

m#r!%a*an *!m%!lan s(r#ssor )an$

m#m%#n$ar!hi in(#$ri(as *!li( an

m#m#rl!*an in(#r@#nsi %#n$a,asan

*#(a(%#n-#$ahan.

7. K#l#'ihan @ol!m# -airan s#rin$

m#nim'!l*an *on$#s(i %ar!. G#&ala

##ma %ar! a%a( m#n!n&!*an $a$al

&an(!n$ *iri a*!(. G#&ala %#rna4asan %aa

$a$al &an(!n$ *anan is%n#a" 'a(!*"

or(o%n#a 5 a%a( (im'!l lam'a( (#(a%i

l#'ih s!li( m#m'ai*.

;. Da%a( m#n!n&!*an (#r&ain)a

*om%li*asi ##ma %ar!#m'oli 5 an

'#r'#a ari or(o%n#a an is%n#a

no-(!rnal %aro*sismal )an$ (#r&ai l#'ih-#%a( an m#m#rl!*an in(#r@#nsi s#$#ra.

?. Hi%#r(#nsi an %#nin$*a(an >P

m#n!n&!*an *#l#'ihan @ol!m# -airan an

a%a( m#n!n&!*an (#r&ain)a%#nin$*a(an

*on$#s(i %ar!" $a$al &an(!n$.

8<. Kon$#s(i @is-#ral (#r&ai %aa GK

lan&!( 5a%a( m#n$an$$! 4!n$si

51



$as(#rin(#s(inal.

88. P#n!r!nan mo(ili(as $as(#r a%a(

'#r#4#* m#r!$i*an %aa i$#s(i4 an

a'sor%si. Ma*an s#i*i( (a%i s#rin$

m#nin$*a(*an i$#s(im#n-#$ah

*#(ia*n)amanan a'om#n.

86. Paa $a$al &an(!n$ *anan lan&!("

-airam a%a( '#r%inah *#alam ar#a

%#ri(on#al" m#n)#'a'*an m#nin$*a(n)a

lin$*ar a'om#n asi(#s 5.

8. E*s%r#si %#rasaan masalah a%a(

m#n!r!n*an s(r#ss-#mas" )an$

m#n$#l!ar*an #n#r$i an a%a(

m#nim'!l*an %#rasaan l#mah.

8. P#rl!asan $a$al &an(!n$

m#nim'!l*an *on$#s(i @#na"

m#n)#'a'*an is(#nsi a'om#n"

%#m'#saran ha(i an n)#ri. Ini a*an

m#n$$an$$! 4!n$si ha(i an

m#n$$an$$! m#m%#r%an&an$

m#(a'olism# o'a(.

8=. Tana #4isi( *ali!m an na(ri!m

)an$ a%a( (#r&ai s#h!'!n$an #n$an

%#r%inahan -airan an (#ra%i i!r#(i-.

89. M#nin$*a(*an la&! aliran !rin# ana%a( m#n$ham'a( r#a'sor%si

na(ri!m*loria %aa (!'!l!s $in&al.

M#nin$*a(*an i!r#sis (an%a *#hilan$an

*ali!m '#rl#'ihan. M#n$$an(i *#hilan$an

*ali!m s#'a$ai #4#* sam%in$ (#ra%i

i!r#(i- )an$ a%a( m#m%#n$ar!hi 4!n$si

&an(!n$.

52



87. M#n!r!n*an air (o(al

(!'!hm#n-#$ah r#a*!m!lasi -airan

8;. P#rl! m#m'#ri*an i#( )an$ a%a(

i(#rima %asi#n )an$ m#m#n!hi

*#'!(!han *alori alam %#m'a(asan

-airan.

8?. M#n!n&!*an %#r!'ahan ini*asi4

%#nin$*a(an%#r'ai*an *on$#s(i %ar!.

-. R#si*o (in$$i *#r!sa*an %#r(!*aran $as '#rh!'!n$an #n$an %#r!'ahan

m#m'ran *a%il#r+al@#ol!s" -on(oh %#n$!m%!lan%#r%inahan -airan *#alamar#a in(#rs(i(ialal@#oli 5

T!&!an : Tia* (#r&ai *#r!sa*an %#r(!*aran $as

Kri(#ria hasil :

+ M#n#mons(rasi*an @#n(ilasi an o*si$#nasi a#*!a( %aa &arin$an

+ GDAo*sim#(ri alam r#n(an$ normal

+ '#'as $#&ala is(r#ss %#rna4asan

+ B#r%ar(isi%asi alam %ro$ram %#n$o'a(an alam 'a(as *#mam%!ansi(!asi.I$t"r:"$s- Ras-,$a#

8. A!s*!l(asi '!n)i na4as" -a(a(

*r#*#ls" m#n$i.

6. An&!r*an %asi#n 'a(!* #4#*(i4"

na4as alam.

. Doron$ %#r!'ahan %osisi s#rin$.

. P#r(ahan*an !!* i *!rsi(irah

'arin$ #n$an *#%ala (#m%a( (i!r (in$$i

6<+< #ra&a(" %osisi s#mi 4o,l#r.

So*on$ (an$an #n$an 'an(al.

=. Kola'orasi %#m#ri*saan GDA"

nai o*sim#(ri.

9. Kola'orasi %#m'#rian o*si$#n

(am'ahan s#s!ai ini*asi.

7. B#ri*an o'a( s#s!ai ini*asi :

8. M#n)a(a*an aan)a *on$#s(i

%ar!%#n$!m%!lan s#-r#( m#n!n&!*an

*#'!(!han !n(!* in(#r@#nsi lan&!(.

6. M#m'#rsih*an &alan na4as an

m#m!ah*an aliran o*si$#n.

. M#m'an(! m#n-#$ah a(#l#(a*sis an

%n#!monia.

. M#n!r!n*an *ons!msi

o*si$#n*#'!(!han an m#nin$*a(*an

in4lamasi %ar! ma*simal.

=. Hi%o*s#mia a%a( m#n&ai '#ra(

s#lama ##ma %ar!. P#r!'ahan

*om%#nsasi 'iasan)a aa %aa GK

*ronis.

53



Di!r#(i* an 'ron*oila(or 9. M#nin$*a(*an *ons#n(rasi o*si$#n

al@#olar )an$ a%a( m#m%#r'ai*i

m#n!r!n*an hi%o*s#mia &arin$an.

7. M#n!r!n*an *on$#sr(i al@#olar"

m#nin$*a(*an %#r(!*aran $as.

M#nin$*a(*an aliran o*si$#n #n$an

m#nila(asi &alan na4as *#-il an

m#n$#l!ar*an #4#* i!r#(i- rin$an !n(!*

m#n!r!n*an *on$#s(i %ar!.

. R#si*o (in$$i *#r!sa*an in(#$ri(as *!li( '#rh!'!n$an #n$an (irah 'arin$lama" ##ma" %#n!r!nan %#r4!si &arin$an.

T!&!an : Tia* (#r&ai *#r!sa*an in(#$ri(as *!li(

Kri(#ria hasil :

+ M#m%#r(ahan*an in(#$ri(as *!li(

+ M#n#mons(rasi*an %#rila*!(#*ni* m#n-#$ah *#r!sa*an *!li(

I$t"r:"$s- Ras-,$a#

8. Ka&i *!li( " -a(a( %#non&olan (!lan$"

aan)a ##ma" ar#a sir*!lasin)a

(#r$an$$!%i$m#n(asi" a(a!

*#$#m!*an*!r!s.

6. Pi&a( ar#a *#m#rahan a(a! )an$

m#m!(ih.

. U'ah %osisi s#rin$ i (#m%a(

(i!r*!rsi" 'an(! la(ihan r#n(an$ $#ra*

%asi4a*(i4.

. B#ri*an %#ra,a(an *!li( s#rin$ "

m#minimal*an #n$an

*#l#m'a'an#*s*r#si.

=. P#ri*sa s#%a(! *#s#m%i(ansanal

an !'ah s#s!ai *#'!(!han.

9. Hinari o'a( in(ram!s*!l#r.

7. Kola'orasi '#ri*an (#*anan

8. K!li( '#r#si*o *ar#na $an$$!an

sir*!lasi %#ri4#r" immo'ili(as 4isi* an

$an$$!an s(a(!s #mosi.

6. M#nin$*a(*an aliran arah"

m#minimal*an hi%o*sia &arin$an.

. M#m%#r'ai*i

sir*!lasim#n!r!n*an ,a*(! sa(! ar#a

)an$ m#n$$an$$! aliran arah.

. T#rlal! *#rin$ a(a! l#m'a'

m#r!sa* *!li( an m#m%#r-#%a(

*#r!sa*an.

=. E#ma #%#n#n a%a(

m#n)#'a'*an s#%a(! (#rlal! s#m%i("

m#nin$*a(*an r#si*o (#r(#*an an

*#r!sa*an *!li( %aa *a*i.

9. E#ma in(#rs(i(ial an $an$$!an

54



al(#rna(i4*as!r" *!li( om'a"

%#rlin!n$an si*!(!mi(.

sir*!lasi m#m%#rlam'a( a'sor%si o'a(

an %r#is%osisi !n(!* *#r!sa*an

*!li((#r&ain)a in4#*si.

7. M#n!r!n*an (#*anan %aa *!li("

a%a( m#m%#r'ai*i sir*!lasi.

#. K!ran$n)a %#n$#(ah!an m#n$#nai *onisi" %ro$ram %#n$o'a(an '#rh!'!n$an

#n$an *!ran$ %#mahaman*#salahan %#rs#%si (#n(an$ h!'!n$an 4!n$si

&an(!n$%#n)a*i($a$al.

T!&!an : P#n$#(ah!an *li#n '#r(am'ah (#n(an$ *onisi an %ro$ram

%#n$o'a(an.Kri(#ria hasil :

+ M#n$i#n(i4i*asi h!'!n$an (#ra%i %ro$ram %#n$o'a(an 5 !n(!*

m#n!r!n*an #%iso# '#r!lan$ an m#n-#$ah *om%li*asi

+ M#n)a(a*an (ana an $#&ala )an$ m#m#rl!*an in(#r@#nsi -#%a(

+ M#n$i#n(i4i*asi s(r#ss %ri'ai4a-(or r#si*o an '#'#ra%a (#*ni* !n(!*

m#nan$ani

+ M#la*!*an %#r!'ahan %ola hi!%%#rila*! )an$ %#rl!.I$t"r:"$s- Ras-,$a#

8. Dis*!si*an 4!n$si &an(!n$ normal.

M#li%!(i in4ormasi s#h!'!n$an #n$an

%#r'#aan ari 4!n$si normal. #las*an

%#r'#aan an(ra s#ran$an &an(!n$ an

GK

6. K!a(*an rasional %#n$o'a(an.

. Dis*!si*an %#n(in$n)a m#n&ai

s#a*(i4 m!n$*in (an%a m#n&ai *#l#lahan

an is(irsha( ian(ara a*(i@i(as.

. Dis*!si*an %#n(in$n)a %#m'a(asan

na(ri!m.

=. Dis*!si*an o'a(" (!&!an an #4#*

sam%in$. B#ri*an ins(r!*si s#-ara @#r'al

an (#r(!lis.

8. P#n$#(ah!an %ros#s %#n)a*i( an

hara%an a%a( m#m!ah*an *#(aa(an

%aa %ro$ram %#n$o'a(an.

6. P#mahaman %ro$ram" o'a( an

%#m'a(asan a%a( m#nin$*a(*an

*#r&asama !n(!* m#n$on(rol $#&ala.

. A*(i@i(as 4isi* '#rl#'ihan a%a(

'#rlan&!( m#n&ai m#l#mah*an &an(!n$"

#*sas#r'asi *#$a$alan.

. P#mas!**an i#( na(ri!m ia(as

$rhari a*an m#n$hasil*an #4#* i!r#(i-.

=. P#mahaman *#'!(!han (#ra%#!(i*

an %#n(in$n)a !%a)a %#la%oran #4#*

sam%in$ o'a( a%a( m#n-#$ah (#r&ain)a

55



9. An&!r*an ma*an i#( %aa %a$i

hari.

7. An&!r*an an la*!*an #mons(rasi

!lan$ *#mam%!an m#n$am'il an

m#n-a(a( nai harian an *a%an m#m'#ri

(ah! %#m'#ri %#ra,a(an.

;. #las*an an is*!si*an %#ran

%asi#n alam m#n$on(rol 4a-(or r#si*o

m#ro*o*5 an 4a-(or %#n-#(!s a(a!

%#m'#ra( i#( (in$$i $aram" (ia*

a*(i4(#rlal! a*(i4" (#r%a&an %aa s!a(!

#*s(r#m 5.

?. Bahas !lan$ (ana$#&ala )an$

m#m#rl!*an %#rha(ian m#i* -#%a("

-on(oh %#nin$*a(an *#l#lahan" 'a(!*"

h#mo%(isis" #mam.

8<. B#ri*an *#s#m%a(an %asi#n a(a!

oran$ (#r#*a( !n(!* m#nan)a*an"

m#nis*!si*an masalah an m#m'!a(

%#r!'ahan %ola hi!% )an$ %#rl!.

88. T#*an*an %#n(in$n)a m#la%or*an

(ana$#&ala (o*sisi(as i$i(alis" -on(oh

(#r&ain)a $an$$!an GI an %#n$liha(an"

%#r!'ahan 4r#*!#nsi naiirama"

m#m'!r!*n)a $a$al &an(!n$.86. R!&!* %aa s!m'#r i

mas)ara*a(*#lom%o* %#n!*!n$ s#s!ai

ini*asi.

*om%li*asi o'a(.

9. M#m'#ri*an ,a*(! a#*!a( !n(!*

#4#* o'a( s#'#l!m ,a*(! (i!r !n(!*

m#n-#$ah m#m'a(asi m#n$h#n(i*an

(i!r.

7. M#nin$*a(*an %#man(a!an

s#niri %aa *onisi#4#* o'a(. D#(#*si

ini %#r!'ahan m#m!n$*in*an

in(#r@#nsi (#%a( ,a*(! an m#n-#$ah

*om%li*asi s#%#r(i (o*sisi(as i$i(alis.

;. M#nam'ah %#n$#(ah!an an

m#m!n$*in*an %asi#n !n(!* m#m'!a(

*#%!(!san '#rasar*an in4ormasi

s#h!'!n$an #n$an *on(rol *onisi an

m#n-#$ah '#r!lan$*om%li*asi.

?. P#man(a!an s#niri

m#nin$*a(*an (an$$!n$ &a,a' %asi#n

alam %#m#liharaan *#s#ha(an an ala(

m#n-#$ah *om%li*asi" -on(oh ##ma

%ar!" %n#!monia.

8<. Konisi *ronis an

'#r!lan$m#n$!a(n)a *onisi GK

s#rin$ m#l#mah*an *#mam%!an *o%in$

an *a%asi(as !*!n$an %asi#n an

oran$ (#r#*a(" m#nim'!l*an #%r#si.88. P#n$#nalan ini (#r&ain)a

*om%li*asi an *#(#rli'a(an %#m'#ri

%#ra,a(an a%a( m#n-#$ah

(o*sisi(as%#ra,a(an i r!mah sa*i(.

86. Da%a( m#nam'ah*an 'an(!an

#n$an %#man(a!an

s#niri%#na(ala*sanaan i r!mah.

56



)!+ I'p#"'"$tas-

Im%l#m#n(asi %#la*sanaan %aa *li#n m#nin$i(is ila*sana*an s#s!ai #n$an

%#r#n-anaan %#ra,a(an )an$ m#li%!(i (ina*an+(ina*an )an$ (#lah ir#n-ana*an

ol#h %#ra,a( ma!%!n hasil *ola'orasi #n$an (im *#s#ha(an lainn)a s#r(a

m#m%#rha(i*an *onisi an *#aaan *li#n.

)!2 E:a#uas-

E@al!asi ila*!*an s#(#lah i'#ri*an (ina*an %#ra,a(an #n$an m#liha( r#s%on

*li#n" m#n$a-! %aa *ri(#ria #@al!asi" (aha% ini m#r!%a*an %ros#s )an$

m#n#n(!*an s#&a!ah mana (!&!an (#lah (#r-a%ai.

BAB IV

)! K"s-'pu#a$

Kariomio%a(i *#lainan 4!n$si o(o( &an(!n$ #n$an %#n)#'a' )an$

(ia* i*#(ah!i an '!*an ia*i'a(*an ol#h %#n)a*i( ar(#ri *oron#r"

*#lainan &an(!n$ 'a,aan -on$#ni(al5" hi%#r(#nsi a(a! %#n)a*i( *a(!%.

Kariomio%a(i )an$ s#-ara har4iah '#rar(i %#n)a*i( mio*ari!m" a(a! o(o(

&an(!n$" i(anai #n$an hilan$n)a *#mam%!an &an(!n$ !n(!* m#mom%a

arah an '#r#n)!( s#-ara normal. Konisi s#ma-am ini -#n#r!n$ m!lai

#n$an $#&ala rin$an" s#lan&!(n)a m#m'!r!* #n$an -#%a(. Paa *#aaan

57



ini (#r&ai *#r!sa*an a(a! $an$$!an mio*ari!m" s#hin$$a &an(!n$ (ia*

mam%! '#r*on(ra*si s#-ara normal.

Kariomio%a(i s#-ara $aris '#sar i *#lom%o**an m#n&ai ma-am:

85 Kariomio%a(i Hi%#r(ro%i*: Kariomio%a(i hi%#r(ro%i KH5

i*#nal &!$a s#'a$ai idiopati! ypertropi! su"aorti!

stenosis a(a! asymmetri! septal ypertropy i#4inisi*an

s#'a$ai hi%#r(ro%i ari mio*ari!m an %#ni%isan s#%(!m

in(#r@#n(ri*!lar i'anin$*an #n$an inin$ '#'as ari

@#n(ri*#l *iri asim#(ris s#%(al hi%#r(ro%i5 #n$an !*!ran

r!an$an @#n(ri*#l *iri )an$ normal a(a! s#i*i( m#n$#-il

(an%a aan)a hi%#r(#nsi ma!%!n s(#nosis aor(a.

65 *ariomio%a(i R#s(ri*(i4: Kara*(#ris(i* !(ama ari

*ariomio%a(i r#s(ri*(i4 KR5 aalah 4!n$si )an$ a'normal

ari ias(oli*" )an$ is#'a'*an *#*a*!an inin$ @#n(ri*#l

an ham'a(an %#n$isian @#n(ri*#l s#hin$$a m#n!r!nn)a

@ol!m# ias(oli*" nam!n *#(#'alan mio*ari!m @#n(ri*#l

*iri normal an 4!n$si ias(oli* &!$a normal" 'iasan)a

s#*!n#r i*ar#na*an in4ilrasi ari mio*ari!m.

5 Kariomio%a(o Dila(asi: Kariomio%a(i ila(asi KD5

m#m%!n)ai *ara*(#ris(i* %#nin$*a(an @ol!m# sis(oli* an

ias(oli* @#n(ri*#l *iri )an$ i(anai #n$an (#rila(asin)a

*#!a @#n(ri*#l (#r!(ama @#n(ri*#l )an$ *iri" &aran$ )an$

*anan" )an$ '#ra*i'a( m#n!r!nn)a *on(ra*(ili(as

mio*ari!m s#hin$$a m#n!r!n*an -!rah &an(!n$

)!& Sara$

S#'a$ai %#ra,a( har!s s#lal! si$a% alam %#nan$anan

%#n)a*i( m)o-ari (i s %#ra an$an o(o( &an(!n$5 *a r#n a a* an

m#n&ai 4a(al &i*a (#rlam'a( m#nan$anann)a. S#lain i(! %#ra,a(

&!$a m#m'#ri h#al(h #!-a(ion *#%aa *li#n an *#l!ar$a a$ar m#r#*a

4aham #n$an m)o-ari(is an 'a$aimana %#n$o'a(ann)a.

58



Daftar Pustaka

/)nn# " Bra!n,al E. Cardiomyopaty and myo!arditis. Dalam : Kas%#r DL #(

al. Harrison0s Prin-i%l#s o4 In(#rnal M#i-in# 89(h Ei(ion. Th# M-Gra,+Hill

>om%ani#s" In-. Uni(# S(a(#s o4 Am#ri-a. 6<<=.

Ta)lor RB. 6<<=. Taylors !ardio#as!ular diseases a and"ook . S%rin$#r S-i#n-#"

In-. Uni(# S(a(#s o4 Am#ri-a.

J#rri JJ. 6<<7. Pra!ti!al *uide to te Care o$ te Medi!al Patient +t ed . Mos')"

An Im%rin( o4 Els#@i#r. Phila#l%hia.

59



So4ro ASM. 6<<9, Aspek *enetik Kardiomiopati alam sim%osi!m A%o%(osis

>harmin$ (o D#a(h. Ho(#l 'oro'!!r" a*ar(a.

Sir#$ar AA. 6<<=. Kariomio%a(i Prim#r %aa Ana*. Ba$ian Ilm! K#s#ha(an

Ana* Ja*!l(as K#o*(#ran Uni@#rsi(as S!ma(#ra U(ara. onlin#5"

h((%:li'rar).!s!.a-.io,nloa4*ana*+a'!llah.%4 " ia*s#s ; a$!s(!s 6<<;5.

G!na,an >A. 6<<. Kariomio%a(i Hi%#r(ro4i*. >#rmin D!nia K#o*(#ran. No.

8 hal 8?.

/aha' AS. 6<<. P#n)a*i( an(!n$ Ana* #isi . EG>: a*ar(a

h((%:!s#'rains.,or%r#ss.-om6<<;<?86*ariomio%a(i

http://library.usu.ac.id/download/fk/anak-abdullah.pdf


http://usebrains.wordpress.com/2008/09/12/kardiomiopati/


http://usebrains.wordpress.com/2008/09/12/kardiomiopati/

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