Cardiovaskuler Disorders

Asuhan Keperawatan Pada Klien

Dengan
Penyakit Jantung Koroner

Cardiovaskuler System

Endocrine
stem

Deskripsi
Merupakan kondisi patologis pada
arteri koroner yang ditandai dengan
penimbunan abnormal lipid dan
jaringan fibrosa pada dinding
vaskuler yang mengakibatkan
perubahan struktur dan fungsi arteri
serta mengakibatkan penurunan
aliran darah ke jantung.

Etiologi
Kelainan metabolisme lipid
Koagulasi darah
Kelainan biofisika serta biokimia
pada dinding arteri.

Patofisiologi
The cardiovascular continuum of events
Myocardial
Ischemia

Coronarry Artery Disease

/ CAD

plaque
Atherosclerosis

Risk Factors
( DYSLIPIDEMIA , BP, DM,
Insulin Resistance, Platelets,
Fibrinogen, etc)

Ischemia = oxigen supply

and demand imbalance
Adapted from
Dzau et al. Am Heart J. 1991;121:1244-1263

PLATELET
AGGREGATION

COAGULATION

PLAQUE RUPTURE

FIBRIN
FORMATION

The cardiovascular continuum of events

Coronary
Thrombosis
Myocardial
Ischemia

CAD

Atherosclerosis

Risk Factors
( DYSLIPIDEMIA , BP, DM,
Insulin Resistance, Platelets,
Fibrinogen, etc)

Adapted from
Dzau et al. Am Heart J. 1991;121:1244-1263

The cardiovascular continuum of events

ACS / acute
coronary disease
Coronary
Thrombosis
Myocardial
Ischemia

CAD

Atherosclerosis

Risk Factors
( DYSLIPIDEMIA , BP, DM,
Insulin Resistance, Platelets,
Fibrinogen, etc)

Adapted from
Dzau et al. Am Heart J. 1991;121:1244-1263

KOMPLIKASI :
ACS
Coronary
Thrombosis

Myocardial
Ischemia

CAD

Atherosclerosis

Risk Factors
( DYSLIPIDEMIA , BP, DM,
Insulin Resistance, Platelets,
Fibrinogen, etc)

Arrhythmia and
Loss of Muscle

Remodeling

Ventricular
Dilatation
Congestive
Heart Failure
End-stage
Heart Disease
Adapted from
Dzau et al. Am Heart J. 1991;121:1244-1263

Manifestasi Klinis
Nyeri dada
Infark miokardium
Perubahan pola EKG
Aneurisma ventrikel
Disritmia
Suddent death

Pengkajian
Faktor Resiko

Modifiable
Merokok
Hipertensi
Kolestrerol darah
tinggi
Hiperglikemia
Stress
Non modifiable
genetik

Keluhan Nyeri dada

Cardiac Catheterization
Cardiac catheterization provides
the most definitive source for
diagnosis
Cardiac catheterization shows
the presence of atherosclerotic
lesions

Blood Lipid Levels

Blood lipid levels may be
elevated
Cholesterol lowering
medications may be prescribed
to reduce the development of
atherosclerotic plaques

Surgical Procedures
Laser Angioplasty
Atherectomy to remove the plaque from
the artery
Vascular stent to prevent the artery from
closing and prevent restenosis

Medication
Nitrat
Calcium channel blocker to dilate
coronary artery and reduce
vasospasm
Cholesterol lowering medications
-Blocker to reduce BP in individuals
who are hypertensive

Interventions
Instruct the client regarding the
purpose of diag- nostic medical and
surgical procedures and pre and post
procedure expectations
Assist the client to identity risk factor
that can be modified
Assist the client set goals to promote
lifestyle changes that will reduce the
impact of risk factors
Assist the client to identify barrier to
compliance with the therapeutic plan
and to identify methods to over coma

Instruct the client regarding a low

calorie, low sodium, low cholesterol,
and low fat diet, with an increase in
dietary fiber
Stress to the client that dietary
changes are not temporary and must
be maintained for life; instruct the
client regarding prescribe medications
Provide community resources to the
client regarding exercise, smoking
reduction, and stress reduction as
appropriate