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D
NON-ST ELEVATION
MYOCARDIAL INFARCTION
PRESENTED BY :
QUINY KURNIA
C 1 11 1 1 1 7 1
SUPERVISOR :
DR.PENDRIK TANDEAN, SP.PD-KKV, FINASIM
D E PAR T M E N T O F C A R D I O L O G Y AN D VAS C U L A R
MEDICINE
M E D I C A L F AC U L T Y O F H A S A N U D D I N U N I V E R S I T Y
M AK AS S AR
2016
PATIENT IDENTITY
Name : Mr.N
Age : 33 y.o
Address : Makassar
MR : 740326
Date of Admission : January 8th 2016
HISTORY TAKING
General Status
Moderate illness / well nourished/ Composmentis
Weight: 55 kg
Height : 165
BMI : 20.2 kg/m2
Vital Status
Blood pressure :150/90 mmHg
Heart rate : 92 bpm
Respiratory rate : 26 rpm
Temperature : 36,5oC
PHYSICAL EXAMINATION
Cor :
Inspection : ictus cordis not visible
Palpation : ictus cordis not palpable, thrill (-)
Percussion :
Upper border 2nd ICS sinistra
Right border 4th ICS linea parasternalis dextra
Left border 5th ICS linea midclavicularis sinistra
Auscultation : heart sound I/II pure, regular, murmur (-)
PHYSICAL EXAMINATION
Abdomen :
Inspection : flat, follows breath movement
Auscultation : peristaltic (+), normal
Palpation : liver and spleen not palpable
Percussion : tympani
Extremities :
Edema (-)
ELECTROCARDIOGRAPHY
Captopril 12.5mg/8jam/oral
Simvastatin 40 mg/24 jam/oral
Alprazolam 0,5mg/24jam/oral
Laxadyne syr 10ml/24jam/oral
DISCUSSION
INTRODUCTION
Acute coronary
syndromes (ACS)
is a term for situations
where the blood supplied
to the heart muscle is
suddenly blocked.
described as a group of
conditions resulting from
acute myocardial
ischemia (insufficient
blood flow to heart
muscle)
PATOPHYSIOLOGY
WHO DIAGNOSTIC CRITERIA
Diagnostic
ECG changes
Non-
Modifiable
Modifiable
Smoking
Gender & Age
Hypertension Men > 45 years old
Diabetes mellitus Women > 55 years old
Hypercholesterolemia
Family history
Obesity Heart disease in biological
brother or father > 55 years
Psychosocial stress old
Heart disease in biological
Lack of physical activity sister or mother > 65 years old
CARDIAC BIOMARKERS
GOAL OF TREATMENT
Hemodynamic
Relieve pain
stabilization