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7/24/2019 kuliah Kardiovaskuler 1
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Pemeriksaan Laboratoriumpada
penyakit Cardiovaskuler
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CONGENITAL HEART DIEAE
PULMONARY STENOSIS
COACTATION OF THE AORTAATRIAL SEPTAL DEFECT
VENTRICULAR SEPTAL DEFECT
PATENT DUCYUS ARTERIOSUS
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!AL!"LAR HEART DIEAE
MITRAL STENOSIS
MITRAL REGURGITATIONAORTIC STENOSIS
AORTIC REGURGITATION
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#CORONAR$ ARTER$ DIEAE%
Angina pektoris stai!
Angina pektoris ti"ak stai! In#ark $iokar" ak%t
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DIT"R&ANCE O' RATE ( RH$T)
SUPRAVENTICULAR ARRHYTMIAS
VENTRICULAR ARRHYTMIAS
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CARDIAC FAILLURE
ACUTE PULMONARY EDEMAMYOCARDITIS & CARDIOMYOPATHIES
RHEUMATIC HEART DISEASE
DISEASE OF THE PERICARDIUM
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!AC"LAR DIEAE
DISEASES OF THE AORTA
ATHEROSCLEROTIC OCCLUSIVEDISEASE
VENOUS DISEASES
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At*eros+lerosis
Penea!an "i !apisan
s%inti$a en"ote!
Men'%$at "an
$en%r%nkan a!iran
"ara(
http://www.doereport.com/enlargeexhibit.php?ID=71947/24/2019 kuliah Kardiovaskuler 1
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Pe$eriksaan !aoratori%$) Men*ari #aktor risiko CAD "an CVD
) Ti"ak $enent%kan "iagnosis
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Pro,il lipid
a$an risiko
+o!, Tota! - .// 0 .1/ +o!, LDL - 23/ 0 24/
+o!, HDL 0 5/ - 36
Trig!iseri"a - .// 0 1//
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+o!, Tota! - .// "iinginkan
.// ) .34 atas tinggi
0 .1/ tinggi
+o!, LDL - 2// opti$a!
2// ) 2.4 $en"ekati opti$a!
23/ ) 264 atas tinggi
25/ ) 274 tinggi
0 24/ sangat tinggi
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+o!, HDL - 1/ ren"a(
0 5/ tinggi
TG - 26/ nor$a!
26/ ) 244 atas tinggi
.// ) .14 tinggi0 6// sangat tinggi
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Lp #a%
) Apo ) A
) LDL !ike protein *ontaining Apo ) 8 2//
Men'er%pai p!as$inogen
Dapat $eng(a$at #irino!isis
Meningkatat(eros*!erosis9 P:+9 stroke
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Homo+ystein
Me$i*% at(eros*!erosis;)
Mengin"%ksi r%sakn'a en"ote!) Sti$%!asi oksi"asi LDL
) pro!i#erasi
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ACA)
Meningkatkan sintesis PAF Firinogen
) +a"ar tinggitro$osis
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Peny- .antun/ koroner
Pen'%$atan seagian ata% $en'e!%r%(
"ari sat% ata% !ei( pe$, Dara( koronerata% *aang>*aangn'a,
Pen'%$atan 0 ?6@ !%$en arteria
iske$ia "an Ak%t $iokar"ia! in#ark AMIB
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A)I
Pato#isio!ogi)
At(erosk!erosis
iske$ia
in#ark
+riteria HO) Gea!a k!inis
) E+G
) Tes !a, En'$=petan"a ant%ng
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Petanda 0antun/
En'$e)
CP+9 C+M89 LDHMiog!oin
Troponin
Hs>CRP
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Miog!oinMiog!oin)
+o$ponen protein
oksigenasi) 8M ke*i!$%"a( "i!epas ke sirk%!asi
) Sensiti
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S%>%nit C+;S%>%nit C+;)
8) M
Iso#or$;
) C+>88
) C+>MM) C+>M8C+>M8 ./@ "i otot ant%ng./@ "i otot ant%ng
sensiti
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TroponinTroponin)
Unit kontrakti! otot serat !intangUnit kontrakti! otot serat !intang Fi!a$en tipisFi!a$en tipis
) +o$p!eks troponin
Troponin C 27k"Bikat Ca & inisiasi kontraksi,
Troponin T 349?k"Bikat ko$p!,Troptropo$iosin,
Troponin I ..96k"B(a$at kontraksi saat istira(at,
Fi!a$en tea!Fi!a$en tea!
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Miog!oin C+>M8 *Tn,I *Tn,T
8M k"B 2?97 7. ..96 349?
Meningkat .>1 a$ 1>5 a$ 3>1 a$ 3>1 a$
Peak 4>2. a$ 2.>.1 a$ 2.>25 a$ .1>17a$
Ret%rn .1>35 a$ .1>?. a$ 6>4 (ari2/>21
(ari
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Hs>CRP) Ak%t #ase reaktan
) In#!a$asi siste$ik "i(%%ngkan "ng r%pt%r p!ak kea"ianak%t koroner
LDH) Mengkata!isis re2.
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Peny- .antun/ reumatik
+er%sakan kat% ant%ng akiat kar"itis re%$atik
ak%t 'ang er%!ang>%!ang,
De$a$ re%$atik ak%t) .>3 $ingg% Post in#eksi Streptococcus hemolyticus grup A.
) Reaksi tipe a%toi$$%n ko!agen 26 ta(%n
) In#!a$asi "i sen"i9 ant%ng "an k%!it,
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Pemeriksaan laboratorium P.R
Ti"ak a"a tes spesi#ik
Tes (an'a $e$%ktikan) a"an'a in#eksi Strepto*o**%s 'g ar%
) "an proses in#!a$asi er!angs%ng
LED9 CRP9 !e%kosit9 #irinogen "an a!#a .
g!o%!in $eningkat
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Tes $en%n%kkan in#eksi ar%)
8iakan a(an "ari sap tenggorokan
Strepto*o**%s gr%p A positi#
Tes $en%n%kkan in#eksi see!%$n'a) Titer anti strepto!isin O ASTOB ser%$ $eningkat
) Titer anti "eoksirio n%k!ease DNAseB 8$eningkat
) Titer strepto!isin $eningkat
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Endokarditis
In#eksi pa"a en"okar"i%$ ata% kat%p ant%ng,
Pen'ea;) 8akteri an'akB
) :a$%r ata% ri*ketsia
Laoratori%$) LEDin#!a$asi
) Le%kosit N="engan ga$aran netro#i!ia 7/>76@
) Ane$ia nor$ositik
) Ga$a g!o%!in in#eksi kronik
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Perikarditis
Pera"angan perikar" parieta!9
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Perikar"itis kronik) E#%si perikar"ia! kronik
Vir%s9 akteri9 t*9 SLE9 post in#ark9 tra%$a9 ostr%ksi$etastase9"!!,
) E#%si konstrikti# Ra"iasi9 neop!as$a9 t*
) +onstrikti#
8akteri9 t*9 a$%r9
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Perbedaan transudat ( eksudatPerbedaan transudat ( eksudat
+eker%(an erni( ker%( 8: - 29/26 0 29/26 Prot,tota! - 3 g="L 0 3 g="L Ratio prot - /96 0 /96 LDH - .// IU 0 .// IU Ratio LDH -/95 0 /95 :$!, Se! - 2///=%L 0 2///=%L 8ek%an ti"ak a"a a"a +o!estero! - 66 $g="L 0 66 $g="L
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oal untuk tu/as tamba*an
:e!askan "engan tepat se$%a para$eter
'ang an"a keta(%i9 para$eter %nt%k "eteksi
ker%sakan otot ant%ng "ari sintesis sa$pai
ere"ar "i sirk%!asi siste$ik,