penyakit vaskuler.pptx

8/10/2019 penyakit vaskuler.pptx

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PENYAKIT VASKULER

CECEP E.K.



Sirkulasi darah



PEMBULUH DARAHARTERI DAN VENADinding !"al # !rda$a % la$isan& '!'"a(a darah $ada

!kanan inggiLa$isan luar 'r$ )aringan k*n!k i+ +i"r*us '!n,!gahru$ urLa$isan !ngah- * * $*l*s # )aringan k*n!k i+ g !las is '!'!lihara !kanan darahLa$isan dala'- !$i !k s/ua'*us 0!nd* !liu'1 g sangahalus un uk '!n,!gah $!'"!kuan darahDi$!ngaruhi *l!h si'$a isV!na dan 2!n*l! '!'"a(a darah dari ka$il!r



Ka$il!r

Ka$il!r '!'"a(a darah dari ar !ri*lak! 2!na dis!luruh )aringan k!,ualikar ilag*& !$id!r'is& l!nsa dank*rn!aT!kanan darah %34%5 ''HgT!r)adi $!r ukaran gas& na riu'&$r*duk sa'$ah an ara darah dan

)aringan



6 anda $!n ai 2askul!r $!ri+!r

N !riP*ikil* !r'ia

Tdk ada d!n uPu,aParal sis

Par!s !sia 0'!nurun a s!nsasi1



Arteriosclerosis /Atherosclerosis

• Pengerasan pada arteri• dapat terjadi pada hampir

semua artery dalam tubuh.• Jika arteri tertutup maka

pompa jantung gagal

sirkulasi menurun termasukdalam jatung sendiri



High "l**d ,h*l!s !r*lHigh "l**d $r!ssur!

S'*king7"!siLa,k *+ $h si,ala, i2i

Causes



Risk Factors

Un,*n r*lla"l!Un,*n r*lla"l!• Sex• Hereditary• Race• Age

ControllableControllable• High blood

pressure

• High bloodcholesterol

• Smoking• Physical activity• Obesity• Diabetes• Stress and anger



Other Tests Include...• Blood tests used to evaluate kidney and

thyroid !unction as "ell as to checkcholesterol levels and the presence o!

anemia#• Chest $%ray sho"s the si&e o! your heart

and "hether there is 'uid build up aroundthe heart and lungs#

• (chocardiogram sho"s a graphic outline o!the heart)s movement

• (*ection !raction +(,- determines ho" "ellyour heart pumps "ith each beat#



Man $!*$l! ar! a"l! * 'anag!,*r*nar ar !r dis!as! (i h li+!s l!,hang!s and '!di,a i*ns.

7 h!r $!*$l! (i h s!2!r! ,*r*nar

ar !r dis!as! 'a n!!d angi*$las*r surg!r .

Treatment



Treatment (continued)

.- Stenting• a stent is introduced into a blood vessel on a balloon

catheter and advanced into the blocked area of the artery• the balloon is then inflated and causes the stent to expand

until it fits the inner wall of the vessel, conforming tocontours as needed

• the balloon is then deflated and drawn back • The stent stays in place permanently, holding the vessel

open and improving the flow of blood.



Treatment(continued)/- Angioplasty

• a balloon catheter is passed through the guiding catheter to thearea near the narrowing. A guide wire inside the balloon catheteris then advanced through the artery until the tip is beyond thenarrowing.

• the angioplasty catheter is moved over the guide wire until the balloon is within the narrowed segment.

• balloon is inflated, compressing the plaque against the arterywall

• once plaque has been compressed and the artery has beensufficiently opened, the balloon catheter will be deflated andremoved.



Treatment (continued)

! "ypass surgery

• healthy blood vessel is removed from leg, arm or chest• blood vessel is used to create new blood flow path in your heart•

the #bypass graft$ enables blood to reach your heart by flowingaround %bypassing!the blocked portionof the diseasedartery. The increased

blood flow reducesangina and the riskof heart attack.



P r e v e n t i o n

• Get regular medical checkups.• Control your blood pressure.• Check your cholesterol.• Don’t smoke.• Exercise regularly.• Maintain a healthy weight.• Eat a heart-healthy diet.• Manage stress.



THROMBOANGIITIS OBLITERANS(BUERGER’S DISEASE)

Bu!rg!r8s dis!as! di andai d!ngan adan a$!radangan "!rulang $ada la$isanin !r'!di! ar !ri s!r a 2!na k!,il $ada"agian "a(ah u"uh )uga !ks r!'i as a as

a$i )arang.M!ngaki"a kan $!'"!n ukan r*'"us dan*klusi $!'"uluh darahBu!rg!r8s dis!as! di akini s!"agai $!n aki

au *i''un! ang '!ngaki"a kan *klusi$ada "agian dis alP!n !"a" idak dik! ahui ! a$i di akinikar!na 2askuli is au *i'un!



S!ring !r)adi $ada laki4laki 934%5 ahundan s!'ua sukuT!rda$a "uk i "ah(a $!r*k*k "!ra

'!n)adi $!n !"a" a au +ak *r ang'!'$!r"!raU'u'n a !rda$a $ada !ks r!'i as"a(ah a$i !ks r!'i as a as$un "isa

!rk!naBiasan a "ila !ral dan si'! ris d!ngan l!si+*,al



Clinical Mani !stationsN !ri '!ru$akan ang u a'aPasi!n '!ng!luh kra' kaki !ru a'a

!la$ak kaki ang '!l!ngkung s! !lah

la ihanN !ri "!rkurang "ila is irahaKadang n !ri !r"akar di$!r"!ra *l!hgangguan !'*si& nik* in a au dingin

S!nsi i+i as !rhada$ dingin $ada i$!ra naund di !'ukan :;5 $asi!n dan s!ring!rk!na $ada angan



Tanda +isik !rdiri a as '!rah 0$!ru"ahan(arna "iru k!'!rahan1 $ada kaki dan idakadan a nadi kaki a$i nadi $*$li !al dan

+!'*ral 'asih adaNadi ulnar dan radial "!rkurang; idak adaPar!s !sia 'ungkin adaP!ru"ahan (arna da$a "!rk!'"ang'!n)adi luka dan ganggr!n



Ass!ss"!nt an# Dia$nosticFin#in$s

T!kanan darahDu$l!< ul ras*n*gra$h un uk'!liha $a !n, $!'"uluh darah$r*<i'al dan 2isualisasi luasn a$!n aki $ada "agian dis alC*n ras angi*gra$h



Mana$!"!ntSa'a s!$!r i r!a '!n un uka h!r*s,l!r*sisTu)uan u a'a un uk '!ningka kan

sirkulasi& '!n,!gah "!r a'"ahn a$!n aki & dan '!lindungi !ks r!'i as darirau'a dan in+!ksi

Tr!a '!n $ada luka dan ganggr!n ai u'!'ini'alkan in+!ksi dan d!"rid!'!n

)aringan n!kr*sisH!n ikan '!r*k*k



=!)ala s!ring "!rkurang d!ngan'!ngh!n ikan r*k*kVas*dila *r )arang dir!s!$kan kar!na'!n !"a"kan dila asi $ada $!'"uluhn*r'al dan '!'$!r"uruk k!adaanBl*k si'$a ! ik r!gi*nal a au

gangli*n!, *' "!rguna un uk'!nghasilkan 2as*dila asi dan'!ningka kan aliran darah



SUR=ICAL MANA=EMENT 7>C7MPLICATI7NS

?ika ganggr!n "!rk!'"ang'!ngaki"a kan *klusi ar !ri $ada kakidilakukan a'$u asiIndikasi a'$u asi adalah ganggr!n"!ra & )ika ar!a in+!ksi "asah& n !ri$ada saa is iraha ang h!"a & s!$sis



AORTIC ANEUR%SMAdan a kan ung a au dila asi $ada i ikl!'ah dinding a*r aB!n uk ang "iasan a adalah sakular a au

+usi+*r'Sakular 'un,ul $ada sa u sisi $!'"uluh?ika s!luruh s!g'!n ar !ri dila asi dis!"u+usi+*r'

An!uris'a '!ru$akan k*ndisi s!riuskar!na "ila ru$ ur '!n !"a"kan$!rdarahan dan k!'a ian



THORACIC AORTIC ANEUR%SM

Kira4kira @5 dari s!luruh h*ra,i,a*r i, an!ur s' dis!"a"kan *l!ha h!r*s,l!r*sis.K!"an akan laki4laki an ara 34 3

ahunKira4kira :;% $asi!n h*ra,i,an!ur s's '!ninggal kar!na ru$ ur!



Clinical Mani !stationsK!"an akan as '$ *'a i,.N !ri "iasan a k*ns an $ada saa "!r"aring=!)ala ang '!n,*l*k adalah s!sak aki"a

!kanan kan ung $ada ra,h!a& "r*nkusu a'a a au $aru4$aru i u s!ndiriBa uk& s!rak& s rid*r& k!l!'ahan& hilangsuara 0a$h*nia1 aki"a $!n!kanan !rhada$sara$ laring!al& dan dis$hagia



M!#ical Mana$!"!ntPada k!"an akan kasus dilakukan $!'"!dahanTindakan u'u' s!$!r i $!'!riksan TD dan k*r!ksi+ak *r r!sik*T!kanan sis *lik di$!r ahankan an ara :33 :93

''Hg d!ngan *"a an i hi$!r !nsi 0h drala in!h dr*,hl*rid! FH drala in!G& !s'*l*l h dr*,hl*rid!FBr!2i"l*,G a au "! a4"l*,k!r s!$!r i a !n*l*lFT!n*r'inG a au i'*l*l 'al!a ! FTi'*$ i,G1. Un uk'!ngurangi ,ardia, ,*n ra, ili 0$r*$ran*l*l1Tu)uan $!'"!dahan un uk '!'$!r"aiki an!uris'ad!ngan '!lakukan 2as,ular gra+



ARTERIAL EMBOLISMAND ARTERIAL THROMBOSIS

Su'"a an 2askul!r aku '!ru$akan$!n !"a" !'"*lus a au a,u ! hr*'"*sis.7klusi ar !ri aku da$a !r)adi kar!na

in)ur ia r*g!nik s!la' $!'asangan ,a ! !rin2asi+& $!'asangan s !n a au in ra4a*r i,"all**n $u'$P!n !"a" lain- rau'a 0+rak ur1& luka

!'"us ang '!rusak in i'a ar !ri



Clinical Mani !stations

T!rgan ung ukuran dari !'"*lusDa'$ak ang u a'a adalah

!rh!n in a aliran darah $ada "agiandis alVas*s$as'! s!kund!r da$a"!rk*n ri"usi !rhada$ is,h!'ia

T!'$a ang $aling s!ring di !'ukan. C!r!"ral& '!s!n !ri,& r!nal& dan,*r*nar ar !ri!s ar!



Ass!ss"!nt an# Dia$nosticFin#in$s

E,h*,ardi*gra$h Dua4di'!nsi*nala au rans!s*$hag!al!,h*,ardi*gra$h & ,h!s <4ra & and!l!, r*,ardi*gra$hDu$l!< and D*$$l!r ul ras*n*gra$hda$a '!n!n ukan adan a dan

luasn a $!n !"a" a h!r*s,l!r*sis&Ar !ri*gra$h )uga dilakukan



M!#ical Mana$!"!nt

Tindakan !rgan ung $!n !"a"P!ng!l*laan !'"*li aku d!ngan$!'"!dahanH!$arin "*lus 5333 :3333 uni IV



SUR=ICAL MANA=EMENT

E'!rg!n, !'"*l!, *'Ar !rial !'"*li "iasan a di r!a '!nd!ngan ,ara '!'asukan ka ! !r!'"*l!k *'i



PHARMAC7L7=IC THERAPYTr!a '!n d!ngan an ik*agulan dan h!$arin un uk'!n,!gah hr*'"us7"a r*'"*li ik ar !ri '!'"an u '!'!,ahkan!'"*lus>i"rin4s$!,i+i, hr*'"*l i, '!di,a i*ns 0 issu!$las'in*g!n a, i2a *r F 4PA& al !$las!& A, i2as!G dansingl!4,hain ur*kinas!4 $! $las'in*g!n a, i2a *rFs,u4PA& $r*4ur*kinas!G1Thr*'"*l i, '!di,a i*ns adalah r! !$las! 0r4PA&R! a2as!1& !n!, !$las! 0TNKas!1& dans a$h l*kinas!.K*n raidikasi in !rnal "l!!ding& CVA 0"rain a a,k&s r*k!1& 'a)*r surg!r & un,*n r*ll!d h $!r !nsi*n&dan k!ha'ilan.



RA%NAUD’S DISEASEM!ru$akan 2as*k*ns riksi ar !ri s!,arain !r'i !n aki"a dari dingin n !ri dan$u,a $ada )ari a au kuku.

P!n !"a" idak dik! ahui 'ungkin aki"agangguan sis !' i''un*l*gi=!)ala $r*duksi $anas "asal dan "ahkan

urunE$is*d! dirangsang *l!h +ak *r !'*si dan

)uga *l!h s!nsi i+i i ang idak "iasa !rha$dingin



Biasa !r)adi $ada (ani a :6 3 ahundan 'un,ul $ada 'usi' dinginIs ilah Raynaud’s phenomenon digunakanun uk '!ngga'"arkan k*ndisi !$is*d!in !r'in !n 2as*k*ns riki dari ar !ri k!,ilkaki dan angan ang '!n !"a"kan$!ru"ahan (arna dan suhuU'u'n a unila !ral dan '!ng!nai sa ua au dua )ariB!rkai an d!ngan $!n aki sis !'ik ang'!ndasari s!$!r i s,l!r*d!r'a& s s !'i,lu$us !r h!'a *sus& rh!u'a *id



Clinical Mani !stations

Pu,a all*r & , an*sisKarak !ris ik $!ru"ahan (arna dariRa naud8s $h!n*'!n*n diga'"arkans!$!r i $u ih& "iru dan '!rahNu'"n!ss& g!li& dan n !ri !r"akarC!nd!rung "ila !ral dan si'! rik



M!#ical Mana$!"!nt

Hindari rangsangan "!nda dinginCal,iu' ,hann!l "l*,k!rs- ni+!di$in!0Pr*,ardia& Adala 1 !+!k i+'!ngurangi g!)alaS '$a h!, *'



L%M1HANGITISL '$hangi is '!ru$akan $!radangan $adasaluran li'+! k!"an akan dari +*kus in+!ksi"iasan a h!'*l i, Streptococcus.

li'+! ')d "!ngkak d$ )uga n!kr* ik dan!r"!n ukn a a"s!s 0su$$ura i2!l '$had!ni is1. Paling s!ring- $aha& aksila a auda!rah s!r2ikals *,king s!"aikn a di$akai $ada !ks r!'i as

ang !rk!na s!la'a "!"!ra$a "ulan un uk'!n,!gah !d!'a )angka $an)ang



L%M1HEDEMA ANDELE1HANTIASIS

L '$h!d!'as ar! ,lassi+i!d as $ri'ar 0,*ng!ni al 'al+*r'a i*ns1 *rs!,*ndar 0a,/uir!d *"s ru, i*ns1. Tissu! s(!lling *,,urs in h!!< r!'i i!s "!,aus! *+ an in,r!as!d /uan i *+ l '$h ha r!sul s +r*'*"s ru, i*n *+ l '$ha i, 2!ss!ls. I is !s$!,iall 'ark!d (h!n h!!< r!'i is in a d!$!nd!n $*si i*n. Ini iall & h! !d!'a is s*+ & $i ing&and r!li!2!d " r!a '!n . As h! ,*ndi i*n $r*gr!ss!s& h! !d!'a"!,*'!s +ir'& n*n$i ing& and unr!s$*nsi2! * r!a '!n .Th! '*s ,*''*n $! is ,*ng!ni al l '$h!d!'a 0l '$h!d!'a$ra!,*<1& (hi,h is ,aus!d " h $*$lasia *+ h! l '$ha i, s s !' *+ h!l*(!r !< r!'i . This dis*rd!r is usuall s!!n in (*'!n and +irsa$$!ars "! (!!n ag!s :5 and 95. Th! *"s ru, i*n 'a "! in h! l '$hn*d!s and h! l '$ha i, 2!ss!ls. S*'! i'!s& i is s!!n in h! ar' a+ !r

an a<illar n*d! diss!, i*n 0!g& +*r "r!as ,an,!r1 and in h! l!g inass*,ia i*n (i h 2ari,*s! 2!ins *r ,hr*ni, hr*'"*$hl!"i is. In h!la !r ,as!& h! l '$ha i, *"s ru, i*n usuall is ,aus!d " ,hr*ni,l '$hangi is.



M!#ical Mana$!"!nt

Th! g*al *+ h!ra$ is * r!du,! and ,*n r*l h! !d!'aand $r!2!n in+!, i*n. A, i2! and $assi2! !<!r,is!s assisin '*2ing l '$ha i, +luid in * h! "l**ds r!a'.E< !rnal ,*'$r!ssi*n d!2i,!s 'ilk h! +luid $r*<i'all

+r*' h! +** * h! hi$ *r +r*' h! hand * h! a<illa.h!n h! $a i!n is a'"ula *r & ,us *'4+i !d !las i,,*'$r!ssi*n s *,kings ar! (*rn h*s! (i h h! high!s,*'$r!ssi*n s r!ng h 0!<,!!ding 3 '' Hg1 ar!r!/uir!d.

h!n h! l!g is a++!, !d& s ri, "!d r!s (i h h! l!g!l!2a !d 'a aid in '*"ili ing h! +luids.



PHARMAC7L7=IC THERAPY

As ini ial h!ra$ & h! diur! i, +ur*s!'id! 0Lasi<1 is$r!s,ri"!d as n!!d!d * $r!2!n h! +luid *2!rl*ad ha,an r!sul +r*' h! '*"ili a i*n *+ !< ra,!llular +luid. Diur! i,s ha2! als* "!!n us!d $allia i2!l +*r

l '$h!d!'a in ,*n)un, i*n (i h !l!2a ing h! l!g and(!aring !las i, ,*'$r!ssi*n s *,kings *r sl!!2!s.H*(!2!r& h! us! *+ diur! i,s al*n! has li l! "!n!+i"!,aus! h!ir 'ain a, i*n is * li'i ,a$illar +il ra i*n "d!,r!asing h! ,ir,ula ing "l**d 2*lu'!.

I+ l '$hangi is *r ,!lluli is is $r!s!n & an i"i* i, h!ra$is ini ia !d. Th! $a i!n is augh * ins$!, h! skin +*r!2id!n,! *+ in+!, i*n.

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