Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                
Scribd Logo
Upload

Welcome to Scribd!

  • 41 views

    Kel. Jantung Didapat (Acquired) Kelainan Jantung Karena Infeksi

    Uploaded by

    adindamelati
    1. The most common types of acquired heart disease in Indonesia are rheumatic fever (RF), diphtheria, and subacute bacterial endocarditis. RF is the leading cause and can lead to secondary heart valve damage if not diagnosed and treated promptly. 2. RF is caused by group A streptococcal infections, most commonly occurring alongside upper respiratory infections. Incidence is higher during epidemics and in isolated communities. 3. Treatment for RF and rheumatic heart disease (RHD) involves primary prevention of streptococcal infections, secondary prevention to prevent RF relapses, and relief of symptoms through medications, valve surgery, or interventions like balloon valvuloplasty. Management requires long-

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd

    Kel. Jantung Didapat (Acquired) Kelainan Jantung Karena Infeksi

    Uploaded by

    adindamelati
    41 views20 pages
    1. The most common types of acquired heart disease in Indonesia are rheumatic fever (RF), diphtheria, and subacute bacterial endocarditis. RF is the leading cause and can lead to secondary heart valve damage if not diagnosed and treated promptly. 2. RF is caused by group A streptococcal infections, most commonly occurring alongside upper respiratory infections. Incidence is higher during epidemics and in isolated communities. 3. Treatment for RF and rheumatic heart disease (RHD) involves primary prevention of streptococcal infections, secondary prevention to prevent RF relapses, and relief of symptoms through medications, valve surgery, or interventions like balloon valvuloplasty. Management requires long-

    Original Description:

    drdc

    Original Title

    4. DR DAN DC

    Copyright

    © © All Rights Reserved

    Available Formats

    PPT, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    1. The most common types of acquired heart disease in Indonesia are rheumatic fever (RF), diphtheria, and subacute bacterial endocarditis. RF is the leading cause and can lead to secondary heart valve damage if not diagnosed and treated promptly. 2. RF is caused by group A streptococcal infections, most commonly occurring alongside upper respiratory infections. Incidence is higher during epidemics and in isolated communities. 3. Treatment for RF and rheumatic heart disease (RHD) involves primary prevention of streptococcal infections, secondary prevention to prevent RF relapses, and relief of symptoms through medications, valve surgery, or interventions like balloon valvuloplasty. Management requires long-

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    41 views20 pages

    Kel. Jantung Didapat (Acquired) Kelainan Jantung Karena Infeksi

    Uploaded by

    adindamelati
    1. The most common types of acquired heart disease in Indonesia are rheumatic fever (RF), diphtheria, and subacute bacterial endocarditis. RF is the leading cause and can lead to secondary heart valve damage if not diagnosed and treated promptly. 2. RF is caused by group A streptococcal infections, most commonly occurring alongside upper respiratory infections. Incidence is higher during epidemics and in isolated communities. 3. Treatment for RF and rheumatic heart disease (RHD) involves primary prevention of streptococcal infections, secondary prevention to prevent RF relapses, and relief of symptoms through medications, valve surgery, or interventions like balloon valvuloplasty. Management requires long-

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 20

    KEL.

    JANTUNG DIDAPAT (ACQUIRED)


    KELAINAN JANTUNG KARENA INFEKSI

    DI INDONESIA YANG TERBANYAK:


    1.DEMAM REUMATIK(DR), 2. DIFTERIA DAN
    3.ENDOKARDITIS LENTA
    1.DEMAM REUMATIK: OK MENYEBABKAN
    KEL. JANTUNG KE-2 PADA ANAK SETELAH
    KEL.JANTUNG KONGENITAL DI USA.
    DI INDONESIA DR PENYEBAB UTAMA.
    DR PERLU DIDIAGNOSA CEPAT, DAN DIOBATI
    SEGERA DPT MENCEGAH KEL. KATUP J.
    [BIAYA BANYAK & ANGKA KEMATIAN TINGGI]

    INSIDENS 3% PADA MASA EPIDEMIK DAN


    INSIDENSNYA 0.3% PD MASA ENDEMIK
    ETIOLOGINYA:STREP. BETA HEMOL.GRUP A,
    -DR SERING TERJADI BERSAMAAN URI
    -ASRAMA MILITER, KELOMPOK MASY. YG
    TERISOLIR SERING EPIDEMI.
    -INSIDENS DR PARALEL DGN INSIDENS URI
    OK GABHS.

    Pathology :
    -Aschoff bodies
    antigen
    presenting cells
    - Acute phase : inflammation process
    in pericard, myocard & pericard
    - Chronic phase : injury of the valve
    - Difference of clinical and pathologi
    cal manifestation in some countries
    - Host immunological response
    take main role in clinical manifesta
    tion

    Diagnosis :
    1944 : Dr.T.Duckett Jones : Jones Criteria
    1955 : Modification of Jones Criteria
    1965 & 1984 : Revised of Jones Criteria
    1992 : Update Jones Criteria
    Jones Criteria (focused)
    Problems : over diagnosis or under diagnosis

    Diagnosis

    1965 Jones Criteria (revised)

    Major manifestation
    Carditis
    Polyarthritis
    Chorea
    Subcutan nodule
    Erythema marginatum
    Evidence of previous
    Strept. Infection
    CULTURE / ASTO

    Minor manifestation
    Fever
    Arthralgia
    Prolonged PR interval
    ECG
    Increase BSR
    C reactive protein (+)
    Leucocytosis
    Previous history RF /
    RHD inactive

    Diagnosis

    1992 Jones Criteria (Updated)


    Major manifestation
    Carditis
    Polyarthritis
    Chorea
    Subcutan nodule
    Erythema margina tum

    Minor manifestation
    Fever
    Arthralgia
    Increase BSR
    C reactive protein (+)
    Leucocytosis
    Prolonged PR interval ECG

    Evidence of previous
    Strept. infection

    13.

    19.
    GABHS Cardiogenik
    Rheumatic fever / RHD - pathogenesis

    Jones Criteria Mayor CAPOCHES

    Treatment RF & RHD


    1. Primary preventions :
    to eradicate Streptococcal infectcion :
    during acute RF attack
    2. Secondary prevention :
    to prevent relaps of cute RF
    3. Relief the symptoms :
    - carditis / CHF
    - arthritis
    - Chorea

    Treatment RF & RHD

    1. Primary prevention :
    1. Benzatine PNC G injection 1 X / i.m.
    (BW > 27 kg 1,2 million unit)

    (BW < 27 kg 600.000 unit)

    2. Pencilline V : 250 mg/400.000 unit QID


    / oral : 10 days

    Erythromycine : 40 mg /kg BW / day


    TID-QID / oral : 10 days

    Clindamycine, Nafcillin, Amoxycillin,

    Cefalexin

    Treatment RF & RHD

    Duration secondary prevention


    Categori
    Duration
    RF with carditis & permanent
    valve abnormalities

    minimal 10 years
    until 40 yrs or
    longlife

    RF with carditis without perma


    nent valve abnormalities

    10 years or until
    adult

    RF without carditis

    5 years or until
    21 years

    Treatment RF & RHD

    Relief the symptoms


    A. Carditis :
    Anti inflammatory

    - Carditis : Prednison : 2 mg/kg BW/day

    tapp.
    2-6 weeks
    off

    - Mild Carditis : Aspirin 90-100 mg/kg BW 4-6


    4-8 weeks
    week

    B. Arthritis

    - Aspirin : 100 mg/kg BW/ day : 2 weeks


    2-3 weeks : doses decrease

    Treatment RF & RHD

    C. Heart Failure :

    - Bedrest
    - Digoxin
    - Diuretics
    - Vasodilator

    - Fluid & salt restriction

    D. Chorea :
    - Physical stres & emotional must be controlled
    - Anti inflammation drug : controversial
    - Phenobarbital : 15-30 mg TID-QID
    - Haloperidol : 0,5 mg ---> 2 mg TID
    - Valproic acid / Chlorpromazine / Diazepam

    Table. Guidelines for Bed Rest and Ambulation and Recommended


    antiinflammatory agents

    Arthritis

    alone
    Bed Rest
    1-2 wk
    Indoor ambulation 1-2 wk
    Outdor activity
    1-2 wk
    (school)
    Full activity
    1-2 wk
    Prednisone
    Aspirin

    0
    0

    Carditis
    minimal
    2-3 wk
    2-3 wk
    2-3 wk
    2-3 wk
    0
    0

    Carditis
    moderate
    4-6 wk
    4-6 wk
    4-6 wk

    Carditis
    severe
    2-4 mo
    2-3 mo
    2-3 mo

    4-6 wk

    2-3 mo

    2-4 wk
    2-4 wk

    2-6 wk
    2-6 wk

    Minimal Carditis Questionable cardiomegaly ; Moderate carditis definite but mild


    cardiomegaly, Severe carditis, marked cardiomegaly or CHF

    Surgical treatment and invasive intervention


    Surgical treatment :
    1. Valve Replacement :
    - MR

    - MS

    - AR

    2. Valvuloplasty
    Invasive Intervention :
    - Ballon Mitral Valvuloplasty (BMV) with
    Inoue ballon : MS

    DC
    Decompensatio Cordis
    Gagal Jantung

    Conto: Mitral insuffisiensi


    Setiap ventric.sist, ada darah naik
    ke Atrium Kilama2
    Stagnasi di Atrium Ki
    V.Pulm. vasc.paru penumpukan cairan inf. Batuk kronik.
    darah masuk ke Ao Jantung kerja keras (HR=Tachycardia)
    Jantung membesar (Cardiomegali), Bila kerja,perlu O2 banyak napas
    (Dyspnoe deffort, sampai orthopnoe ). Tanda2

    DC kiri

    PS darah berkurang masuk ke


    A.Pulm.
    Darah banyak ter
    kumpul dalam V.Ki, A.Ki VCS
    (TVC) VCI (Hepatomegali)
    Edem pretibial, Edema dorsal
    pedis, Ascites Jantung kerja
    keras (Cardiomegali) dan Kalau
    kerja sesak napas (Tachypnoe).
    Freq.Jantung naik (Tachycardi)

    Tanda DC Kanan

    PENGOBATAN DC
    1. DIGITALIS
    2. DIURETIK
    Dosis dan cara pemberian
    harus diperlajari baik-baik

    Terima

    kasih

    You might also like