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    CHF Ec Cad

    Uploaded by

    Akbar Iskandar
    The patient, a 66-year-old woman, presented with shortness of breath for 5 days along with nausea, vomiting and loss of appetite. Her medical history includes hypertension, diabetes, and a previous hospitalization for similar symptoms. Her physical exam found elevated blood pressure, enlarged heart size, and rales in her lungs. Tests showed signs of heart failure and coronary heart disease. She was diagnosed with heart failure due to coronary heart disease and treated with oxygen, diuretics, and medications to manage her heart failure and hypertension.

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

    CHF Ec Cad

    Uploaded by

    Akbar Iskandar
    62 views17 pages
    The patient, a 66-year-old woman, presented with shortness of breath for 5 days along with nausea, vomiting and loss of appetite. Her medical history includes hypertension, diabetes, and a previous hospitalization for similar symptoms. Her physical exam found elevated blood pressure, enlarged heart size, and rales in her lungs. Tests showed signs of heart failure and coronary heart disease. She was diagnosed with heart failure due to coronary heart disease and treated with oxygen, diuretics, and medications to manage her heart failure and hypertension.

    Original Description:

    CHF EC CAD

    Original Title

    CHF EC CAD

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    The patient, a 66-year-old woman, presented with shortness of breath for 5 days along with nausea, vomiting and loss of appetite. Her medical history includes hypertension, diabetes, and a previous hospitalization for similar symptoms. Her physical exam found elevated blood pressure, enlarged heart size, and rales in her lungs. Tests showed signs of heart failure and coronary heart disease. She was diagnosed with heart failure due to coronary heart disease and treated with oxygen, diuretics, and medications to manage her heart failure and hypertension.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    62 views17 pages

    CHF Ec Cad

    Uploaded by

    Akbar Iskandar
    The patient, a 66-year-old woman, presented with shortness of breath for 5 days along with nausea, vomiting and loss of appetite. Her medical history includes hypertension, diabetes, and a previous hospitalization for similar symptoms. Her physical exam found elevated blood pressure, enlarged heart size, and rales in her lungs. Tests showed signs of heart failure and coronary heart disease. She was diagnosed with heart failure due to coronary heart disease and treated with oxygen, diuretics, and medications to manage her heart failure and hypertension.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 17

    Heart Failure e.

    c Coronary
    Heart Disease
    Norsikawaty Haya
    Case presentation

    Patient Identitiy
    Name

    : Mirs. N
    Age
    : 66 years old
    MR
    : 237766
    Address : Barukang Street, Makassar

    History taking
    Chief

    complaint : shortness of breath


    History taking :
    The patient came to RSWS with a chief
    complaint shortness of breath, it occurs since 5
    days ago. It happened if she was getting a rest
    and activity. Sometimes the patient waked up at
    night due to shortness of breath. The patient
    also had nausea, vomit, and lost appetite. She
    also felt waist pain like something creep on
    there.
    Urinate and defecate was normal.

    Past medical history


    She

    entered Stella Maris with nerve


    disturbance on 1984
    She has got hypertention and diabetes
    mellitus a year ago. She had a regular
    medicine.
    She also had opname history with a same
    complaint a year ago.

    Risk factor
    She

    had hypertention and diabetes


    mellitus
    She doesnt smoke and she is not
    alcoholic
    In her family, no one have a same disease
    and there is no sudden death history.

    Physical examination

    Vital Sign :

    Head Examination :

    Blood pressure : 180/110 mmHg


    Pulse
    : 108/min
    Breath : 32/min
    Body temperature
    : 36,5oC

    Eyes : there is anemis. No cyanosis and no icterus


    Neck : JVP R+2 cmH20

    Thoracal Examination :

    Inspection
    : Symetric
    Palpation
    : no mass, no tenderness
    Percussion
    : Sonor
    Auscultation
    : Breath Sound is bronchovesikular
    Additional sound : ronchi diffuse, no wheezzing

    Physical examination

    Heart Examination :

    : ictus cordis was visible


    : ictus cordis was palpable
    : widening of heart size
    : regular of I/II Heart Sound, no

    Abdominal Examination :

    Inspection
    Palpation
    Percussion
    Auscultation
    murmur

    Inspection
    Palpation
    Percussion
    Auscultation

    : normal
    : no mass
    : tympani like sound, no acites
    : peristaltic sound (+), normal

    Extremity : there was no oedema at left or right legs

    Additional examination

    Blood Test :

    : 10,3
    : 332

    Electrolyte :

    Hb
    GDS

    Na
    K: 4,5
    Cl

    : 134
    : 99

    Liver Function Test :

    SGOT : 28
    SGPT : 81

    Additional examination
    Lipid

    Profile Test :

    Total

    Cholesterol
    HDL Cholesterol
    LDL Cholesterol
    Triglyceride
    Urine

    Test :

    Ureum
    Creatinin
    Uric

    : 258
    : 41
    : 188
    : 147

    Acid

    : 82
    : 1,7
    : 6,9

    Electrocardiography
    Tachycardia

    sinus
    Heart Rate : 110 bpm
    Poor R-wave, V1-V5
    LBBB

    Suggestion additional examination


    Chest

    X-Ray
    Echocardiogram

    Management
    Oxygen

    4-6 litre
    Heart diet
    IVFD NaCl 0,9% : 12 dpm
    Lasix 2 amp/12 hours/IV
    Nitrocyn 20 mg
    Captopril 12,5 mg 1-0-1
    Aspilet 80 mg 0-1-0
    Spironolakton 25 0-2-0

    Diagnose
    Heart

    Failure e.c Coronary Heart Disease


    (CHD)
    DM type 2

    Discussion
    Heart

    failure is the pathophysiologic state in


    which the heart, fails to pump blood with the
    requirements of metabolism of tissues and/or
    pumps only from an abnormally elevated
    diastolic filling pressure.
    Heart failure may be caused by myocardial
    failure, like myocardial infarction, termhypertention or cardiomyopathy
    In certainly condition, even the myocard have a
    good contractility, it cant fulfill the systemic need
    blood for body metabolism.

    Patomechanism
    Inadequate

    adaptation of the cardiac


    myocytes to increased wall stress in order
    to maintain adequate cardiac output
    following myocardial injury
    Most important among these adaptations
    are the (1) Frank-starling mechanism, (2)
    Myocardial hypertrophy, (3) Activation of
    neurohumoral systems

    Discussion
    Coronary

    Heart disease (CHD) is narrowing of


    the small blood vessel that supply blood and
    oxygen to the heart. CHD is also called coronary
    artery disease
    CHD is usually caused by a condition called
    atherosclerosis, which occurs when fatty
    material and a substance called plaque builds
    up on the walls of the arteries.
    As the coronary arteries narrow, blood flow to
    the heart can slow down or stop, causing chest
    pain (stable angina), shortness of breath, heart
    attack, and other symptoms.

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