Laporan Kasus

Non ST Elevation Myocardial Infarction

Disusun Oleh:

Shabrina Maharani

KEPANITERAAN KLINIK
BAGIAN ILMU KARDIOLOGI & KEDOKTERAN VASKULER
FAKULTAS KEDOKTERAN UNIVERSITAS RIAU
RSUD ARIFIN ACHMAD
PEKANBARU

1
Background

Heart disease caused by coronary artery abnormalities is called coronary heart

disease (CHD). This disease attacks the blood vessels that drain blood to the heart
resulting in narrowing of the coronary arteries. This narrowing of the coronary arteries
occurs due to the process of atherosclerosis or spasm or a combination of both. 1,2Acute
coronary syndrome is related to pathophysiology in general which is known to be
associated with most cases of Unstable Angina Pectoris (UAP), Non ST myocardial
infarction (NSTEMI) and myocardial infarction with ST elevation (STEMI).2

Case Illustration

Mr. S, 53 years old, complained of heartburn, which has been increasingly

burdensome since 1 day. 1 day SMRs patients experience heartburn, pain is stabbing
puncture, the pain is felt up to the left chest, also felt a sudden pain and intermittent, the
pain is influenced by the activity, the pain occur when patients feel numbness in the left
arm. Chest pain is reduced by rest, the patient is more comfortable with sitting pain also
accompanied by cold sweat. Pain is felt for approximately 30 minutes. The patient
complained of feeling heavy in the neck and the body felt weak.

On physical examination found the left heart border in the anterior axilary line.
From the investigations performed, troponin reactive enzymes were obtained. From the
EKG, T inverted is obtained in lead I, aVL, V4, V5, V6, ST segment depression in lead I,
aVL, V4, V5, V6 and left ventricular hypertrophy. Troponin rective

2
Diagnosis
Non ST Elevation Myocardial Infarction

Pharmacotherapy :

 ISDN 3 x 5 mg
 Clopidogrel 1 x 75 mg
 Aspilet 1 x 80 mg
 Ranitidin 2x1 amp
 Amlodipin 1x5 mg
 Bisoprolol 1x2,5 mg
 Simvastatin 1x20 mg

Conclusion
Pharmacological therapy can be given Anti-ischemia, aatiplatelet, Anticoagulants
or thrombolytics, statins and invasive therapy.

DAFTAR PUSTAKA

1. World Health Organization. Deaths from coronary heart disease. Cited 2017 Jan.
Available from:http://www.who.int/mediacentre/factsheets/fs317/en/
2. Rahman AM. Angina Pektoris Stabil. Dalam : Sudoyo AW, Setiuohadi B, Alwi I,
Simadibrata M, Setiati S. (Editor). Buku Ajar Ilmu Penyakit Dalam. Jilid III. Edisi
IV. Penerbit FK UI,2006. Jakarta: p.1611.