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HEART DISEASE PAPERS

CHAPTER I
1.1 INTRODUCTION Heart diseaseis adisease that is veryscaryfigure Even todayin Indonesia,heartdiseaseranks . firstas the causeof death. Heart diseaseis oftenconsidered adiseaseofoldmonopolies. I used to besuch diseasessuffered bythe elderlyespecially thoseaged 60years and over, becauseageis also oneriskfactorfor heartdisease.Butnowthere isa tendencyalsosuffered bypatients under theage of 40years. This couldoccur because oflifestyle changes, especially inmodernurbanyoungpeople. When the era of globalization lead to information more easily available, developing countries can immediately imitate western countries are considered to mirror the pattern of modern life. Some behaviors such as eating fast food (fast food) that contain high levels of saturated fat, smoking, alcohol, overwork, lack of exercise, and stress, has become a way of life, especially in urban areas. Though all of these behaviors may be the factors that cause heart disease. 1.2 VIEW Every year, about 1.2 million people in the United States suffered a heart attack, and many of them die. CHD, which often leads to heart attack, is a major killer of men and women in theUnitedStates. More peoplecansurvivean attackorrecoverbetterfrom the heartiftheygethelpfaster. Ofthosewhodied ofa heart attack, about halfdiedan hour afterthe firstsymptoms and before they reach the hospital

CHAPTERII
DISCUSSION
2.1.Definition The heart(Latin, cor) isacavity, cavities, muscularorganthat pumpsbloodthroughbloodvesselsbyrepeatedrhythmiccontractions. The termcardiacmeansrelated to the heart, from theGreekcardiatothe heart. The heartis oneorganthat plays a rolein thecirculatory system. Heart attackisacondition thatcauses heart wasnot functioning. This conditionusually occurs suddenly,andoften calledheart failure. Causes ofheart failure vary, butusually the main causeisimpairedblood supply toheart muscles, becausethe blood vesselsthat normallydrain blood to theheart musclesare blocked or hardened, either because of fatandcholesterol, orbecause thesubstancechemicalssuch asexcessiveuse of drugscontainingPhenolPropanoAlanine(ppa) which can be foundinmedicationssuch asDecolgen, andnicotine. Heart attack(also knownasmyocardialinfarction)is the death ofheartmusclefromthe suddenobstructionof a coronary arteryby abloodclot. Coronaryarteriesareblood vesselsthat supply theheartmusclewith bloodandoxygen. Obstructionofthe coronaryarteriesseizeorremovethe bloodand oxygenfromthe heartmuscle, causinginjury to theheartmuscle. Therewoundthe heartmusclecauseschest painandfeeling (sensation) chestpressure. Ifblood flow is notrestoredto the heart musclein 20Sampa40 minutes, death ofheartmusclethat can not berestoredwillbegin tohappen. Musclecontinuesto dieforsix toeighthoursat which time theheartattackusuallyis "fully". Thedeadheartmuscleis eventually replacedby scar tissue. Lately also often found to sudden heart failure when someone is on the move, as it attacked a few athletes in the world renowned football in the middle of a football field. Usually it is caused by the imposition of heart activity that exceeds the threshold, or the lack of warm up before exercise. 2.2 Symptom Not allheartattacksbegin withpain, chestsuddenlydestroythat oftenappearon TVorinmovies. In onestudy, for example, one third ofpatients whosufferedheartattackshad nochestpain. These patientstend to beolder, female, ordiabetes. Thesewarningsignsandsymptoms ofheartattackis not the sameforeveryone. Manyheartattacksstart slowlyasmild painordiscomfort. Somepeople have nosymptoms at all. Heart attacksthat occurwithoutsymptomsorverymildsymptomsis called asilentheartattack.
y

Chest pain or discomfort. The most common heart attack symptom is chest pain or discomfort. These include a new chest pain these include a new chest pain or discomfort or changes in existing patterns of chest pain or discomfort.Most heart attacks involve discomfort in thecenter

or left side of the chest that oftenlasted for more than a few minutes or go and come back. inconvenience felt likeuncomfortable pressure, squeezing, fullness, or pain. That feeling can be mild orsevere. Heart attack pain sometimes feel like indigestion or heartburn. The symptoms of angina (an-JI-AN-ti or seven-ti) can be similar to symptoms of heartattack. Angina is chest pain that occurs in people who have coronary heart disease, usually when they're active. Angina pain usually lasts for only a few minutes and gowith the rest. Chest pain or discomfort that does not go away or change from the usual pattern (forexample, occur more often or when you're resting) can be a sign of a heart attack.All chest pain should be examined by a doctor. Other commonsignsand symptoms ofheartattackwas the emergence ofa newsymptom: y Upperbodydiscomfortinone or botharms, back, neck, jaw, orupperabdomen y Shortnessof breath, whichmayoccurwithor beforechest discomfort y Nausea(feeling sickyour stomach), vomiting, dizzinessora suddendizziness, coldsweatorbreaking out y Sleep problems, (fatigue) fatigue, orlack of energy Not allpeople experienceheartattackshavecharacteristic symptoms.In additionthere are alsoother symptomsare: y Coughing y Crushingchest pain y Dizziness y Dyspnea(shortness of breath) y The facelookedgray y A feelingof terrorthatyour life willcometoan end y Feelingreally bad(common sense) y Restlessness y The man wasstickyandsweaty y Vomiting y Armpain(more commonly the left arm, butmaybeboth arms) y Upper backpain y Feelingunwellthe whole y Nosymptoms(approximately one-quarter ofallheart attacksareno symptoms, nochest painornew symptoms. Heartattacksaresilent (without symptoms) isparticularlycommonamong patientswithdiabetesmellitus)

2.3.Cause A heart attack occurswhen the flow ofoxygen-rich bloodto theheartmusclesuddenlybecomesblocked. Mostheart attacks occuras a resultofcoronaryheartdisease(CHD). CHDis a conditionin which awaxy substancecalledplaquebuild upincoronaryarteries. These arteriessupplyoxygen-rich bloodtoyourheart. When thebuild up of plaquein arteries, a condition called atherosclerosis. Plaquebuildupoccurredover the years.Finally, theplaquecan rupture(breakopen) in the arteries. This causesbloodclotsthatform on thesurface of theplaque. If theclotbecomeslargeenough, can belargelyorcompletelyobstructbloodflowthroughcoronaryarteries. If theblockageisnot treated quickly, partofthe heartmusclefedby thearterybeginsto die. healthyhearttissueis replacedwith scar tissue. Thisheartdamagemay not beobvious, or it maycausesevereorlong lastingproblems. CoronaryArterySpasms A common causeof heartattackisseverespasm(tightening) of thecoronaryarteries.Seizureswerecut offbloodflowthrougharteries. Seizuresmayoccur incoronaryarterieswere unaffectedby atherosclerosis.What causescoronaryarteriestospasmis notalways clear. Seizuressometimesmaybe associatedwith: y Takingcertain drugs, likecocaine y Emotionalstressorpain y Exposure toextremecold y Smoking Exposure to riskfactors thatcauseheartdiseaseas to whichset outin OnecardiologistCongressin MunichGermany, namely: 1) Smoking 2) High blood pressure 3) Diseaseor Diabetessugar 4) Ascheme ofdivision offat=waisttohipratio 5) Eatingthe wrong 6) Excessive physicalactivity 7) ConsumingAlcohol 8) The amountof fatin the blood 9) Psychosocial factors However,there arefourmajorfactorscausingheartdisease, namely: y Smokedtoo muchover the years y Levels ofbloodfats(cholesterol) is high y Highbloodpressure y Diabetes Riskfactorscan not controlinclude: y Age. The risk ofheart disease increasesfor menafterage45 andforwomen afterage55 (or aftermenopause). y Family historyof earlyheartdisease. Yourriskincreases ifyour fatherorbrotherdiagnosedwithheartdiseasebefore age55 years, orifyour motheror sisterdiagnosedwithheart disease beforeage 65 y Preeclampsia(pre-e-Klamp-se-ah). This condition candevelop duringpregnancy.The twomainsignsofpreeclampsiaareelevated blood pressureandexcess proteinin the urine.

Preeclampsia isassociatedwith alifetime riskofheartdisease, heartattack, heart failureandhighbloodpressure.

includingCHD,

2.4.Diagnosis The doctor will diagnose a heart attack based on your signs and symptoms, yourhealth history and family, and the test results. Diagnostic Tests: y ECG (Electrocardiogram) EKG is a test, a simple painless that can detect and record the heart's electricalactivity. Tests show how fast the heart is beating and its rhythm (steady or irregular).An EKG also noted the strength and timing of electrical signals as they pass througheach part of the liver.An ECG may show signs of heart damage due to coronary heart disease (CHD) andother signs of previous heart attack or current. y Blood Test During a heart attack, heart muscle cells die and release proteins into thebloodstream. Blood tests can measure the amount of this protein in the bloodstream.Higher levels of this protein usually indicates a heart attack.Blood tests are used include troponin test, test CK or CK-MB, myoglobin and serumtests. Blood tests are often repeated to check for changes from time to time. y Coronary Angiography Coronary angiography (an-jee-OG-ra-fee) is a test that uses dye and special x rays toshow the inside of your coronary arteries. This test is often done during a heart attackto help locate blockages in the coronary arteries.To get the dye into the coronary arteries, your doctor will use a procedure calledcardiac catheterization (Kath-e-ter-ihZA-shun).A thin flexible tube called a catheter is inserted into a vein in your arm, groin (upperthigh), or neck. The tube is threaded into your coronary arteries, and dye is releasedinto your bloodstream. Special x rays are taken while the dye flows through the coronary arteries. The dyeallows your doctor to learn the flow of blood through the heart and blood vessels.If your doctor find a blockage, he may recommend a procedure called angioplastyAN-jee-oh-plas-tee). This procedure can help restore blood flow through the blockedartery. Sometimes a small mesh tube called a stent is placed in the artery to helpprevent blockage after the procedure. 2.5.Prevention Prevention ofHeart Attack Whilepeople can notcontroltheir family historyandgenetics, theycan minimizetheriskfactorsof heartdiseaseby: y Quitting smoking y Controllinghighbloodpressure, cholesterol, diabetes y Exercise regularlyand y Take ababyaspirina day These are allchallenges oflifetopreventheartdisease, stroke, andperipheral vascular disease.Even withthe best ofpreventativecare, heartattackoccurs.Topreventa heart attack: y Keepyourbloodpressure, bloodsugar, andcholesterolundercontrol y Do not smoke y Considerdrinking1 to2 glassesof alcoholorwine eachday. Moderateamounts ofalcoholcanreduce therisk ofcardiovascular problems. However, drinkinglargeamounts ofnomore harmthan good y Eatlow-fatdietrich infruitsandvegetablesand low inanimal fats

y y y

Eatfish twicea week. Roastedorgrilled fishis betterthanfriedfish. Frycan bedevastating tosomehealthbenefits Exercisedaily orseveraltimes a week. Walking is agoodform ofexercise Lose weightifyou are overweight

PreventingHeart Diseasewith aHealthyLifestyle Prevention effortstoavoidheartdiseaseandbeginswithimprovinglifestyleandcontrollingriskfactors, thereby reducing the chance of gettingthe disease. Forpreventionof heartdiseaseto avoidobesity/overweightandhighcholesterol.Startbyeating morevegetables, fruits, grains, fishandother fibrousfoods. Reducemeat,snacks(snacks), andhigh-calorie foods thatcontainsaturated fatandlots ofothers.Foods thatcontain lots ofcholesterolaccumulatein theblood vessel wallsand causeatherosclerosisthat triggerheartdisease. Quitting smokingis the targetto be achieved, alsoavoidsmokefrom the environment Smoking causesreducedbloodvesselelasticity, thereby increasing the hardening ofthearteries, andincreasesbloodclottingfactorsthat triggerheartdisease. Smokershave achanceof strokeand coronary heart diseaseabout twotimes highercomparedwith nonsmokers. Drink alcohol in moderation The morealcoholthen chances arehemorrhagicstrokes,especially the highertype. Alcohol canraisebloodpressure, weakenedheart, thickenbloodand causearterialspasms. Performexercise/physicalactivity. Exercise canhelp reducebody weight,controllingcholesterol, loweringblood pressureandotherrisk factorswhichareaffected byheart. Controlhighbloodpressureandbloodsugarlevels Hypertensionis amajorfactorofcoronary heart disease. Avoidthe use ofdrugssuch asheroin, cocaine,amphetamines. PreventingHeart Disease andStrokewithPlantMedicines Several types ofherbs that can beusedtopreventheartdiseasehas the effect ofblood circulationandas ananticoagulantwhich preventsblood clots, heart diseaseisthemaincause ofvascular disorders. 2.6.Treatment The initial treatment forheartattackscouldpreventorlimitdamage toheartmuscle.Actingquickly, theearly symptomsofheartattack,couldsave lives. Medical personnelcanbegindiagnosisandtreatmentevenbefore reaching thehospital.Specifictreatmentis usuallyinitiated immediatelyifa heart attackis suspected, evenbefore thediagnosisis confirmed. These include: y Oxygen Therapy y Aspirinto thin the bloodand preventfurtherbloodclotting y Nitroglycerintoreduce theworkload ofyourheartandincreasebloodflowthroughcoronaryarteries y Treatment forchest pain After thediagnosis ofheartattackis confirmedorstrongly suspected, doctorsbegintreatmentto trytoquicklyrestorebloodflowto the heart. Twomaintreatmentis a"clot-busting" drugs andangioplasty, a procedure used to opencloggedcoronaryarteries. Clots-Busting Drugs

Thrombolysisdrug, also called"clot busters," are usedto dissolvebloodclotsthatblock thecoronaryarteries. To workproperly, these medicationsmust be given withina fewhours ofinitialsymptomsof heartattack. Ideally, drugsshould beadministeredas soon aspossible. Angioplasty Angioplastyis a surgical procedurethat opensblocked or narro wedcoronaryarteries.This procedure isalsocalledpercutaneousintervention(a-ku-TA-ne-us) coronary, orPCI.Athinflexibletubewith a balloonorotherdeviceonthe end isthreadedthroughbloodvesselsto the coronary arteriesare narrowed or blocked.Once in place, the balloon isinflatedtopushplaqueon artery walls.This restoresbloodflow througharteries.During the procedure, the doctormayput asmallmeshtubecalled astentin theartery. The stenthelpspreventblockagesinarteriesin the monthsor years afterangioplasty. OtherTreatmentsforHeart Attacks 1) Medicines y Betablockers Betablockersreduce theworkload ofyourheart. These drugs arealsousedtoreducechest painand discomfortand helpspreventrecurrence ofheartattacks. Betablockersare alsousedto treatarrhythmias(irregular heartbeat). y ACEinhibitors ACEinhibitorslower blood pressure andreducestrain onyourheart.Theyalso helpslow down thefurtherweakeningof the heart muscle. y Anticoagulants Anticoagulant, or"blood thinners," to preventbloodclotsforming inyourarteries.These drugsalsokeepexistingclotsfromgetting bigger. y Anticlottingdrugs Anticlottingdrugsstop theplatelets from clumpingandformingbloodclotsthat are notdesirable.Examplesanticlottingdrugsincludingaspirinandclopidogrel. You may also begivenmedication torelieve painandanxiety, treatarrhythmias(whichoftenhappensduringa heart attack), or loweryour cholesterol(these drugs arecalledstatins). 2) Medical Procedures y Coronary artery bypass grafting (CABG) During CABG, the surgeon removes a healthy artery or vein from your body. Artery or can also be used to treat heart attacksvein and then connected, or grafted, into the blocked coronary artery.Artery bypass graft or venous (ie, going around) blocked sections of coronaryarteries. It provides a new route for blood flow to the heart muscle. y Leave Hospital After Treatment Most people spend several days in hospital after a heart attack. When you leave thehospital, the treatment does not stop. At home, your treatment may includemedications daily and cardiac rehabilitation (rehab). Your doctor may want you tohave a flu shot and pneumococcal vaccine every year.Your doctor also may recommend changes in lifestyle, including following a hearthealthy diet, be physically active, maintaining a healthy weight, and smokingcessation. Taking these steps can reduce your chances of having a heart attack. y Cardiac rehabilitation Your doctor may recommend cardiac rehabilitation to help you recover from heartattacks and to help prevent heart attacks. Almost everyone who has

suffered a heartattack can benefit from rehabilitation.Cardiac rehabilitation is a medically supervised program that can help improve thehealth and welfare of the people who have heart problems.Cardiac rehabilitation team may include doctors, nurses, exercise specialists, physicaland occupational therapy, dietician or nutritionist, and psychologist or mental health specialist. Rehab has two parts: Exercise training. This section will help you learn how to exercise safely, strengthenyour muscles, and increase your stamina. Your exercise plan will be based on yourpersonal abilities, needs, and interests. Education, counseling, and training. This part of rehabilitation to help youunderstand the condition of the heart and looking for ways to reduce the risk of heartproblems later in life. Rehabilitation team will help you learn how to cope with stressadjusting to new lifestyles and overcome your fears about the future.

2.7. MisconceptionAbout HeartDisease 1. Heartdiseaseonly occursin obese peoplealone 2. Heart diseasecan not bein a child oryoungperson 3. Womenfree of heart disease 4. Heart diseaseis onlyone kind of 5. Healthyheart, could not haveheart disease 6. No associationwithstroke 7. Heart diseaseis a hereditary disease 8. Heart diseasecan not be prevented 9. Heart diseasebecauseoftensurprised 10. Heart diseasearisebecauseoften eatbananamenu

2.8 Galery

CHAPTER III
CLOSING
3.1 Conclusion Based on theexposurecan be concludedthatheartdiseaseisacondition thatcauses theheartcan notcarry outtheir duties properly. Theseinclude: y Weakheartmuscle. Itisa congenital abnormality. Weak heartmuscleto makethepatientcan notperformredundantactivities, because theimposition ofexcessivecardiacperformancewill cause painin the chest, andsometimescancause the bodytoappearbluish.People withweak heart muscle iseasyto pass out. y The gap between theright atriumandleftthe porch, because of incompleteformation ofa separate layer betweenthe second platform whenthe patient is stillinthe womb. This causes the bloodcleananddirtybloodmixed.This diseasealsomakespeople unable to performstrenuous activities, due tostrenuous activitiesalmostcertainly will make thepatient's body turnedblueandshortness ofbreath,although it does not causepainin the chest. Thereare also variations ofthisdisease,namely a personreallyhas onlyone porch. 3.2 Advice Nopreventionisbettertopreventdiseaseandheartattacks, in addition toa healthylifestyle(as is often up early, notoftenstay up toolate atnight, andavoidingcigarettes andalcoholic beverages), a healthydiet(emphasis on eating fibrous foodsand vegetables, and not eating too much fatty food and high cholesterol), and regular exercise and not excessive, the above is good advice to be executed for each person to maintain health, especially heart.

Daftar Pustaka

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