Terminology

Acute Coronary Syndrome : Refers to a group of

conditions due to decreased blood flow in the coronary
arteries. Diveded into: unstable angina, STEMI and Non
STEMI
T Troponin : Contractile protein complex filaments
found in muscle fibers, including the heart muscle.
Used as markers of cardiac muscle necrosis
CVCU : An abbreviation of the Cardiovascular Care
Unit, is the special care patients with heart disease,
such as myocardial infarction, congestive heart failure,
disaritmia, heart valve disease and other
Clinical chemistry examination : Examination
to analyze chemical substances dissolved in
the blood, eg cardiac troponin T levels
inspection, creatinine and other
Nitroglycerin : The first-line drug for
myocardial infarction and angina pectoris, is a
vasodilator and can be given in several ways
(oral, sublingual, and others)
Sedative drugs: Drugs used as lowering
anxiety
Problem Identification
1. What caused Mr. Ali came with complaints of chest feels oppressed and
accompanied by shortness of breath?
2. Are there age and sex relationship with Mr. illness. Ali?
3. Why doctors lying Mr. Ali and give the oxygen?
4. What caused Mr. Ali felt chest tightness, cold sweats, and vomiting while he
works?
5. Is there a relationship Mr. disease. Ali with SKA disease suffered by his sister?
6. Why the late ACS could die and how treatment of ACS?
7. How interpretation of tests done the doctor?
8. Why doctors give nitrates and sedatives drugs?
9. What is the result if Mr. Ali if not treated in CVCU?
10. How about the result of T examination? and whether other tests?
11. How the doctor's advice to lifestyle, diet, exercise and regular medical
treatment?
12. What is the diagnosis of the Mr. Ali disease?

Analysis of the Problem
1. What caused Mr. Ali came with complaints of chest feels
oppressed and accompanied by shortness of breath?
Chest complaints squeezed taste can be caused by various
kinds of diseases, especially heart defects, and gastritis.
Abnormalities of the heart that causes chest pain especially
Chronic heart disease (angina pectoris and myocardial
infarction). Chest pain here mainly due to the lack of
myocardial oxygen supply dibanidngkan needs that can
lead to a decrease in pH and stimulation of pain receptors.
Shortness of breath is the compensation body is starved of
oxygen, metabolic acidosis or due to hypertension caused
by left ventricular hypertrophy

2. Are there age and sex relationship with Mr.
illness. Ali?
Based on the epidemiology of chronic heart
disease (CHD) affects more men than women,
due to the habit of smoking, drinking alcohol, and
estrogen protective factors that exist in women
Most CHD events over 40 years mainly due to
exposure to substances atherogenic
3. Why doctors lying Mr. Ali and give the oxygen?
Mr. Ali was laid to increase blood flow to the
peripheral
Given oxygen to balance the supply with oxygen
demand

4. What caused Mr. Ali felt chest tightness, cold
sweats, and vomiting while he works?
Sweating can be caused by activation of the
sympathetic because of CHD that will cause skin
vasoconstriction to reduce heat dissipation by the
body.
Vomiting can be caused teraktivasinya vagus
caused mainly inferior chest pain, or caused by
metabolic acidosis
5. Is there a relationship Mr. disease. Ali with SKA
disease suffered by his sister?
Yeah, because of chronic heart disease can be
caused by hereditary factors or a family history


6. Why the late ACS could die and how treatment of
ACS?
Because if left untreated, the heart muscle will be
a lack of oxygen supply can cause death and
cardiac death and leads to death
7. How interpretation of tests done the doctor?
Blood pressure 180/100 mmHg is a
Hypertension, and hypertension can be caused by
activation of the sympathetic nerve, or could be
as a CHD risk factor that affects Mr. Ali.
Normal ECG means the possibility of Mr. Ali
suffered from angina pectoris or non-STEMI.
8. Why doctors give nitrates and sedatives drugs?
Nitroglycerin nitrate drugs primarily used as a
first-line drug for CHD, is due to vasodilation, thus
lowering the oxygen demand of the heart muscle.
Given a sedative to reduce anxiety that are
usually found in patients with CHD
9. Why doctors give nitrates and sedatives drugs?
if not treated in CVCU can cause repeated of
chest pain, especially when the effects of the
drug has run out.
10. How about the Troponin T examination? and whether
other tests?
Presence of troponin levels in the blood is a marker for
necrosis of the heart muscle, and refers to myocardial
infarction.
Other test such us CMKB, and another hearts enzyme.
11. How the doctor's advice to lifestyle, diet, exercise and
regular medical treatment?
Diet preferred to eat less fatty foods, which can decrease
the risk of atherosclerosis, regular exercise, and regular
medical treatment so as to prevent recurrence of disease
For the prevention and of handling can be shortened to
ABCDE A (Antiplatelet and anticoagulant), B (Beta Blockers
and Blood pressure), C (Cholesterol and Cigarette), D
(Diabetes and Diet), and E (Exercise)

12. What is the diagnosis of the Mr. Ali disease?
Non STEMI, bercause the (+) of Troponin T
test, and normal EKG indicate that there is no
elevating in ST segment.
Scheme
Learning Objective
1. CHD and the Clasification of CHD
2. CHD risk factor
3. Angina Pectoris
4. Myocardial Infark
5. Comprehensive management of CHD