CHEST PAIN (NYERI DADA)

ØDifferential of The Chest Pain
    - Keluhan paling sering utk Penyakit Jantung
     - Tapi banyak Non Cardiac

ØHistory  sangat penting.

Anamnese

ü Terus menerus/kadang-kadang

ü Lamanya

ü Posisi Tubuh

ü Pemicu : exercise, emosi, Food, posture,  movement, breathing

ü Penjalaran

üKwalitas : crushing, burning, stabbing

RPD (riwayat penyakit dulu)

1.PJK

2.Gastric problem

3.Post Operasi Thorax

4.Pericarditis

5.Hipertensi, DM

Differential diagnosis of chest paiN

Pemeriksaan

Inspeksi :

§ Shock : pucat, keringat      myocardial infarction

                                               dissecting aorta

    pulmonal embolism

§ Nafas tampak berat      heart failure

§ Mual, muntah       gastric problem

§ Batuk        heart failure, pneumonia

Palpasi + Auscultasi

vPulse & blood pressure : hipo & hipertensi, bradycardia, tachicardia, irreguler pulse

v Pucat, Cyanosis

v JVP (jugular venous pressure)

v Carotid pulse waveform

v Apex cardis

v Pericardial rub, S III, murmur

Characteristics of different types of chest pain

Blood Test

oD L

oCardiac biomarkers : CKMB, Troponin T

oFungsi Renal

oBlood Gas

oLFT (liver function tests)

Pemeriksaan Penunjang

ØEKG

Ø Thorax Foto

Ø Echocardiography

Ø CT Scan

Ø MRI

Ø Exercise tolerance test

First line test to exclude a chest pain emergency