GROUP 12

1.MUHAMMAD ANAM RIFAI ((12700230)

2.CRHISTIEN NATHALIA ( 12700106)
3.TAUFIK HIDAYAT (12700004)
4.M. RIZALIANOR (12700114)
5.TIKA RISKY P S (12700138)
6.NI MADE HENDRAYANI SURANY
(12700048)
7.ARIFANDI ANGGA P (12700238)

Presentation Title
8.IDAHRUDHIN Z A (12700024)
9.WIDYA TSORAYA (12700170)
10.MIRA BELLADONA A (12700202)
Subtitle or company
11.FUADinfo
HASAN (12700014)
 CORONARY HEART DESEASE

1. ETIOLOGY
2. CLINICAL MANIFESTATION
3. DIAGNOSIS
4. TREATMENT
5. PREVENTION
 1. ETIOLOGY

Coronary heart disease is a disease that occurs due to blockage

or narrowing of the results of coronary artery blood vessels. As we

all know, the coronary arteries serve to mengaliran blood by

bringing in nutrients and oxygen needed by the heart muscle to

function properly pump blood throughout the body.

The disease is caused by the buildup of fat in the vessel wall

oroner, and this is gradually followed by various processes such

as accumulation of connective tissue, blood clots, etc.. With the

buildup must be narrowed or even can clog blood vessels. That

way it will result in the area of heart muscle is deprived of blood

flow, causing a variety of serious repercussions, of angina pectoris

(chest pain) to heart infarction. We all know him as a heart attack.

This attack can cause sudden death.

Some of the causes of this disease, among others, levels of total

cholesterol and high LDL cholesterol, a history of heart disease in

the family heredity, hypertension, low HDL cholesterol levels,

obesity, smoking, diabetes mellitus, lack of exercise, and even

stress. So it should we avoid these things from an early age

 2. CLINICAL MANIFESTATION
A full physical examination needs to be performed when someone is suspected
of having coronary heart disease. The doctor will check the temperature (to
exclude infective cause of chest pain), respiratory rate (some patients may be
breathless), pulse rate (for rate and regularity) and blood pressure (as
high blood pressure is a risk factor for coronary heart disease).
A cardiovascular examination will be performed to assess the heart function
(e.g. for the presence of heart failure, valvular disease) and the presence of
peripheral vascular disease.
The respiratory system will also be assessed to rule out lung diseases causing
similar complaints (chest pain, breathlessness).
 3. DIAGNOSIS

Investigations for coronary heart disease include a series of blood tests

including a full blood count to determine whether anaemia is present, cardiac

enzymes (measures substances released following damage to the heart

muscle), lipid profile and thyroid tests if indicated (as hyperthyroidism can

cause angina). An heart tracing (electrocardiography, ECG) and a chest X-ray

will also be performed.

 4. TREATMENT
If you experience an anginal attack you will be treated immediately with
morphine (for chest pain), oxygen, nitrates (to open up the vessels around the
heart) and aspirin or clopidogrel to reduce the risk of heart attack.
More invasive options are percutaneous coronary intervention (PCI) and
coronary artery bypass grafting (CABG) are sometimes required. PCI aims to
open up a coronary artery (blood vessel that brings blood and oxygen to the
heart muscle) and restore blood flow, usually with a balloon inserted by a
catheter through the femoral artery in the groin area. CABG is an "open heart"
surgery where the saphenous vein from the leg is used to carry blood around
the obstruction in the heart.
A heart attack is a medical emergency and requires urgent treatment to allow

survival. If you experience prolonged chest pain do not hesitate to seek medical

care. For acute heart attack, early management comprises:

High flow oxygen.

Pain relief (usually morphine) and medication to stop vomiting.

Aspirin plus thrombolysis (to break off the clot) or primary PCI.

Detection and management of acute complications: arrhythmia (irregular heart

beat), ischaemia, heart failure. It is likely you will be monitored carefully with an

ECG to detect complications. If an arrhythmia occurs defibrillation may be

required.
Long-term management focuses on reduction of cardiovascular risk factors that

could cause future adverse cardiac events. Hypertension is a major cause of

recurrent myocardial infarction in patients with CHD so it should be

aggressively treated with agents such as a beta-blockers and ACE-inhibitors.

Lifestyle factors such as tobacco cessation, healthy food choices, weight

control and increased physical activity are essential factors in the management.

In addition, lipid control (with statin medications and diet) and strict blood

glucose control may also be necessary.

In summary, patients with established CHD (and all patients as a primary
preventative measure) are encouraged to:
Stop smoking.
Exercise more.
Lose weight if overweight.
Reduce or control blood pressure.
Control diabetes.
Control lipid (fat) levels and cholesterol.
Management will depend on your underlying risk factors and treatments may
vary across individuals. Long-term aspirin (an anti-platelet medication) has
shown to be beneficial in reducing recurrent heart attack and mortality in
several clinical trials and is recommended in virtually all patients. All individuals
who have experienced a heart attack or are known to suffer coronary heart
disease should be prescribed short-acting nitrate sprays. An action plan for the
event of future chest pain will be explained to you by your doctor.
If chest pain occurs patients should:

Rest and administer the short-acting nitrates.

Take some aspirin (between 150 and 300mg) unless you have

contraindications for this medication.

Call an ambulance (dial 000) if chest pain/discomfort not completely relieved in

10 to 15 minutes. If ambulance services are not available where you live you

will be given a designated clinician who you should call.

With early and effective management the risk of death from acute heart attack

and future sequelae are markedly reduced.

 5. PREVENTION
Heart disease prevention is considered important before and after someone is
diagnosed with the condition:
Primary prevention refers to measures that should be done to reduce the risk of
heart disease in everyone.
Secondary prevention refers to measures to reduce the risk of progression of
heart disease in a patient who has already been diagnosed. Many of these
measures are similar or the same as those recommended for primary
prevention.
Key prevention measures include:
All patients should stop smoking
Maintain cholesterol levels at appropriate levels using a heart healthy diet,
exercise, and medications
Maintain an appropriate low blood pressure level
Maintain an active lifestyle
Use an antiplatelet drug, such as aspirin, if appropriate (see Medications
section of this report)
Manage diabetes and kidney disease when present
THANK YOU