1.1 Anamnesis, Physic Diagnostic - Dr. Donny H. SpJP (Slide)(1)

8/18/2019 1.1 Anamnesis, Physic Diagnostic - Dr. Donny H. SpJP (Slide)(1)

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Haji General Hospital Surabaya


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“There is a disorder of the breast, marked with st rong and pecul iar

symptom s, cons iderable for the k ind of danger belonging

to it , and no t extremely rare, of wh ich I do not recol lectany m ent ion among

medical authors. The seat of i t , and sense of st rangl ing and anxiety wi th

wh ich i t is at tended, may make i t not impro per ly be called angina

pectoris....”


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common complaint

life threatening

Chest pain


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• Tabel 1. Cardiac and Noncardiac Causes of Chestpain

• Cardiac Causes

• Ischemic

• Angina

• Myocardial Infarction

•

Aortic Stenosis• Hyperthrophic cardiomyopathy

• Coronary vasospasm

• Non ischemic

• Pericarditis

• Aortic dissection

• Mitral valve prolapse

•

Differentiating Cardiac non Cardiac


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Noncardial causes

Gastroesophageal

Reflux esophagitis

Esophageal Gastritis

Peptic ulcer

Pulmonary

Pneumothorax

Pulmonary embolism

Pleuritis

NeoplasmBronchitis

Musculoskeletal

Costochondritis

Rib fracture

Compression radiculopathy

Dermatologic

Herpes zoster

Karnath,et al. Review of clinical signs. Hospital physician.2004


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ANGINA PECTORIS

The initial assessment requires a focused history (including

risk factor analysis), a physical examination, an

electrocardiogram, and frequently serum cardiac markers


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ANAMNESA

•

character/CircumstanceTabel 2


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Gambar 1


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Tabel 3. Tabel 4.


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Exacerbating/Alleviating Factors

Exercise, activity

Take a rest, drugs


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Canadian Cardiovascular Society Functional Classification of Angina


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> Pattern: acute or chronic,contanstan or intermitten,

frequency,accelerating> Onset: sudden, gradual

> Duration of episode of problem, change in duration

> Why is patient coming now

Timing

Relevant past medical history


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Relevant social history

• Alcohol, tobaco, or illiit drugs (cocaine)

Relevant family history

Impact patient perception of the problem , not add to

diagnosis


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Physical Examination


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Serum Cardiac Biomarkers


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1.1 Anamnesis, Physic Diagnostic - Dr. Donny H. SpJP (Slide)(1)

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