PENDEKATAN HOLISTIK

DIAGNOSIS DAN MANAJEMEN

NYERI DADA

dr. Lowry Yunita, SpJP, FIHA

 Our situation . . .

 Chest symptoms are common and are most often

caused by a benign condition.
 In situations when the condition is life-threatening,
treatment is more successful if started immediately
after onset of symptoms.
 Many patients with a serious condition wait too
long before seeking professional help and not all
patients in need of urgent medication or
procedures are promptly identified in the health
care system.
Erhardt L, et al. Eur Heart J; 2012: 23, 1153 - 1176
 Definition of Angina
 Angina is pain or constricting discomfort that typically
occurs in the front of the chest (may radiate to the
neck, shoulders, jaw or arms), brought on by physical
exertion or emotional stress.
 Atypical symptoms  gastrointestinal discomfort,
breathlessness or nausea.
 Main symptom of myocardial ischaemia  caused by
atherosclerotic obstructive coronary artery disease
restricting blood flow and therefore oxygen delivery
to the heart muscle.
Stable angina: management, NICE guideline 2011, nice.org.uk/guidance/cg126
 Stable Angina
 Is a chronic medical condition with a low but
appreciable incidence of acute coronary events and
increased mortality.
 The aim of management is to stop or minimise
symptoms, and to improve quality of life and long-
term morbidity and mortality.
 Management options include lifestyle advice, drug
treatment and revascularisation using percutaneous
or surgical techniques.

Stable angina: management, NICE guideline 2011, nice.org.uk/guidance/cg126

Riskesdas 2013
Montalescot G, et al. European Heart Journal (2013) 34, 2949–3003
Clinical Pre-test Probability in patients
with stable chest pain symptoms
Initial Diagnostic Management of
Patient With Suspected CAD
 Non-invasive testing
in patients with suspected SCAD
and an intermediate PTP
Characteristics Of Tests Commonly Used To
Diagnose The Presence Of CAD
Blood Tests In Assessment Of Patients With Known
Or Suspected SCAD In Order To
Optimize Medical Therapy
 Definition of Risk
for Various Test Modalities
Management Based On Risk Determination For
Prognosis In Patients With Chest Pain And
Suspected SCAD
Medical Management Of Patients With
Stable Coronary Artery Disease
Pharmacological Treatments In Stable
Coronary Artery Disease Patients
 Indications For Revascularization Of
Stable Coronary Artery Disease Patients on
Optimal Medical Therapy
 Global Strategy Of Intervention In
Stable Coronary Artery Disease (SCAD) Patients
With Demonstrated Ischaemia
THANK YOU