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MANAGEMENT OF CORONARY ARTERY DISEASE IN BPJS ERA

Rampengan, Starry H. (2014) MANAGEMENT OF CORONARY ARTERY DISEASE IN BPJS ERA. In: Makassar Cardiovascular Update XIII 2014.

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      Abstract

      Coronary Artery Disease (CAD) is most commonly due to the arrowing of the coronary arteries sufficiently to prevent adequate blood supply to the myocardium. The narrowing is usually caused by atherosclerosis. Atherosclerosis is a process that can involve many of the body's blood vessels with a variety of presentations. When it involves the coronary arteries it results in coronary artery disease, the cerebral a1teries; cerebrovascular disease (transient ischemic attack, stroke), the aorta; aortic aneurysms, the ilea-femoral and popliteal arteries; peripheral vascular disease, the mesenteric arteries; intestinal ischemia. Coronary artery disease is the single most common cause of death in the developed world, responsible for about 1 in every 5 deaths. It is estimated that more than 16 million Americans have CAD and 8 million have had a myocardial infarction (Ml). Every year approximately 1 million will have a new myocardial infarction. Based on data from the Framingham trial nearly 50% of males and 30% of females over the age of 40 will develop coronary artery disease. Coronary artery disease can present in a variety of ways. The classical presentation is with chest discomfort. Chest discomfort resulting from myocardial ischemia secondary to coronary artery disease is called angina pectoris (squeezing of the chest). Discomfort is diffuse and not localized and may radiate down the arms, as low as the umbilicus and up to the lower jaw. This may be associated with shortness of breath (dyspnea). This discomfort is the result of myocardial ischemia however it is one of the last manifestations to appear. Due to the myocardium's complete reliance on coronary blood flow for energy supply, within a few beats of coronary occlusion, diastolic and systolic dysfunction set in and the electrocardiogram begins to register abnormalities before the patient begins to experience angina pectoris. This explaini:; why patients may describe associated shortness of breath when they experience angina. The association of both symptoms together indicates that the myocardium fed by the narrowed vessel is sizable.

      Item Type: Conference or Workshop Item (Paper)
      Subjects: R Medicine > R Medicine (General)
      Divisions: Fakultas Kedokteran > Fakultas Kedokteran Umum
      Depositing User: Mr. Benhard W. Tampangela, ST
      Date Deposited: 18 Jul 2016 11:06
      Last Modified: 18 Jul 2016 16:02
      URI: http://repo.unsrat.ac.id/id/eprint/1185

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