NURSISWATI

DEPATMENT OF MEDICAL SURGICAL NURSING

Anatomy of Coronary
Artery

INFLAMMATION AND
INFECTION
IN
THE
HEART

RHEUMATIC FEVER

IS AN ACUTE SYSTEMIC INFLAMMATORY

CONDITION THAT APPEARS TO RESULT FROM AN

ABNORMAL IMMUNE REACTION OCCURING A
FEW WEEKS AFTER AN UNTREATED INFECTION,
USUALLY CAUSED BY CERTAIN STRAINS OF
GROUP A BETAHEMOLYTIC STREPTOCOCCUS
INVOLVES THE HEART AND OTHER PARTS SUCH
AS JOINTS AND SKIN

USUALLY OCCURS IN CHILDREN 5-15 YEARS

THE INFECTION COMMONLY APPEARS AS AN

UPPER RESPIRATORY INFECTION, TONSILITIS,

PHARYNGITIS, OR STREP THROAT.
ANTIBODIES TO THE STREPTOCOCCUS
ORGANISM FORM AS USUAL AND THEN REACT
WITH CONNECTIVE TISSUE (COLLAGEN) IN
THE SKIN, JOINTS, BRAIN, AND HEART
CAUSING INFLAMMATION.

DURING THE ACUTE STAGE, THE

INFLAMMATION IN THE HEART MAY INVOLVE

ONE OR MORE LAYERS OF THE HEART:
1. PERICARDITIS..OUTER LAYERMAY
INCLUDE EFFUSION
2. MYOCARDITISHEART MUSCLEASCHOFF
BODIES, MAY INTERFERE WITH CONDUCTION
3. ENDOCARDITIS..VALVESBECOME
EDEMATOUS AND VERRUCAE FORM
PANCARDITIS

OTHER SITES OF INFLAMMATION IN PATIENTS

WITH RHEUMATIC FEVER INCLUDE:

THE LARGE JOINTS, PARTICULARLY IN THE LEGS,

WHICH MAY BE INVOLVED WITH SYNOVITIS IN A

MIGRATORY POLYARTHRITIS
THE SKIN..RED MACULES OR POPULES THAT
ENLARGE AND HAVE WHITE CENTERS
THE WRISTS, ELBOWS, KNEES, OR ANKLES
BASAL NUCLEI IN THE BRAINCAUSING
INVOLUNTARY JERKY MOVEMENT OF THE FACE,
ARMS, AND LEGS.

SIGNS AND SYMPTOMS

RHD
LOW GRADE FEVER
LEUKOCYTOSIS
MALAISE
ANOREXIA
FATIGUE
TACHYCARDIA, EVEN AT REST
HEART MUJR MURS INDICATE THE SITE OF

INFLAMMATION

CONT..
EPISTAXIS & ABDOMINAL PAIN MAY BE

PRESENT
ACUTE HEART FAILURE MAY DEVELOP FROM
ARRYTHMIA

PERICARDITIS
NYERI PRECORDIAL
NYERI PERIKARDITIS BERKURANG DG DUDUK
TEGAK DAN MEMBUNGKUK KE DEPAN
FRICTION RUBgesekan pericard
EFUSI PERIKARDIUMsuara jtg lbh lemah
TAMPONADE JANTUNG
NADI PARADOKSAL
EKGElevasi ST segmen..tanpa perub QRS

Efusi pericardium
Impuls apeks jantung dpt hilang atau atau

kadang teraba
Fluoroskopi memperlihatkan denyut ventrikel
berkurang
Perkusi pekak

TANDA EWART

TAMPONADE JANTUNG
PENGUMPULAN CAIRAN INTRAPERICARDIUM
MENYEBABKN OBSTRUKSI SERIUS THD

MASUKNYA DARAH KE KE2 ATRIUM BS

MENIMBLK TAMPONADE
250 CC-1000 CC

MYOCARDITIS
PEMBESARAN JANTUNG & TANDA2 DECOMP

ENDOKARDITIS
NON INFEKTIF
INFEKTIF

MANIFESTASI KLINIS
KELAINAN VASKULER
RUPTUR KATUP

THANKS