HEART

FAILURE
Roro Wigid
Anatomi jantung
Fisiologi sirkulasi
Preload
CO2-O2
 Afterload/
Stroke Volume

CO = SV x HR
O2-CO2
Patofisiologi gagal jantung
Frank Starling Mechanism
Gagal jantung BACKWARD 2 KALI
 Edema
pulmonum
 Edema
pulmonum
Gagal jantung BACKWARD 2 KALI
 Gagal jantung BACKWARD 2 KALI

HT Pulmonum
Edema Perifer
 Gagal
Jantung
kiri
 Gagal
Jantung
kanan
Pemeriksaan JVP
Kriteria diagnosis gagal jantung : Kriteria Framingham

Kriteria Mayor Kriteria Minor

● Paroxysmal nocturnal dyspnea or orthopnea ● Ankle edema
● Neck-vein distention ● Nocturnal cough
● Rales ● Dyspnea on ordinary exertion
● Cardiomegaly ● Hepatomegaly
● Acute pulmonary edema ● Pleural effusion
● Protodiastolic gallop (S3 gallop) ● Decrease in vital capacity by one third from
● Increased venous pressure (≥16 cm H2O at right maximum recorded
atrium) ● Tachycardia (heart rate ≥120 bpm)
● Increased circulation time (≥25 sec)
● Hepatojugular reflux
2 Mayor / 1 Mayor + 2 Minor

Izumi et al ,2012
Klasifikasi New York Heart Association
(NYHA) functional class
Klasifikasi New York Heart Association
(NYHA) functional class
No limitation of physical activity. Ordinary physical activity does not cause
Class I undue breathlessness, fatigue, or palpitations.

Slight limitation of physical activity. Comfortable at rest, but ordinary physical

Class II activity results in undue breathlessness, fatigue, or palpitations.

Marked limitation of physical activity. Comfortable at rest, but less than ordinary
Class III physical activity results in undue breathlessness, fatigue, or palpitations.

Unable to carry on any physical activity without discomfort. Symptoms at rest can
Class IV be present. If any physical activity is undertaken, discomfort is increased.
Stage Gagal Jantung
 Stage Gagal Jantung
Stage A Stage B
Patient who is at risk of developing Patient who has structural heart
heart failure but has not yet disease associated with heart failure
developed structural cardiac but has not yet developed symptoms.
dysfunction

Stage C
Patient who has current or prior
symptoms of heart failure associated
with structural heart disease.
Stage D
Patient who has structural heart disease
and marked heart failure symptoms despite
maximal medical therapy and requires
advanced interventions
 Terapi

Warm Dry Warm Wet

WET
(Kongesti)

COLD
(Shock)
Dry Cold Wet Cold
 Pertanyaan
Seorang pasien laki-laki 59 tahun datang ke UGD dengan keluhan sesak memberat,dan pasien tampak
gelisah. Tekanan darah 80 palpasi, akral dingin dan basah, saturasi oksigen 78 %, ronki terdengar dari
lapang paru kanan dan kiri. Termasuk dalam klasifikasi gagal jantung manakah pasien tersebut diatas
menurut Stevenson Klasifikasi IV
a. Warm and wet
b. Cold and dry
c. Cold and wet
d. Warm and dry
 Pertanyaan
Seorang wanita berusia 65 tahun datang ke Puskesmas dengan keluhan sesak apabila naik tangga 2 lantai
sejak 3 bulan terakhir. Pemeriksaan tanda vital didapatkan tekanan darah 120/80 mmHg, denyut nadi 90
x/menit, frekuensi napas 22x/menit, suhu 36.9.0C. Pemeriksaan fisik ditemukan ictus cordis terlihat di
ICS VI 2 cm lateral dari mid clavicular line sinistra, terdengar rhonki basah halus di basal paru.
Kemungkinan klasifikasi gagal jantung pasien tersebut diatas?
a. HF stage C, Functional class 4
b. HF stage C, Functional class 3
c. HF stage C, Functional class 2
d. HF stage C, Functional class 1
THANK
YOU