Heart failure is a major clinical and public health problem with a prevalence of more than 23 million worldwide. Treatment of Heart Failure consists of pharmacological and non-pharmacological measures including physical exercise or cardiac rehabilitation. Cardiac rehabilitation is a set of integrated efforts or programs carried out to control the underlying causes of cardiovascular disease, improve physical, mental condition and as a secondary preventive measure. Cardiac rehabilitation aims to increase the patient's functional capacity, psychological adaptation to the chronic disease process, the foundation for long-term behavior and lifestyle changes to favorably influence long-term prognosis, and maintain an independent lifestyle as long as possible. The method that was used in this research is literature review by comparing the secondary data from literatures that was published in medical journal database such as PubMed, ClinicalKey and Google Scholar by following the inclusion and exclusion criteria. Reviews had been done in ten literatures that fulfill the inclusion and exclusion criteria. Those ten literature states that cardiac rehabilitation has many benefits in patients with heart failure. In conclusion, cardiac rehabilitation programs in patients with heart failure have many benefits on a patient's fitness. Cardiac rehabilitation programs can improve the quality of life in patients. The cardiac rehabilitation program increases Vo2Max and the endurance capacity of the heart. Cardiac rehabilitation program as a preventive step because it can prevent worsening heart health.Keywords: Heart failure, chronic heart failure, rehabilitation Abstrak: Gagal jantung adalah masalah klinis dan kesehatan masyarakat yang utama dengan prevalensi lebih dari 23 juta di seluruh dunia. Penananganan Gagal Jantung terdiri dari penanganganan farmakologis dan non farmakologis yang antara lain latihan fisik atau rehabilitasi jantung. Rehabilitasi jantung adalah sekumpulan upaya atau program yang terintegrasi yang dilakukan untuk mengontrol penyebab dasar penyakit kardiovaskular, memperbaiki kondisi fisik, mental dan sebagai langkah preventif sekunder. Rehabilitasi jantung bertujuan untuk meningkatan kapasitas fungsional pasien, adaptasi psikologis terhadap proses penyakit kronis, landasan bagi perubahan perilaku dan gaya hidup jangka panjang untuk mempengaruhi prognosis jangka panjang secara menguntungkan, dan mempertahankan gaya hidup mandiri selama mungkin. Metode penelitian yang digunakan adalah literature review (studi pustaka) dengan membandingkan data sekunder dari literatur-literatur yang dipublikasi dalam database jurnal kedokteran PubMed,ClinicalKey dan Google Scholar sesuai dengan kriteria inklusi dan eksklusi yang ada. Studi pustaka dilakukan pada sepuluh literatur yang memenuhi kriteria inklusi dan eksklusi. Sepuluh literatur tersebut menyatakan bahwa rehablitasi jantung memiliki banyak manfaat pada kebugaran pasien dengan gagal jantung. Sebagai simpulan, program rehabilitasi jantung pada pasien dengan gagal jantung memiliki banyak maanfaat pada kebugaran pasien. Program rehabilitasi jantung dapat meningkatkan kualitas hidup pada pasien. Program rehabiltasi jantung meningkatkan Vo2Max dan kapasitas daya tahan jantung. Program rehabilitasi jantung sebagai langkah preventif karena dapat mencegah perburukan kesehatan jantung.Kata Kunci: Heart failure, chronic heart failure, rehabiltasi jantung
Acute Coronary Syndrome (ACS) is a syndrome that occurred due to pathological changes inside the coronary artery wall which cause myocardial ischemic, Unstable Angina Pectoris (UAP), and Acute Myocardial Infarct (AMI) such as Non ST Elevation Myocardial Infarct (NSTEMI) and ST Elevation Myocardial Infarct. The prevalence of coronary heart disease (CHD) in Indonesia is 0.5% from the total sample of non-communicable diseases and from the total sample diagnosed with CHD the highest is in Middle Sulawesi (0.8%) followed by North Sulawesi (0.7%). This study aimed to obtain the prevalence of ACS in Prof. Dr. R. D. Kandou Hospital from 1 January to 31 December 2014. This was a descriptive retrospective study. Data were obtained from the medical record and Cardiovascular and Brain Center (CVBC) of Prof. Dr. R. D. Kandou Hospital in Manado. The results showed that there were 126 cases of ACS, 72 cases (57.1%) of UAP, 35 cases (37.8%) of NSTEMI, and 19 cases (15.1%) of STEMI. From the 126 cases there were 90 males (71.4%) and 36 females (28.6%). Based on age there were 2 cases (1.6%) of 31-40 years old, 15 cases (11.9%) of 41-50 years old, 42 cases (33.3%) of 51-60 years old, 48 cases (38.1%) of 61-70 years old, 16 cases (12.7%) of 71-80 years old, and 3 cases (2.4%) of over 80 years old. Based on histories of ACS assisted diseases, there were 87 (69.0%) cases of hypertension, 32 cases (25.4%) of diabetes mellitus, 37 cases (29.4%) of dyslipidemia, 7 cases (5.6%) of obesity, 19 cases (15.1%) of smokers, and 122 cases (96.8%) of ACS patients had more than one risk factor. Conclusion: In this study, the most prevalence of ACS was UAP, males, aged 61-70 years, and had hypertension history. Keywords: acute coronary syndrome, prevalence Abstrak: Sindrom Koroner Akut (SKA) merupakan keadaan terjadinya perubahan patologis dalam dinding arteri koroner, sehingga menyebabkan iskemik miokardium dan menimbulkan Unstable Angina Pectoris (UAP) serta Infark Miokard Akut (IMA) seperti Non ST Elevation Myocardial Infarct (NSTEMI) dan ST Elevation Myocardial Infarct (STEMI). Di Indonesia prevalensi penyakit jantung koroner (PJK) sebesar 0,5% dari total sampel penyakit tidak menular dan tertinggi di Sulawesi Tengah sebanyak 0,8% diikuti Sulawesi Utara 0,7% dari total pasien terdiagnosis PJK. Penelitian ini bertujuan untuk mengetahui prevalensi penderita SKA yang dirawat di RSUP Prof. Dr. R. D. Kandou Manado periode 1 Januari 2014 sampai 31 Desember 2014. Penelitian ini merupakan studi deskriptif retrospektif dengan menggunakan data Bagian Rekam Medik dan Cardivascular and Brain Center (CVBC) RSUP Prof. Dr. R. D. Kandou Manado. Hasil penelitian memperlihatkan 126 kasus SKA, kasus UAP sebanyak 72 kasus (57,1%), NSTEMI 35 kasus (37,8%), dan STEMI 19 kasus (15,1%). Laki-laki sebanyak 90 kasus (71,4%) dan perempuan 36 kasus (28,6%). Kelompok umur 31-40 tahun sebanyak 2 kasus (1,6%), 41-50 tahun 15 kasus (11,9%), 51-60 tahun 42 kasus (33,3%), 61-70 tahun 48 kasus (38,1%), 71-80 tahun 16 kasus (12,7%), dan >80 tahun 3 kasus (2,4%). Riwayat hipertensi sebanyak 87 kasus (69,0%), diabetes melitus 32 kasus (25,4%), dislipidemia 37 kasus (29,4%), obesitas 7 kasus (5,6%), dan merokok 19 kasus (15,1%). Simpulan: Prevalensi kasus SKA terbanyak adalah kasus UAP, berjenis kelamin laki-laki, berumur 61-70 tahun, serta memiliki riwayat hipertensi.Kata kunci: sindrom koroner akut, prevalensi
Myocardial infarction is classified into ST-segment elevation myocardial infarction (STEMI) and Non-ST-segment elevation myocardial infarction (NSTEMI). STEMI patient is considered for a reperfusion therapy, consisting of percutaneous coronary intervention (PCI), fibrinolytic therapy, and coronary artery bypass grafting (CABG). This study was aimed to determine the effectiveness of reperfusion therapy in STEMI patients. This was a literature review study. The results described the effectiveness of reperfusion therapy in terms of the time action, as follows: effective PCI if <120 minutes, fibrinolytic therapy <90 minutes, and CABG within four to 30 days after angiography. In case of revascularization with PCI there was a decrease in mortality and complications of reinfarction, major bleeding, and stroke. There was a reduction in complications of cardiogenic shock with fibrinolytic therapy when given within the first 60 minutes of symptom onset. Fibrin-spesific fibrinolytics (accelerated infusion alteplase, tenecplase, and reteplase) were the most effective regimen associated with reduced mortality. CABG procedure is recommended in coronary anatomical conditions that was not suitable for PCI and several other indications; although the complications were high but the survival of 30 days and one year was very good. In conclusion, PCI is the first line choice and effective if performed less than the first 120 minutes. Fibrinolytics are effective if they are administered during the first 60 minutes in case the PCI is not performed. Moreover, CABG is recommended in anatomical coronary condition that is not suitable for PCI and other indications.Keywords: reperfusion therapy, acute myocardial infarction, STEMI Abstrak: Infark miokard diklasifikasikan atas ST-segment elevation myocardial infarction (STEMI) dan Non-ST-segment elevation myocardial infarction (NSTEMI). Pada pasien STEMI diper-timbangkan untuk dilakukan terapi reperfusi yang terdiri dari percutaneous coronary intervention (PCI), terapi fibribolitik, dan coronary artery bypass grafting (CABG). Penelitian ini bertujuan untuk mengetahui efektivitas terapi reperfusi pada pasien STEMI. Jenis penelitian ialah literature review. Hasil penelitian ini menjelaskan efektivitas terapi reperfusi ditinjau dari waktu tindakan. Tindakan PCI efektif dilakukan <120 menit, terapi fibrinolitik <90 menit, dan CABG dalam empat hingga 30 hari setelah angiografi. Pada kasus revaskularisasi dengan tindakan PCI terdapat penurunan mortalitas dan komplikasi reinfark, perdarahan mayor, dan stroke. Terdapat penurunan komplikasi syok kardiogenik pada terapi fibrinolitik bila diberikan dalam 60 menit pertama setelah onset gejala. Fibrin-spesific fibrinolytics (accelerated infusion alteplase, tenecplase, dan reteplase) merupakan regimen yang paling efektif dikaitkan dengan penurunan mortalitas. Tindakan CABG direko-mendasikan pada kondisi anatomi koroner yang tidak sesuai untuk PCI dan beberapa indikasi lain; meskipun komplikasi tinggi namun kelangsungan hidup 30 hari dan satu tahun sangat baik. Simpulan penelitian ini ialah tindakan PCI merupakan pilihan lini pertama dan efektif diberikan dalam waktu <120 menit. Fibrinolitik efektif diberikan dalam 60 menit pertama bila PCI tidak dapat dilakukan sedangkan tindakan CABG direkomendasikan pada kondisi anatomi koroner yang tidak sesuai untuk PCI dan beberapa indikasi lain.Kata kunci: terapi reperfusi, infark miokard akut, STEMI
ST-Elevation Myocardial Infarction (STEMI) is a kind of acute myocardial infarctions (AMI) with a high rate of mortality. Patients with STEMI are usually treated with reperfusion therapy consisting of primary percutaneous coronary intervention (primary PCI) and fibrinolytic therapy. This study was aimed to determine the success rate of reperfusion therapy in patients with STEMI at Prof. Dr. R. D Kandou Hospital Manado from January to December 2016. This was a descriptive observational study with a retrospective approach. Samples were patients with STEMI treated with reperfusion therapy at Prof. Dr. R. D Kandou Hospital Manado from January to December 2016, obtained by using consecutive sampling method. There were 73 patients in this study consisted of 82.2% of males and 17.8% of females. Most patients were >60 years old; 39.0% treated with primary PCI and 43.8% with fibrinolytic therapy. According to duration of therapy administration, most primary PCI were given at >90 minutes (80.5%) and fibrinolytic therapy at >30 minutes (75%). The success rate of primary PCI was higher in patients treated at ≤90 minutes (100%) compared to patients treated at >90 minutes. Moreover, the success rate of fibrinolytic therapy was higher in patients treated at ≤30 minutes (100%) compared to patients treated at >30 minutes (75%). Ventricular tachycardia (34.6%) was the most common type of reperfusion arrhythmia. Conclusion: The success rate of reperfusion therapy (primary PCI and fibrinolytic) in STEMI patients was higher if it was administered according to the optimum recommendations and targets.Keywords: STEMI, success rate of reperfusion therapy Abstrak: ST elevasi miokard infark (STEMI) merupakan jenis infark miokard akut (IMA) dengan mortalitas yang tinggi. Penatalaksanaan pasien STEMI dilakukan dengan terapi reperfusi yang terdiri primary percutaneous coronary intervention (primary PCI) dan fibrinolitik. Penelitian ini bertujuan untuk mengetahui angka keberhasilan terapi reperfusi pada pasien STEMI di RSUP Prof. Dr. R. D. Kandou Manado periode Januari-Desember 2016. Jenis penelitian ialah deskriptif observasional dengan pendekatan retrospektif. Sampel penelitian ialah pasien STEMI yang menerima terapi reperfusi, dirawat di RSUP Prof. Dr. R. D. Kandou Manado periode Januari-Desember 2016, yang diperoleh dengan teknik consecutive sampling. Dari total 73 pasien STEMI didapatkan pasien berjenis kelamin laki-laki (82,2%) lebih banyak dibandingkan perempuan (17,8%). Kelompok usia terbanyak ialah >60 tahun; 39,0% untuk terapi primary PCI dan 43,8% untuk terapi fibrinolitik. Waktu dilakukannya terapi reperfusi terbanyak dengan waktu terapi >90 menit untuk terapi primary PCI (80,5%) dan >30 menit (75%) untuk terapi fibrinolitik. Angka keberhasilan terapi primary PCI <90 menit lebih tinggi (100%) dibandingkan dengan terapi primary PCI >90 menit (96,6%), dan angka keberhasilan terapi fibrinolitik <30 menit lebih tinggi (100%) dibandingkan dengan terapi fibrinolitik >30 menit (75%). Jenis aritmia reperfusi ditemukan terbanyak ialah aritmia ventrikel takikardi 34,6%). Simpulan: Angka keberhasilan terapi reperfusi (primary PCI dan fibrinolitik) pada pasien STEMI lebih tinggi jika dilakukan tepat waktu sesuai dengan sasaran terapi optimal.Kata kunci: STEMI, angka keberhsilan terapi reperfusi.
Acute Coronary Syndrome (ACS) is a collection of symptoms caused by acute myocardial ischemia. Over the past decade, several studies linking hyperglycemia on admission to higher mortality rate of patients with ACS, including acute myocardial infarction (AMI). This study aimed to obtain the profile of blood glucose levels among ACS patients at Prof. Dr. R.D. Kandou Hospital Manado from January to December 2014. This was an observational descriptive study with a retrospective approach. The results showed that there were 126 ACS patients; 21 patients were eligible for inclusion criteria. The number of male patients are higher than of female patients; most patients aged >60 years old; and the most type of ACS was unstable angina pectoris. Of the 21 patients, there were 6 patients with type 2 DM. Conclusion: Plasma glucose levels in ACS patients on admission tend to be normal, but fasting plasma glucose is higher in the NSTEMI and STEMI patients. Keywords: ACS, type 2 DM, stress hyperglycemia, admission, plasma glucose, fasting plasma glucose Abstrak: Sindroma Koroner Akut (SKA) adalah kumpulan gejala yang disebabkan oleh iskemik miokard akut. Selama dekade terakhir ini, beberapa studi menghubungkan hiperglikemia pada saat masuk rumah sakit dengan angka mortalitas yang semakin tinggi pada pasien dengan SKA, termasuk Infark Miokard Akut (IMA). Penelitian ini bertujuan untuk mengetahui gambaran kadar glukosa darah pada pasien SKA di RSUP Prof Dr. R. D. Kandou Manado periode Januari – Desember 2014. Penelitian ini menggunakan metode deskriptif observasional dengan pendekatan studi retrospektif. Hasil penelitian mendapatkan 126 pasien SKA tetapi yang memenuhi kriteria inklusi hanya 21 saja. Penderita laki-laki lebih banyak dibandingkan perempuan, golongan usia terbanyak >60 tahun, dan jenis SKA terbanyak ialah angina pektoris tidak stabil. Didapatkan pula 6 pasien dengan riwayat DM tipe 2 sebelumnya dan 15 pasien tanpa riwayat DM tipe 2. Simpulan: Kadar glukosa darah sewaktu pada pasien SKA cenderung normal, tetapi kadar glukosa darah puasa meningkat pada jenis STEMI dan NSTEMI. Kata kunci: SKA, DM tipe 2, stres hiperglikemik, glukosa darah sewaktu, glukosa darah puasa
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