gagal jantung kiri

7/17/2019 Gagal Jantung Kiri

http://slidepdf.com/reader/full/gagal-jantung-kiri-568ee7116bf49 1/22

Gagal Jantung KiriLAPORAN KELOMPOK

BLOK XIII KARDIOVASKULAR

SKENARIO 3

GAGAL JANTUNG KIRI DENGAN GEJALA AWAL HIPERTENSI STADIUM III

OLEH :

1. HERRY PRASETYANTO G0008105

2. IKE PRAMASTUTI G000810

3. IMAM RI!ALDI G000810"

#. IRA RISTINAWATI G0008111

5. I!!ATUL MUNA G0008113

$. KATHARINA B. DINDA S.M. G0008115

. NURSANTY S. G0008231

8. REDYA AYU T. G0008233

". RES%HITA ADITYANTI G0008235

10. RIESKA WIDYASWARI G00082311. SALMA ASRI NOVA G000823"

KELOMPOK "

NAMA TUTOR : &'. H(') P*'+,-,)&)/ MMR

AKULTAS KEDOKTERAN

UNIVERSITAS SEBELAS MARET

2010

BAB I

PENDAHULUAN



A. Latar Belakang Masalah

P(&( /+('), 3 B,/ S)4- K('&),(/*' 4'&(6(4 ,'(+7 (/)(/) 95#

4(*+; &(4(+7 / '*-( (/)4 &+7(+ /*(+ *4(-( (/ +(6( &)'4()

<(4*/ <'&((/ =('+( -'( -*&( <'&<('&<(' */(' 4)&*' &(+/+>)+7 <'/*'(+7 '4( /&*( /(/) 4)&(/ --<+7/(/. P+&')4( --))/)

')=(?(4 6'+( &)'(=(4 &) '*-( (/)4 /('+( -+&')4( (/)4 '*6( &(+

/-*&)(+ 4( &)<') ,<(4,<(4(+ &(+ /(&((+ --<()/ ((4 )4)'((4 &)

'*-( (/)4. P(&( () 6-')/((+ @)/ &)&(6(4/(+ 4/(+(+ &('( 180100

--H7 ('4 '(4 9HR; 120 -+)4 '7*(' '6)'(4),+ '(4 9RR; 32

-+)4 ** <(&(+ 3$50%&(+ C*7*(' +,* 6'*' 9JVP; 4)&(/

-+)+7/(4. H() )+6/) -+*+C*//(+ &)+&)+7 &(&( )-4') &(+ )>4*

>,'&) <'7' / (4'( <(=(. H() 6(6() &)4-*/(+ )>4* >,'&)

<'7' / (4'( <(=( &) 6(4)*- )+4'>,4( 9SI%; VI 2 >- (4'( )+(

-&),/()/*('). P(&( 6'/*) &)&(6(4/(+ () <'*6( <(4( C(+4*+7 /)')

<'7' /

(4'( <(=( &(+ <(4( /(+(+ C(+4*+7 6(&( SI% V )+( 6('(4'+( /(+(+.

H() (*/*4() &)&(6(4/(+ <*+?) C(+4*+7 I )+4+)4( -+)+7/(4 <*+?)

C(+4*+7 II +,'-( <))+7 6(+)4,)/ &) (6/ -+C((' / (4'( &(+ )'(-(

7(,6 6,)4). P(&( 6-')/((+ 6('* &)&(6(4/(+ )/*' +,'-( ',+/)

<(( <(( (* &(+ 6(&( 6-')/((+ (<&,-+ 4)&(/ &)&(6(4/(+

6(4,-7() &(+ 4)&(/ (&( (>)4.

P(&( 6-')/((+ (<,'(4,')*- &)&(6(4/(+ /(&(' -,7,<)+ 9H<; 1# 7'&

'*- *'*- $5 '*- /'(4)+)+ 1#. H() 6-')/((+ EKG &)&(6(4/(+ 4(4')( ?6'4',6? &(+ 4 +4')> ?6'4',6?. P(&( 6-')/((+ ,4,

4,'( 4(-6(/ (&(+?( /('&),-7() &+7(+ %TR 0$0 (6 >,'&) <'7'

/ (4( <(=( 6)+77(+7 C(+4*+7 -+,+C, &(+ (>*(')() 6('*

-+)+7/(4. P(&( 6-')/((+ (+()( 7( &('( -+*+C*//(+ ()&,)

-4(<,)/ 4'/,-6+().

P(&( 6-<(C('(+ KBKPBL 9K*')/**- B'<() K,-64+) P',<-

B(& L('+)+7; /+('), &((- 4*4,')( &)('(6/(+ &(6(4 -+C(&) 4')77'

(4(* 6-)>* *+4*/ --6(C(') )-*)-* &((' <),-&) &(+ /)+)/ *()

&+7(+ (('(+ 6-<(C('(+ ?(+7 *&( &)44(6/(+. A&(6*+ (('(+6-<(C('(+ ?(+7 4( &)4+4*/(+ (+4('( ()+: 6+7(4*'(+ 4/(+(+ &('(

6(4,7+) &(+ 6(4,@),,7) 7C(( 4(+&( &(+ () 6-')/((+ @)/ &(+

6+*+C(+7 6(&( 6+&')4( 6', 6+7(/(+ &)(7+,) 6+&')4( 6(&(

/+('),.

B'&(('/(+ ( &) (4( 6+*) <'*(( *+4*/ -+>(6() &(+ --+*)

(('(+ 6-<(C('(+ 4'<*4 ()+ -(*) 4*4,')( 44(6) C*7( -(*)



6+*)(+ (6,'(+ )+). P+*)(+ (6,'(+ )+) &)('(6/(+ &(6(4 &)C(&)/(+ <((+

6-<(C('(+ -(()=( ?(+7 <'(+7/*4(+ &(+ <((+ (*() C(*

-(+( 6+>(6()(+ (('(+ 6-<(C('(+ ?(+7 *&( &)&(6(4/(+.

B. Rumusan Masalah

1. B(7()-(+( 6+7(4*'(+ 4/(+(+ &('(F2. B(7()-(+( 6)&-),,7) &(+ 4),,7) 6+?(/)4 ?(+7 7(7( C(+4*+7 /)')F

3. B(7()-(+ 6(4,@),,7) 7(7( C(+4*+7 /)')F

#. B(7()-(+( () 6-')/((+ 6(&( 6+&')4(F

5. A6( /-*+7/)+(+ &)(7+,) 6+&')4(F

$. B(7()-(+( 6+(4((/(+((+ 6+?(/)4 ?(+7 &) &')4( 6()+F

C. Tujuan

1. M+74(*) 6+7(4*'(+ 4/(+(+ &('(

2. M+74(*) 6)&-),,7) &(+ 4),,7) 6+?(/)4 ?(+7 7(7( C(+4*+7 /)')

3. M++4*/(+ 6(4,@),,7) 7(7( C(+4*+7 /)')

#. M+74(*) () 6-')/((+ 6(&( 6+&')4(

5. M+74(*) /-*+7/)+(+ &)(7+,) 6+?(/)4 6()+

$. M+74(*) 6+(4((/(+((+ 6+?(/)4 6()+

D. Manfaat

1. M-<+4*/ 6,( 6)/)' -(()=( -+C(&) 4'('( &(+ )4-(4)/

2. M(()=( -(-6* -+?**+ 4*)(+ )-)( ?(+7 <()/ &(+ <+('

3. M+(-<( 6+74(*(+ -(()=( 4+4(+7 -/(+)- 6+?(/)4 6(&(

)4- /('&),(/*'.

#. M+(-<( 6+74(*(+ -(()=( 4+4(+7 4'(6) &(+ 6+>7((+

6+?(/)4 6(&( )4- /('&),(/*'.

BAB II

TINJAUAN PUSTAKA

A. Denisi

G(7( C(+4*+7 (4(* 6(?( C(+4*+7 (&(( )+&',- /)+) 9/*-6*(+ 4(+&(

&(+ 7C((; &)4(+&() , (/ +(6( 9&)6+*; &(+ -*&( ( 9(4)7*;

<()/ 6(&( ((4 )4)'((4 (4(* ((4 (/4))4(; ?(+7 &)<(</(+ , /()+(+

4'*/4*' (4(* *+7) C(+4*+7 ?(+7 -+77(+77* /-(-6*(+ +4')/ 9<))/

C(+4*+7; *+4*/ -+7)) &(+ -+7*('/(+ &('( / )'/*().G(7( C(+4*+7

/,+74) -'*6(/(+ *(4* )+&',- /)+) ?(+7 &)4(+&() &+7(+ (&(+?(

(<+,'-()4( *+7) +4')/ /)') &(+ /()+(+ '7*() +*',,'-,+(

&)'4() &+7(+ )+4,'(+) /-(-6*(+ /'C( @) '4+) >()'(+ &(+

--+&/+?( *-*' )&*6.

B. Etiologi



P+?<(< '')< &(') 7(7( C(+4*+7 (+4('( ()+: (')4-)( 9-)(+?(: (4')(

@<')(4),+; -<,) 6('*6('* 96*-,+('? -<,)-; )6'4+) -()7+( (4(*

(>>'(4& 6+?(/)4 4)',)& 9)6,4)',)&)- (4(* )6'4)',)&)-; (*('

('4 &)( *+4(< (+7)+( )7 ,*46*4 ()*' 7(7( 7)+C(

6'-((((+ ?(+7 &)4)-<*/(+ , 6+7,<(4(+ 9-&)>(4),+)+&*>&6',<-; )+4(/ 9(*6(+; 7('(- ?(+7 4)+77) &(+ (+-)( <'(4.

M+*'*4 %,=) MR D(' O 92008; 6+?<(< 7(7( C(+4*+7 &(6(4

&)/()@/()/(+ &((- +(- /(47,') *4(-(:

1. K7(7((+ ?(+7 <'*<*+7(+ &+7(+ (<+,'-()4( -),/('& &(6(4

&)<(</(+ , )(+7+?( -),)4 9)+('/ -),/('&; /,+4'(/) ?(+7 4)&(/

4'/,,'&)+() 94 <*+& <'(+> <,>/; <'/*'(+7+?( /,+4'(/4))4(

9/('&),-),6(4);.

2. K7(7((+ ?(+7 <'*<*+7(+ &+7(+ ,',(& 9)6'4+);.

3. K7(7((+ ?(+7 <'*<*+7(+ &+7(+ (<+,'-()4( /(4*6.

#. K7(7((+ ?(+7 &)<(</(+ (<+,'-()4( ')4- C(+4*+7 94(/)/('&);.

5. K7(7((+ ?(+7 &)<(</(+ (<+,'-()4( 6')/('& (4(* *) 6')/('&

94(-6,+(&;.

$. K()+(+ /,+7+)4( C(+4*+7.

(/4,' P'&)6,)) &(+ (/4,' P+>4*

(/4,' P'&)6,))

Y(+7 -'*6(/(+ (/4,' 6'&)6,)) 7(7( C(+4*+7 (+4('( ()+: )6'4+)

6+?(/)4 ('4') /,',+' /('&),-),6(4) +?(/)4 6-<** &('( 6+?(/)4

C(+4*+7 /,+7+)4( 4+,) -)4'( &(+ 6+?(/)4 6')/('&)(.

(/4,' P+>4* Y(+7 -'*6(/(+ (/4,' 6+>4* 7(7( C(+4*+7 (+4('( ()+: -+)+7/(4+?(

(*6(+ 9)+4(/; 7('(- /4)&(/6(4*(+ -+C((+) 6+7,<(4(+ (+4) 7(7(

C(+4*+7 )+(/ -),/('& (/*4 )6'4+) (')4-)( (/*4 )+/) &-(- -<,)

6('* (+-)( 4)',4,/)/,) /(-)(+ &(+ +&,/('&)4) )+/4).

C. Patosiologi

G(7( C(+4*+7 (&(( )+&',- /)+) ?(+7 &)4(+&() , (/ +(( &(+

(4)7* 9((4 )4)'((4 (4(* ((4 (/4))4(; ?(+7 &)<(</(+ ,

/4)&(/-(-6*(+ C(+4*+7 --,-6( &('( &+7(+ />6(4(+ ?(+7 >*/*6

*+4*/ --+*) /<*4*(+ -4(<,)/ C(')+7(+ (4(* /-(-6*(+ -(/*/(+( )+) 6(&( 4/(+(+ 6+7))(+ ?(+7 -+)+7/(4.

G(7( C(+4*+7 -'*6(/(+ /6') &(') @+( >,--,+ 6(4=(? &+7(+

<'<(7() 4),,7) <'*6( /('&),-),6(4) 9&)(4() )6'4',@/ '4')/4);

6+?(/)4 /(4*6 C(+4*+7 9-)4'( &(+ (,'4(; )6'4+) <'(4 ?(+7 4(/ &),<(4)

/,+*-) (/,, &(+ ,<(4,<(4(+ &(+ ()+()+. J(&) -*( <+4*/

6+?(/)4 C(+4*+7 9<()/ 6(&( ,4,4 C(+4*+7 6-<** &('( C(+4*+7



6')/('&)( /,+7+)4( (')4-)(; &(6(4 <'(/)' -+C(&) 7(7( C(+4*+7.

B'<(7() (/4,' 4),,7) &(6(4 <'6'(+ -+)-<*/(+ 7(7( C(+4*+7 ?(+7

/-*&)(+ -'(+7(+7 4)-<*+?( -/(+)- /,-6+() &(+ C)/(

-/(+)- /,-6+() )+) <'<)(+ -(/( &(6(4 -+)-<*/(+ 7C((

7C(( 7(7( C(+4*+7. M/(+)- /,-6+() C(+4*+7 4'<*4 <'*6(:1. M/(+)- '(+/S4(')+7

M/(+)- '(+/S4(')+7 <'('4) -(/)+ <(' ,4,4 C(+4*+7 &)'7(+7/(+

(-( 6+7))(+ -(/)+ <(' //*(4(+ /,+4'(/) &(+ -(/)+ <(' 6*(

C*-( &('( ?(+7 &)6,-6( / &((- (,'4( (4(* ('4') 6*-,+().

K,+4'(/) +4')/ ?(+7 -+*'*+ (/(+ -+7(/)<(4/(+ 6+7,,+7(+ '*(+7

?(+7 4)&(/ -6*'+( )+77( ,*- &('( ?(+7 -+*-6*/ &- +4')/

((4 &)(4, 9,*- (/)' &)(4,)/; <) <(' &(') +,'-(. B'&(('/(+

*/*- '(+/S4(')+7 6+)+7/(4(+ ,*- )+) (/(+ -+)+7/(4/(+ 6*( &(?(

/,+4'(/) +4')/ )+77( &(6(4 -+7()/(+ >*'( C(+4*+7 ?(+7 <)

<('.

2. H)6'4',@ V+4')/

P+)+7/(4(+ ,*- (/)' &)(4,)/ C*7( (/(+ -+)+7/(4/(+ 4/(+(+ &)

&)+&)+7 +4')/ ?(+7 C)/( 4'C(&) 4'*-+'* -(/( (/(+ -'(+7(+7

6'4*-<*(+ )6'4',@ +4')/. T'C(&)+?( )6'4',@ +4')/ <'*+7)

*+4*/ -+7*'(+7) 4/(+(+ &)+&)+7 &(+ -+)+7/(4/(+ -(( '(<*4 ,4,4

)+77( --)('( //*(4(+ /,+4'(/) +4')/. D)+&)+7 +4')/ ?(+7

-+7((-) )6'4',@ (/(+ -+)+7/(4 //(/*(++?( 9(4))4( <'/*'(+7;

)+77( -/(+)- /,-6+() )+) (* &))/*4) &+7(+ 6+)+7/(4(+

4/(+(+ &)(4,)/ +4')/ ?(+7 (+C*4+?( C*7( -+?<(</(+ 6+)+7/(4(+4/(+(+ (4')*- /)').

3. A/4)() N*',,'-,+(

P'(+7(+7(+ +*',,'-,+( -+>(/*6 )4- ('( )-6(4)/ )4- '+)+

(+7),4+)+ 6+)+7/(4(+ 6',&*/) ,'-,+ (+4)&)*'4)/ &(+ 664)&(

+(4')*'4)/.

P+*'*+(+ >*'( C(+4*+7 &(6(4 -'(+7(+7 <(','64,' &) )+* >(',4)

&(+ ('/* (,'4( )+77( 4'C(&) 6'(+7(+7(+ )-6(4) &(+ 6+7(-<(4(+

6('()-6(4) ?(+7 -+7(/)<(4/(+ 6+)+7/(4(+ &+?*4 C(+4*+7

/,+4'(/4))4( +4')/ &(+ (,/,+4')/) +( &(+ ('4') )4-)/ )+77(4'C(&)( 6+)+7/(4(+ >*'( C(+4*+7 6+)+7/(4(+ ()'(+ <()/ +( /

C(+4*+7 &(+ 6+)+7/(4(+ 4((+(+ 6')'

P+*'*+(+ >*'( C(+4*+7 -+?<(</(+ 6+*'*+(+ 6'*) ('4') '+()

)+77( -'(+7(+7 '64,' C*4(7,-'** ?(+7 /-*&)(+

-+?)+4) '+)+ &(+ 4'C(&)( )&',)) (+7),4+)+,7+ -+C(&)

(+7),4+)+ I (+7),4+)+ I &)/,+') -+C(&) (+7),4+)+ II , A%E ?(+7



/-*&)(+ -+7)+&*/) (,/,+4')/) &(+ /') (&,4',+ )+77(

4'C(&) 6+)+7/(4(+ 4((+(+ 6')' '4+) +(4')*- &(+ ()' ?(+7

-+7(/)<(4/(+ 6+)+7/(4(+ ()' <()/ +( / C(+4*+7 )+77( 4'C(&)(

6+)+7/(4(+ >*'( C(+4*+7 -(*) -/(+)- '(+/S4(')+7.

G(7( C(+4*+7 6()+7 ')+7 -'*6(/(+ -(+)4() &(') /()+(+ *+7)/,+4'(/4))4( +4')/ 9&)*+7) )4,)/; (4(* 7(+77*(+ '(/() +4')/

9&)*+7) &)(4,)/;. P(&( &)*+7) )4,)/ /,+4'(/4))4( -),/('& -+7((-)

7(+77*(+ )+77( >*'( C(+4*+7 -+*'*+ &(+ -+?<(</(+ /-((+

(4)7* -+*'*++?( /-(-6*(+ (/4))4( @)/ &(+ 7C(( )6,6'*)

()++?(.

P(&( &)*+7) &)(4,)/ 4'C(&) 7(+77*(+ '(/() -),/('& (/)<(4

6+)+7/(4(+ //(/*(+ &)+&)+7 +4')/ &(+ 6+*'*+(+ >,-6)(+> )+77(

6+7))(+ +4')/ ((4 ( &)(4, 4'7(+77*. G(7( C(+4*+7 &)(4,)/

&)&@+))/(+ <(7() 7(7( C(+4*+7 &+7(+ '(/) C/) <) &(') 50.

D)*+7) )4,)/ &(+ &)(4,)/ ')+7/() &)C*-6() <'(-((+ &(+ 4)-<*+?(

7(7( C(+4*+7 )4,)/ <)( --6+7('*) *+7) &)(4,)/. D)(7+,) 7(7(

C(+4*+7 )4,)/ (4(* &)(4,)/ 4)&(/ &(6(4 &)4+4*/(+ &+7(+ (+(-+) &(+

6-')/((+ @)/ (C(. D)(7+,) &)<*(4 &+7(+ 6-')/((+ D,66'

/,/('&),7'(@ ()'(+ &('( -)4'( &(+ ()'(+ +( 6*-,+(). 9

G(7( C(+4*+7 &(6(4 --+7('*) C(+4*+7 /)') C(+4*+7 /(+(+ (4(*

/&*(+?( 9<)+4')/; +(-*+ &((- 6'(/4)/ C(+4*+7 /)') ?(+7 &(+7

4'/+(. M(+)4() 4'')+7 &(') 7(7( C(+4*+7 /)') (&(( &)6+( (4(*

6'(((+ /(<)(+ +(6(. H( )+) 4'*4(-( &)<(</(+ , 6+*'*+(+

>,-6)(+> 6('* (/)<(4 &-( &(+ /,+74) 6('* &(+ , 6+)+7/(4(+(/4))4( '64,' '7(+7 ,4,+,- &) &((- 6('*. D)6+( 6()+7 C(

=(/4* (/4))4( @)/ 9&?6+* &,'4;. D)6+( C*7( C( ((4 6()+

<'<(')+7 9,'4,6+(; /('+( -+)+7/(4+?( C*-( &('( +( ?(+7 /-<()

/ 4,'(/ &(') /4'-)4( <(=( &(+ /('+( 6(&( 6,)) )+) &)('(7-(

4'(+7/(4. D)6+( +,/4*'+( 6(',/)-( (&(( <+4*/ &)6+( ?(+7

&'(-(4)/ 6(&( /(&((+ 4'<*4 6()+ 4'<(+7*+ &+7(+ (/ +(6(

<(4 -+&(&(/ &)'4() <(4*/ +() 4'>/)/ &(+ -+7). M(+)4() ()+

7(7( C(+4*+7 /)') (&(( /((+ ,4,4 6-<('(+ C(+4*+7 4(/)/('&)(

<*+?) C(+4*+7 /4)7( 9S3; 7(,6 ',+/) <(( (* &) <(( 6('* /('+(()'(+ *&('( ?(+7 -=(4) (,* ?(+7 &-(4,(. T'C(&) /'6)4() 6('*

/('+( &-( (,(' &(+ &-( &)+&)+7 <',+/* &(6(4 -+?<(</(+

-+7). S)')+7 &+7(+ <'4(-<(+?( &)(4() +4')/ ,4,4 6(6)(')

<'7' / (4'( )+77( 4'C(&) '7*'7)4() -)4'( &(+ -*'-*' )4,)/

<'+(&( 4)+77). D)(4() /',+) (4')*- /)') C*7( &(6(4 4'C(&) &(+

-+?<(</(+ @<')() (4')*- ?(+7 <'-(+)4() <(7() &+?*4 C(+4*+7



)''7*('? )''7*(' 94)&(/ 4'(4*' >('( 4)&(/ 4'(4*';.;

M(+)4() *4(-( &(') 7(7( C(+4*+7 /(+(+ (&(( <+&*+7(+ +(

)4-)/ &(+ &-( C(')+7(+ *+(/. K,+74) +( )4-)/ >('( /)+)

4(-6(/ <(7() &)4+) +( ' &(+ 6-<('(+ (4) ?(+7 /(&(+7

/(&(+7 +?') 4/(+. B+&*+7(+ )+) C*7( -+?<(</(+ 6+)+7/(4(+ '/*+)4',-<,) +( &((- &(+ -<,* 6('*. E&-( -+?<(</(+ 6+(-<((+

<'(4 &(+ <)((+?( <) C( &) <(7)(+ &6+&+ 4*<* 6'4) /(/) &(+

4*+7/() <(=(. P(&( 7(7( +4')/ ?(+7 <) 6('( &-( &(6(4 -+C(&)

7+'()4(. E*) 6*'( ')+7 4'C(&) 4'*4(-( &) )) /(+(+ &(+ -*+7/)+

&)'4() *) 6')/('&)*- &(+ ()4. P(&( 7(7( C(+4*+7 /(+(+ &)4-*/(+

&)6+* +(-*+ <*/(+ ,'4,6+* (4(* PND. P(&( 6(6() -*+7/)+ &)&(6(4/(+

7'(/(+ <'7,-<(+7 9(; ?(+7 -+(+&(/(+ )6'4',@ +4')/ /(+(+

&(+(4(* &)(4() '4( 6(&( (*/*4() &)&(6(4/(+ <*+?) C(+4*+7 S3 (4(* S#

+4')/ /(+(+.

Patosiologi Gagal Jantung

•

•

•

• )+S('

•

G(7( C(+4*+7 &)<(</(+ , /,+&)) (6(6*+ ?(+7 -+7*'(+7) @)+)

&(') -),/('&)*- (4(* ,4,4 C(+4*+7 -(*) /'*(/(+ (4(* ,',(&)+7.

D+7(+ &-)/)(+ &(6(4 &)<(</(+ , <'(7(- (''(? /,+&)) <(7()

)+('/ -),/('& 9&)-(+( ,4,4 C(+4*+7 //*'(+7(+ ,/)7+ &(+ -(4);

)6'4+) 9?(+7 -+)+7/(4/(+ //*(4(+ /,+4'(/) ?(+7 &)6'*/(+ *+4*/

--,-6( &('(; &(+ (-),)&,) 9&) -(+( 6',4)+ &))-6(+ &) ,4,4 C(+4*+7

-+?<(</(+ )( -+C(&) /(/*;. S(-( =(/4* )+) 6+)+7/(4(+ <<(+ /'C(

(/(+ -+7()/(+ 6'*<((+ 6(&( C(+4*+7 )4* +&)'):

• M+7*'(+7) /,+4'(/4))4( (4(* //*(4(+ /,+4'(/) /('+( ,',(&)+7

+4')/. D((- /(4(+ -+)+7/(4/(+ 6+7))(+ () /,+4'(/4))4(

+4')/ -+)+7/(4 9, */*- '(+/S4(')+7 4+4(+7 C(+4*+7; &(+

http://www.news-medical.net/health/Heart-Failure-Pathophysiology-(Indonesian).aspx

http://www.news-medical.net/health/Heart-Failure-Pathophysiology-(Indonesian).aspx



&+7(+ &-)/)(+ 6+)+7/(4(+ >('&)(> ,*46*4. P(&( 7(7( C(+4*+7

-/(+)- )+) 7(7( /('+( +4')/ ?(+7 ('(4 &+7(+ &('( / 4)4)/

&) -(+( /,+4'(/) ,4,4 C(+4*+7 -+C(&) /*'(+7 @)+. H( )+)

&)<(</(+ 6+*'*+(+ /-(-6*(+ *+4*/ >',)+/ @(-+ (/4)+ &(+

-?,)+ &) <)-'7(+7 ,4,4 C(+4*+7.

• S<*( -+7*'(+7) ,*- 4',/ <(7() () &(') /7(7((+ )4,

&)(4, (4(* /&*(+?(. V,*- )4,)/ (/)' P+)+7/(4(+ <)((+?(

&)<(</(+ , /,+4'(/4))4( <'/*'(+7. P+*'*+(+ () (/)'

&)(4,)/ ,*- *('( &(') 6+7))(+ +4')/ 7(+77*(+ 6'4) ?(+7

4'C(&) /4)/( /6(4*(+ C(4* +4')/ 9?()4* /4)/( &)+&)+7 /(/*;.

• M+7*'(+7) /(6()4( >(&(+7(+. S<(7() C(+4*+7 </'C( <) /'(

*+4*/ --+*) /<*4*(+ -4(<,)- +,'-( C*-( ,*46*4

C(+4*+7 &(6(4 -+)+7/(4 ((4 6'-)+4((+ ,/)7+ -+)+7/(49-)(+?( (4)(+; &)/*'(+7). H( )+) --<')/(+ /,+4')<*) 4'(&(6

)+4,'(+) (4)(+ ')+7 4')(4 6(&( 7(7( C(+4*+7. I+) <'('4) *+4*/

)(+7+?( >(&(+7(+ C(+4*+7 ,'(+7. %(&(+7(+ C(+4*+7 -+7(>*

6(&( /-(-6*(+ C(+4*+7 *+4*/ </'C( <) /'( (-( (4)(+

(4(* (/4))4( <'(4. K('+( C(+4*+7 ('* </'C( <) /'( *+4*/

--+*) /<*4*(+ -4(<,)/ +,'-( 4)&(/ -(-6* --+*)

4*+4*4(+ -4(<,)- 4*<* (-( (4)(+.

• P+)+7/(4(+ &+?*4 C(+4*+7 &)'(+7(+7 , 6+)+7/(4(+ (/4))4(

)-6(4) *+4*/ --6'4((+/(+ >*'( C(+4*+7. A=(+?( )+)

--<(+4* -+7)-<(+7) 7(7( C(+4*+7 &+7(+ -+C(7( 4/(+(+

&('( &(+ 6'*) 4(6) 4-6(4 (+C*4 /47(+7(+ 6(&( -),/('&)*-

-+)+7/(4/(+ 6'*) /,',+' 6'?('(4(+ ?(+7 &(6(4 -+?<(</(+

--<*'*/+?( 6+?(/)4 C(+4*+7 )/-)/. A/4))4( )-6(4) C*7( &(6(4

-+?<(</(+ (')4-)( (4(.

• H)6'4',@ 96+)+7/(4(+ &((- */*'(+ @)/; &(') -),/('&)*-

&)<(</(+ , '(4'(4 ,4,4 C(+4*+7 4'-<*/(+ &)<&(/(+

-+)+7/(4 &((- */*'(+ &((- *6(?( *+4*/ -+)+7/(4/(+/,+4'(/4))4(. H( )+) &(6(4 -+?<(</(+ //(/*(+ -+)+7/(4 &(+

6+*'*+(+ /-(-6*(+ *+4*/ ')/ (-( &)(4,.

• P-<('(+ +4')/ <'/,+4')<*) 4'(&(6 6-<('(+ &(+ <+4*/

<*(4 7(7( C(+4*+7. P+)+7/(4(+ ,*- +4')/ C*7( -+?<(</(+

6+*'*+(+ 4',/ ,*- /('+( )+@)+) -/(+)/ &(+ /,+4'(/4).



E/ *-*- (&(( (( (4* &(') ,*46*4 C(+4*+7 <'/*'(+7 &(+ 4/(+(+

-+)+7/(4 6(&( C(+4*+7. H( )+) -+)+7/(4/(+ '))/, '(+7(+ C(+4*+7

9/** /('+( &)')4-)( +4')/; &(+ -+7*'(+7) *6() &('( / *'*

4*<*. P(&( 6+?(/)4 /',+) ,*46*4 C(+4*+7 <'/*'(+7 -+?<(</(+

C*-( 6'*<((+ &) *'* 4*<* <<'(6( &) (+4('(+?( /,-6+()@),,7) <<'(6( &) (+4('(+?( -'*6(/(+ <(7)(+ &(') 6', 6+?(/)4:

• T/(+(+ &('( ('4') 4*'*+. H( )+) &4)-*(4 <(','64,' 6(&(

)+* /(',4) &(+ ('/* (,'4( ?(+7 )+/ / )+4) 4'(>4* ,)4(')*. P*(4 &)

,4(/ -+)+7/(4/(+ (/4))4( )-6(4) /(4/,(-)+ -6(/(+ /

&((- ()'(+ &('(. M+7)/(4 *+4*/ ((1 () '64,' &)

(,/,+4')/) ('4') )4-)/. H( )+) --<(+4* -+7-<()/(+

4/(+(+ &('( 4(6) C*7( -+)+7/(4/(+ ')4+) 6')' 4,4(

6+)+7/(4(+ <<(+ /'C( C(+4*+7. M+7)/(4 '64,' <4(1 &((-

-),/('&)*- -+)+7/(4/(+ &4(/ C(+4*+7 &(+ --<*(4 /,+4'(/) <)/*(4 &((- *6(?( *+4*/ -+)+7/(4/(+ ,*46*4 C(+4*+7. I+) C*7(

<(7()-(+(6*+ -+)+7/(4/(+ C*-( /'C( C(+4*+7 ('* -(/*/(+.

• S4)-*() )-6(4) ?(+7 -+)+7/(4 C*7( -+?<(</(+ )6,4((-*

*+4*/ -+7*('/(+ (,6')+ 9C*7( &)/+( <(7() ,'-,+

(+4)&)*'4)/ ADH (4(*; ?(+7 -+?<(</(+ '4+) >()'(+ &) 7)+C(. H(

)+) -+)+7/(4/(+ ,*- &('( &(+ 4/(+(+ &('(.

• M+7*'(+7) 6'*) 9()'(+ &('(; / 7)+C( -'(+7(+7 66((+

'+)+ +)- ?(+7 -+7/(4()) 6',&*/) (+7),4+)+ (,6','

/*(4. A+7),4+)+ &(+ -4(<,)4+?( -+?<(</(+ (,>,+4')>4),+ <)

(+C*4 &(+ -'(+7(+7 /') (&,4',+ -+)+7/(4 &(') 4',)& &(')

/+C(' (&'+(. I+) --6',-,)/(+ 7('(- &(+ '4+) >()'(+ &) 7)+C(

C*7( -+)+7/(4/(+ ,*- &('(.

• T)+7/(4 /',+) 4)+77) <'&(' ,'-,+ +*',+&,/')+ 6'4)

/(4/,(-)+ '+)+ (+7),4+)+ &(+ (&,4',+ --6+7('*)

-),/('&)*- >('( (+7*+7 -+?<(</(+ '+,() 4'*/4*'( C(+4*+7

&((- C(+7/( 6(+C(+7. B(+?(/ &(') / '+,() 4(-6(/+?( &)-&)()&+7(+ -+7*<( (/4,' 6'4*-<*(+ <4( 9TG<4(; ?(+7

-'*6(/(+ 4('74 ))' *-*- &(') /(/(& 4'(+&*/) )+?( &)6'(/('()

, /(4/,(-)+ &(+ (+7),4+)+ II &(+ C*7( , (/4,' 6'4*-<*(+

6)&'-( 9EG; ?(+7 4('74 C(*' )+?( &)(/4)/(+ , (&,4',+



• M+7*'(+7) 6'*) ,4,4 '(+7/( -+?<(</(+ (4',@ &(') '(4 ,4,4. H(

)+) &(6(4 -+7(/)<(4/(+ /-((+ 6+)+7/(4(+ &(+ 6+*'*+(+

//*(4(+ (4)7*(<))4? 6*+>(/ -*( /,+4')<*) 4'(&(6 )+4,'(+)

(4)(+.

R)4+) 6')' -+)+7/(4 &(+ &('( '7(+7(+ ,*- ?(+7 <) <('

4-6(4 <) (+C*4 4+4(+7 C(+4*+7 &(+ --6'>6(4 6', /'*(/(+

6(&( -),/('&)*-. V(,/,+4')/) &(+ '4+) >()'(+ -+7()/(+ 4/(+(+

)&',4(4)/ &((- /(6)' -+)+7/(4. I+) 6'7'(+ 6')-<(+7(+ //*(4(+

&((- -+&*/*+7 6-<+4*/(+ >()'(+ )+4'4))( <(7() 6+)+7/(4(+

4/(+(+ >()'(+ 4(-<((+ 6(*/(+ /*(' &(') &('( / &((- C(')+7(+. H(

)+) -+?<(</(+ &-( 9>()'(+ <*)&*6; &((- C(')+7(+. D) )) /(+(+ 7(7(

C(+4*+7 )+) <)((+?( &)-*() &) 6'7(+7(+ /(/) &) -(+( 4/(+(+ +( ?(+7

4)+77) /('+( / 7'()4() 9=((*6*+ C)/( 6()+ &) 4-6(4 4)&*' (/*-*()

>()'(+ &(6(4 &)-*() &) =)(?( (/'(.; H( )+) C*7( &(6(4 4'C(&) &) 6'*4',+77( &) -(+( >()'(+ --<(+7*+*6 ?(+7 &)<*4 (>)4. D) )) /)')

C(+4*+7 7(7( &-( &(6(4 4'C(&) &) 6('*6('* )+) &)<*4 &-( 6('*

/('&),7+)/. H( )+) -+7*'(+7) /(6()4( >(&(+7(+ *+4*/ +4)()

-+?<(</(+ //(/*(+ 6('*6('* &(+ -+7*'(+7) @)+) 6'4*/('(+ 7(

&+7(+ -+)+7/(4/(+ C('(/ (+4('( *&('( &(+ &('(. K,+/*+) &(') )+)

(&(( (/ +(6( &)6+( +,/4*'+( ,'4,6+,( &(+ 6(',/)-(.

GC((7C(( 7(7( C(+4*+7 <(7)(+ <(' &)4+4*/(+ , )) -(+(

C(+4*+7 7(7(. S)) /)') --,-6( &('( / )'/*() )4-)/ &(+7/(+ ))/(+(+ --,-6( &('( / )'/*() 6('*. S-+4('( )) /)') 7(7( C(+4*+7

(/(+ -+7*'(+7) >*'( C(+4*+7 / )'/*() )4-)/ 7C(( (=( ')+7

-+(-6(//(+ /('+( / 6(&( )'/*() 6('*. P(&( &)*+7) )4,)/ '(/)

C/) -+*'*+ -+)+77(/(+ ,*- (<+,'-( &('( &) +4')/ /)'). P(&(

&)*+7) &)(4,)/ 4/(+(+ &)(4,)/ (/)' +4')/(/(+ 4)+77). K+()/(+

&((- ,*- (4(* 4/(+(+ 6*+77*+7 / (4')*- /)') &(+ /-*&)(+ /

6-<** &('( 6('*. P+)+7/(4(+ ,*- (4(* 4/(+(+ &) &((- +( 6('*

-'*(/ &'()+( +,'-( (,) &(+ +)/-(4 ()'(+ >()'(+ &(') /(6)' /

6('+/)- 6('*6('* -+?<(</(+ &-( 6('*. M+77(+77* 6'4*/('(+

7(. J(&) )) /)') 7(7( C(+4*+7 ')+7 -+?(C)/(+ &+7(+ 7C((

6'+(6((+: (/ +(6( ,'4,6+( &(+ 6(',?-( +,>4*'+( &?6+(.

P(&( /('&),-),6(4) ?(+7 6('( / &(') 6+*'*+(+ >*'( C(+4*+7 &(+

6'*) ?(+7 <*'*/ -+C(&) <) C( &(+ 6()+ (/(+ 4'=*C*& &+7(+



/4'-)4( &)+7)+ &(+ <'/')+7(4 )(+,) /(*&)/(), /-((+ *-*-

6*)+7 &(+ )+/,6

P('( )6,/)( ?(+7 &)()/(+ &)<(</(+ , &-( 6('* -+?<(</(+

(,/,+4')/) 6(&( )'/*() 6('*6('* ?(+7 -+7(/)<(4/(+ )6'4+)

6*-,+(. K('+( 4/(+(+ +4')/ /(+(+ -+7()/(+ C(* <) '+&(

&(') +4')/ /)') 9/)4(' 20 --H7 &)<(+&)+7/(+ /)4(' 120 --H7

-()+7-()+7 &((- )+&))&* ?(+7 (4; 44(6) 44(6 -+7()/(+

,*46*4 C(+4*+7 6') (-( &+7(+ +4')/ /)') )+) <'('4) <(=(

6+)+7/(4(+ />) &((- ')4+) (/*' 6('* -+?<(</(+ 6+)+7/(4(+

<(' &((- C*-( 6/'C((+ +4')/ /(+(+ ('* -(/*/(+. N(-*+

-/(+)- *4(-( ?(+7 )) /)') -+?<(</(+ 7(7( C(+4*+7 )) /(+(+ 7(7(

C(+4*+7 <+('+?( 4)&(/ &)6((-) &+7(+ <()/. B<'(6( 4,') --(+77)

-/(+)- ?(+7 &)-&)() , (/4)() +*',,'-,+(. E/ -/(+)/ C*7(

&(6(4 <'/,+4')<*). S<(7() +4')/ /)') -+7((-) &)4+) <**' 64*-)+4'(+4')/*(' / +4')/ /(+(+ 6+*'*+(+ /(6()4( +4')/ /(+(+.

D)*+7) )4,)/

G(7( C(+4*+7 &)<(</(+ , &)*+7) )4,)/ <) -*&( &)(/*). H( )+)

&(6(4 -+?&'(+(/(+ &)7(-<('/(+ <(7() /7(7((+ *+7) 6,-6(

C(+4*+7. H( )+) &)4(+&() &+7(+ '(/) C/) 6+*'*+(+ 9/*'(+7 &(') #5;.

K/*(4(+ /,+4'(/) +4')/ &)-(/(+ &(+ 4)&(/ --(&() *+4*/

-+>)64(/(+ ,*- 4',/ ?(+7 --(&() -+7()/(+ ,*46*4 C(+4*+7?(+7 4)&(/ --(&(). S>('( *-*- ( )+) &)<(</(+ , &)*+7) (4(*

/'*(/(+ -),)4 C(+4*+7 (4(* /,-6,++ -,/* -'/(. D((- 6+?(/)4

<(=((+ 6'4) D*>++ &)4',@ ,4,4 4'*/4*' -,/* -),)4 )+&))&*

4'6+7('*. M),)4 &(+ /,-6,++ -'/( &(6(4 '*(/ , 6'(&(+7(+

96'4) &) -),/('&)4); (4(* )+@4'() 96'4) &) (-),)&,);. R(>*+ &(+ (7+

('-(/,,7) 96'4) 4(+, /,/()+ &(+ (-4(-)+; )+4'(*'

-+?<(</(+ /'*(/(+ &(+ 4' ,/)&(4). M/(+)- ?(+7 6()+7 *-*-

&(') /'*(/(+ ?(+7 -+?<(</(+ )/-)( &(+ )+('/ 6-<+4*/(+ </(

*/(. S4( )+('/ -),/('& -),)4 -(4) &)7(+4)/(+ , C(')+7(+ 6('*4

&4'),*? --6+7('*) *+7) &(') -),/('&)*-. P(&( /,/('&),7'(-

( )+) &)+?(4(/(+ , 7'(/(+ &)+&)+7 (<+,'-( (4(* 4)&(/ (&(.

K('+( +4')/ (&(( 4)&(/ >*/*6 &)/,,+7/(+ (/)' &)(4,)/ +4')/

4/(+(+ &(+ ,*- -+)+7/(4. H( )+) &)4'(+-))/(+ / (4')*-. D) )) /)')

C(+4*+7 4/(+(+ -+)+7/(4 &)4'(+-))/(+ / 6-<** &('( 6('* &(+



4/(+(+ )&',4(4)/ ?(+7 &)()/(+ +)/-(4 4'(((4),+ >()'(+ / &((-

6('+/)- 6('*6('* -+?<(</(+ &-( 6('*. D) )) /(+(+ C(+4*+7

4/(+(+ -+)+7/(4 &)4'(+-))/(+ / )'/*() +( )4-)/ &(+ 4-6(4

4)&*' /(6)' )4-)/ -+&*/*+7 4'(((4),+ >()'(+ / &((- C(')+7(+

,'7(+ 4('74 &(+ /4'-)4( -+7()/(+ &-( 6')' 4'7(+4*+7.

D)*+7) &)(4,)/

G(7( C(+4*+7 &)<(</(+ , &)*+7) &)(4,)/ *-*-+?( &)7(-<('/(+

<(7() /7(7((+ +4')/ *+4*/ <'(+4() &(+ --(&() <)((+?(

-+*+C*//(+ &)+&)+7 +4')/ /(/*. H( )+) -+?<(</(+ -+7)) +4')/

4)&(/ --(&() &(+ , /('+( )4* () &((- 4',/ ,*- 4)&(/

--(&(). K7(7((+ '(/() +4')/ C*7( -+7()/(+ 6+)+7/(4(+

4/(+(+ &)(4,)/ (/)' &(+ () (/)'+?( (&(( )&+4)/ &+7(+ /(*

&)*+7) )4,)/ 9&-( 6('* 6(&( 7(7( C(+4*+7 /)') &-( 6')' 6(&(7(7( C(+4*+7 /(+(+.;

D)*+7) &)(4,)/ &(6(4 &)<(</(+ , 6', -)')6 &+7(+ ?(+7

-+?<(</(+ &)*+7) )4,)/ 4'*4(-( 6+?<(< ?(+7 --6+7('*)

'-,&)+7 C(+4*+7.

D)*+7) &)(4,)/ 4)&(/ &(6(4 --(+)4()/(+ &)')+?( />*() &((-

/4'- @),,7) C)/( *+7) )4,)/ ?(+7 &)(=4/(+. P()+ -*+7/)+

()-4,-(4)/ <+('<+(' <')4)'((4. N(-*+ -'/( (+7(4 6/( 4'(&(6

6+)+7/(4(+ &+?*4 C(+4*+7 &(+ '(+7(+ -+&(&(/ 4(/)/('&)( 9?(+7 &(6(4

&)<(</(+ (+?( , 4(+77(6(+ @),,7) *+4*/ 4+(7( &-(- (4(*

&)&'() (4(* &+7(+ 4(/)(')4-)( 6(4,,7) 6'4) (4')( @<')() +4')/

&+7(+ '6,+ ?(+7 >6(4; &(6(4 -+7(/)<(4/(+ ( &-( 6('*. T)+7/(4

/,+4', ?(+7 --(&() 9<)((+?( &+7(+ (7+ ('-(/,,7) ?(+7

--6'(-<(4 /,+&*/) AV 6'4) /()*- >(++ <,>/' (4(* <4(

<,>/'; O /('+( )4* /*+>) *+4*/ -+>7( &/,-6+().

*+7) +4')/ /)') &)(4,)/ &(6(4 &)4+4*/(+ -(*) /,/('&),7'(@ &+7(+

6+7*/*'(+ <'<(7() 6('(-4' 6'4) E R(), 9(=(/(4')*- +4')//)') -+7)) '(),; E 9+4')/ /)') 6+7))(+ (=(; =(/4* &'() &(+

=(/4* '(/() ),,*-)>.



D. i!ertensi

B*- (&( /(4*(+ 6+&(6(4 -+7+() &@+)) )6'4+). N(-*+ >('(

*-*- )6'4+) &)&@+))/(+ <(7() *(4* /(&((+ &)-(+( 4/(+(+ &('(

((4 )4)'((4 <) &(') +,'-(. P(&( 4(*+ 1""3 JN%DETH --<*(4/()@/() *+4*/ )6'4+) <(7() <')/*4 :

K()@/() T/(+(+

D('( *+4*/ U)( 18

4(*+

D(') -*( /(*

)6'4+) ?(+7 (&(

/)4(' "5 /(*-'*6(/(+ )6'4+) 6')-'+)( ?()4* )6'4+) ?(+7 4)&(/ &)/4(*)

6+?<(<+?(. H)6'4+) +)( (&(( 6+?(/)4 -*4)(/4,')( ?(+7 4)-<*

/('+( )+4'(/) <<'(6( (/4,' '))/, 6'4) 7+4)/ ,<)4( -',/,/

4' &(+ (*6(+ 7('(- ?(+7 <'<)(+. S&(+7/(+ 5 )(+?( (&((

)6'4+) /*+&' ?()4* /(&((+ 4'C(&)+?( 4/(+(+ &('( 4)+77) (/)<(4

6+?(/)4 4'4+4*

T'C(&)+?( )6'4+) -(*) 6-<+4*/(+ (+7),4+)+ II &(') (+7),4+)+ I

?(+7 &)<(+4* , A+7),4+)+ I%,+'4)+7 E+?- 9A%E;. A+7),4+)+ II

<'6'(+ &((- -+()//(+ 4/(+(+ &('( -(*) &*( -/(+)- ?()4*:1. M+)+7/(4/(+ /') ,'-,+ (+4)&)*'4)/ 9ADH;.

P+)+7/(4(+ /') ADH (/(+ -+?<(</(+ 6+7*('(+ *')+ &)/)4

)+77( &('( -+C(&) 6/(4 &(+ ,-,(')4(+?( -+)+7/(4.

2. M+4)-*() /') (&,4',+ &(') /,'4/ (&'+(.

A&,4',+ (/(+ -+7*'(+7) //') N(% 97('(-; &+7(+ >('(

-'(<,'6)+?( &(') 4*<** 7)+C(. N()/+?( /,++4'() N(% (/(+

"ategori#istolik

$mmg%

Diastolik

$mmg%

&ormal '( '(

&ormal

Tinggi)*+ , )*- / , -

i!ertensi

#ta0ium ) )1+ , )/- -+ , --

#ta0ium 2 )3+ , )4- )++ , )+-

#ta0ium * )+ , 2+- ))+ , ))-

#ta0ium 1 ( 2)+ ( )2+



&)+>'/(+ /-<() &+7(+ >('( -+)+7/(4/(+ ,*- >()'(+ /4'(*'

?(+7 6(&( 7))'(++?( (/(+ -+)+7/(4/(+ ,*- &(+ 4/(+(+ &('(.

J(&) 6+)+7/(4(+ /') ADH -+?<(</(+ &('( -+C(&) <) 6/(4

)+77( 4'C(&) 6+)+7/(4(+ )/,)4( &(+7/(+ (&,4',+ (/(+

-+)+7/(4/(+ ,*- &('(. P+)+7/(4(+ )/,)4( &(+ 6+)+7/(4(+,*- &('( -+?<(</(+ 6+)+7/(4(+ 4((+(+ 6')' /-*&)(+ (/(+

-+?<(</(+ 6+)+7/(4(+ 4/(+(+ &('( 9H)6'4+);.

P(&( 6+&')4( )6'4+) <(','64,' -() <'*+7) -+7(4*' 4/(+(+

&('(. N(-*+ -'/( 4( <'(&(64() *+4*/ --6'4((+/(++?( 6(&(

4/(+(+ '(4('(4( ?(+7 <) 4)+77) &(') ,'(+7 +,'-(. H)6'4+) &(6(4

-+)-<*/(+ /'*(/(+ ,'7(+ 4*<* ()+. K'*(/(+ ,'7(+,'7(+ 4('74

?(+7 *-*- &)4-*) (&((:

1. J(+4*+7 : )6'4',@ +4')/ /)') (+7)+( 6>4,') )+('/ -),/('&)*- &(+

7(7( C(+4*+7.

2. O4(/ : 4',/ 4'(+>)+4 )>-)> (44(>/ 9TIA;.

3. P+?(/)4 7)+C( /',+)

#. P+?(/)4 ('4') 6')'

5. R4)+,6(4)

A&(+?( /'*(/(+ ,'7(+ 4('74 4'*4(-( C(+4*+7 &(+ 6-<** &('( (/(+

--6'<*'*/ 6',7+,) 6+&')4( )6'4+). S(-( )+) 4)+77)+?( (+7/(

-,'<)&)4( &(+ -,'4()4( 6+&')4( )6'4+) 4'*4(-( &)<(</(+ ,

6+?(/)4 /('&),(/*'. P+7,<(4(+ )6'4+) 4'&)') (4( 4'(6)

+,+('-(/,,7) &(+ ('-(/,,7). T'(6) +,+('-(/,,7) <'4*C*(+

-+*'*+/(+ 4/(+(+ &('( &(+ -+7+&()/(+ (/4,'(/4,' '))/, '4(6+?(/)4 6+?'4( ()++?(. T'(6) +,+('-(/,,7) ?(+7 &(6(4 &)(/*/(+

(+4('( ()+ -+7+4)/(+ -',/,/ -+*'*+/(+ <'(4 <(&(+ <'<)

-+7*'(+7) (*6(+ 7('(- &(+ (4)(+ @)/. S&(+7/(+ 4'(6) ('-(/,,7)

?(+7 &)(+C*'/(+ , JN% (&(( &)*'4)/( 94)()& (&,4',+

(+4(7,+)4; B4( B,>/' %(>)*- %(++ B,>/' &(+ A+7),4+)+

%,+'4)+7 E+?- I+)<)4,' 9A%EI;.

D. Diagnosis

P+7(/(+ D)(7+,)

P+7(/(+ &)(7+,) 7(7( C(+4*+7 &)<*(4 <'&(('/(+ (+(-+)6-')/((+ @)/ EKG ,4, 4,'( /,/('&)7'(@&,66' &(+ /(44')().

K()@/() *+7),+( &(') T N= Y,'/ H('4 A,>)(4),+ 9NYHA; *-*-

&)6(/() *+4*/ -+?(4(/(+ *<*+7(+ (+4('( (=)4(+ 7C(( &(+ &'(C(4

(4)(+ @)/:

K( I: 4)&(/ 4)-<* 7C(( 6(&( (/4))4( (')(') 7C(( (/(+ 4)-<* 6(&(

(/4))4( ?(+7 <) <'(4 &(') (/4))4( (')(').



K( II: 7C(( 4)-<* 6(&( (/4))4( (')(').

K( III: 7C(( 4)-<* 6(&( (/4))4( <) ')+7(+ &(') (/4))4( (')(').

K( IV: 7C(( 4)-<* 6(&( ((4 )4)'((4.

K')4')( '(-)+7(- &(6(4 6*( &)6(/() *+4*/ -+7(//(+ &)(7+,) 7(7(

C(+4*+7 /,+74).K')4')( -(?,':

1. P(',)-( N,>4*'+( D)6+*

2. &)4+) +( '

3. ',+/) 6('*

#. /('&),-7()

5. &-( 6('* (/*4

$. 7(,6 S3

. 6+)+77)(+ 4/(+(+ +( C*7*(')

8. 'Q*/ 6(4,C*7*('

K')4')( -)+,':

1. &-( /4'-)4(

2. <(4*/ -((- (')

3. &)6+* & ,'4

#. 6(4,-7()

5. *) 6*'(

$. 4(/)/('&)

. 6+*'*+(+ /(6()4( )4( 6'4)7( &(') +,'-(

D)(7+,) &)47(//(+ &(') 2 /')4')( -(?,' (4(* 1 /')4')( -(?,' &(+ 1

/')4')( -)+,' ('* (&( 6(&( ((4 ?(+7 <'(-((+. P+?(/)4 C(+4*+7/,',+' -'*6(/(+ 4),,7) 7(7( C(+4*+7 (/*4 6(&( $00 6()+

4'*4(-( 6(&( *)( (+C*4. %,+4, /()/ 7(7( C(+4*+7 (/*4 (&(( ',</(+

&(*+ /(4*6 >('( 4)<(4)<( (/)<(4 +&,/('&)4) 4'(*-( (4(* )+('/ -),>('&

*(. %*'( C(+4*+7 ?(+7 -+*'*+ 4)<(4)<( -+?<(</(+ 6+*'*+(+

4/(+(+ &('( &)'4() &-( 6')'.

D)(7+,) B(+&)+7

1. PENYAKIT KARDIOVASKULER

1. V+4')>*(' S64( D>4

D/ S64*- V+4')/ 9VSD V+4')>*(' S64( D>4; (&(( *(4* *<(+76(&( 64*- +4')/. S64*- +4')/ (&(( &)+&)+7 ?(+7 --)(/(+

C(+4*+7 <(7)(+ <(=( 9--)(/(+ +4')/ /)') &(+ +4')/ /(+(+;.

A/)<(4+?( C*-( &('( &) &((- 6-<** &('( 6('*6('* -+)+7/(4 &(+

-+?<(</(+:

(/ +((

<(?) -+7((-) /*)4(+ /4)/( -+?**



/')+7(4 ?(+7 <'<)(+

<'(4 <(&(+ 4)&(/ <'4(-<(

2. R7*'7)4() M)4'(

R7*'7)4() K(4*6 M)4'( 9I+/,-64+)( M)4'( I+*@)+) M)4'(; 9M)4'(

R7*'7)4(4),+; (&(( /<,>,'(+ ()'(+ <()/ -(*) /(4*6 -)4'( 4)(6 /()+4')/ /)') <'/,+4'(/)

R7*'7)4() /(4*6 -)4'( ?(+7 ')+7(+ <)( 4)&(/ -+*+C*//(+ 7C((.

K()+(++?( <)( &)/+() (+?( C)/( &,/4' -(/*/(+ 6-')/((+ &+7(+

44,/,6 &)-(+( 4'&+7(' -*'-*' ?(+7 /( ?(+7 &)<(</(+

6+7()'(+ /-<() &('( / &((- (4')*- /)') /4)/( +4')/ /(+(+

<'/,+4'(/).

S>('( <'4((6 +4')/ /)') (/(+ --<(' *+4*/ -+)+7/(4/(+

//*(4(+ &+?*4 C(+4*+7 /('+( +4')/ /)') ('* --,-6( &('( <)

<(+?(/ *+4*/ -+7)-<(+7) /<,>,'(+ <()/ / (4')*- /)').

V+4')/ ?(+7 --<(' &(6(4 -+?<(</(+ 6(6)4() 9 C(+4*+7 <'&<('

/'(; 4'*4(-( C)/( 6+&')4( <'<(')+7 -)')+7 / /)').

A4')*- /)') C*7( >+&'*+7 --<(' *+4*/ -+(-6*+7 &('( 4(-<((+

?(+7 -+7()' /-<() &(') +4')/ /)'). A4')*- ?(+7 (+7(4 --<('

')+7 <'&+?*4 (+7(4 >6(4 &((- 6,( ?(+7 /(>(* &(+ 4)&(/ 4'(4*'

9@<')() (4')*-; ?(+7 -+?<(</(+ <'/*'(+7+?( @)+) 6-,-6((+

C(+4*+7.

P(&( /(&((+ )+) (4')*- <4*<4* (+?( <'74(' &(+ 4)&(/ --,-6(

<'/*'(+7+?( ()'(+ &('( ?(+7 -(*) (4')*- --*+7/)+/(+

4'<+4*/+?( </*(+ &('(. J)/( *(4* </*(+ &('( 4'6( )( (/(+ 4'6,-6( /*(' &(') C(+4*+7 &(+

&(6(4 -+?*-<(4 ('4') ?(+7 <) />) )+77( 4'C(&) 4',/ (4(*

/'*(/(+ ()++?(. R7*'7)4() ?(+7 <'(4 (/(+ -+?<(</(+ <'/*'(+7+?(

()'(+ &('( )+77( 4'C(&) 7(7( C(+4*+7 ?(+7 (/(+ -+?<(</(+ <(4*/

(/ +(( 6(&( ((4 -(/*/(+ (/4))4( &(+ 6-<+7/(/(+ 4*+7/().

3. P+?(/)4 J(+4*+7 H)6'4+)

A&(( 6+?(/)4 C(+4*+7 ?(+7 4'C(&) <(7() (/)<(4 /,-6)/() )6'4+)

6(&( C(+4*+7 &)-(+( /()+(+ (+(4,-)/ 9)6'4',@ &(+ (4(* &)(4(); <()/

&)'4() -(*6*+ 4(+6( &)'4() /()(+(+ *+7),+(9 &/,-6+() C(+4*+7;.

S)-64,-(4)/ C)/(: <'&<('&<(' '(( -(?(+79&)?; )-6,4+ /('+(

/+()/(+ 4/(+(+ &('(. P+?(/)4 C(+4*+7(/*' )6'4+) 6'4) >6(4

>(6/ >6(4 ( (/ +(( (/)4 &(&( <+7/(/ /&*( /(/) &(+ 6'*4.

G(+77*(+ (/*' ()++?( 6'4) 6)(4(/) -(4*')( 6(+&(+7(+ (/<*'

/('+( 6'&('((+ '4)+(- TIA 6+?(/)4 &((' 6'4) 6(&( )6'4+)



/*+&': 6,,&)6) 6,)*')( /-((+ ,4,4 6(&( (&,4',+)- 6')-'

6+)+7/(4(+ BB 6(&( )+&',- %*)+7.

#. G(7( J(+4*+7 K(+(+

GC((7C(( ?(+7 &)4-*) 6(&( G(7( J(+4*+7 K(+(+ (&(( <(7()

<')/*4 H6(4,-7()

A>)4

E&-( U-*-

&)6+*

6+*'*+(+ /(6()4 (/4))4(

+?') &(&( &+?*4 +(&) (-( &+7(+ 7(7( C(+4*+7 /)')

6+)+7/(4(+ J*7*(' V+,* P'*' 9JVP;

H6(4,-7() &(+ (>)4

G'(/(+ <'7,-<(+7 6('(4'+( 9()+7;

T'&+7(' S3 (4(* S# +4')/ /(+(+.

2. NON%ARDIOVASKULAR

PPOK

P+)+7/(4(+ 6',&*/) 6*4*-

P'*<((+ =('+( 6*4*- -+C(&) /*+)+7 (4(* )4(- <(/(+ /(&(+7

6*4*- <'=('+( -'( /('+( &('( ?(+7 4'>(-6*'

B(4*/ ?(+7 4)&(/ -<*-<*

P'7(+7(+ /(/) ?(+7 <+7/(/

G(+77*(+ T)&*'

P+*'*+(+ B'(4 <(&(+ ?(+7 &'(4) T*-,' M&)(4)+*-

T*-,' -&)(4)+*- -+)-<*/(+ -(+,4() /)+) 6(&( 6()+ ?()4*

<(7() <')/*4:

N?') D(&(

B(4*/ /(&(+7 <(4*/ &('(

D-(-

B'/')+7(4 &) -((- (')

N(( P+&/

S,'4+ , <'(4E. Penatalaksanaan

T)+&(/(+ &(+ 6+7,<(4(+ 6(&( 7(7( C(+4*+7 &)4*C*/(+ 6(&( 5 (6/ :

-+7*'(+7) <<(+ /'C( --6'/*(4 /,+4'(/4))4( -),/('& -+7*'(+7)

/<)(+ >()'(+ &(+ 7('(- -(/*/(+ 4)+&(/(+ 4'(&(6 6+?<(< (/4,'

6+>4* &(+ 6+?(/)4 ?(+7 -+&((').

P(&( *-*-+?( -*( 6+&')4( 7(7( C(+4*+7 &)(+C*'/(+ *+4*/ --<(4()



(/4))4( *() <'(4+?( /*(+. T'(6) +,+('-(/,,7) (+4('( ()+: &)4

'+&( 7('(- -+7*'(+7) <'(4 <(&(+ -+7*'(+7) -(/ -+7*'(+7)

4' 6)/) -+7)+&(') ',/,/ ,('(7( 4'(4*' 9N*7',, 200";. B<(+

(=( &(6(4 &)/*'(+7) &+7(+ 6-<(4((+ >()'(+ 6-<')(+ &)*'4)/(

+)4'(4 (4(* (,&)(4,' ()++?(. B<(+ (/)' &)/*'(+7) &+7(+ ,<(4,<(4(,&)(4,' 6'4) A%E)+)<)4,' )&'(()+. K,+4'(/4))4( &(6(4 &)4)+7/(4/(+

&+7(+ ,<(4 ),+,4',6)/ 6'4) &)7)4() &,6(-)+ &(+ &,<*4(-)+ 9S*7+7

&(+ S)4,-6* 2003;.

BAB III

PEMBAHASAN

B'&(('/(+ (+(-+) () 6-')/((+ @)/ &(+ 6-')/((+

6+*+C(+7 6(&( 6+&')4( 4'<*4 /-*+7/)+(+ 6+&')4( -+&')4( 7(7( C(+4*+7 /)'). G(7( C(+4*+7 4'<*4 &)<(</(+ , )6'4+) ?(+7

6+&')4( &')4(. T)&(/ (&(+?( 6+)+7/(4(+ JVP 6(4,-7() (>)4 &(+

6-<+7/(/(+ 6(&( /&*( /(/) 6(&( 6-')/((+ @)/ -+?)+7/)'/(+

&*7((+ 7(7( C(+4*+7 /(+(+. S()+ )4* (/ +(6( 6+&')4( 6(&(

(/4))4( ')+7(+ &(+ -(* 4)&*' '4( (*/*4() 6('* &)&(6(4/(+ *('(

)/*' -+?)+7)'/(+ &*7((+ /()+(+ 6+&')4( (/)<(4 )4-

6'+(6((+. B')/*4 )+) (&(( () (+()) <) (+C*4 6+*) 4'(&(6

/(* &((- /+('),.

P(&( 6+&')4( )6'4+) 4((+(+ 6')' )4-)/ -+C(&) <) 4)+77) &('),'(+7 +,'-( (/)<(4 (&(+?( (,/,+4')/) 6-<** &('(. I4* <'('4)

+4')/ /)') ('* </'C( <) /'( *+4*/ -(=(+ 4((+(+ 4'<*4 (7('

C/) &('( -(/)-( )+77( *6() &('( / -*( C(')+7(+ 4'>(6()

*() /<*4*(++?(. V+4')/ /)') /-*&)(+ -+7,-6+() /(&((+

4'<*4 &+7(+ )6'4',@ ,4,4 C(+4*+7. H)6'4',@ +4')/ /)') 94

+4')> ?6'4',6? LVH; --*+7/)+/(+ C(+4*+7 <'/,+4'(/) <) /*(4

&(+ --6'4((+/(+ ,*- /*+>*6 =((*6*+ 4'C(&) 4((+(+ 4'(&(6

C/). N(-*+ (-( /(-((+ -/(+)- /,-6+() 4'<*4 4)&(/ (7)

-(-6* -+7)-<(+7) 4/(+(+ 6')' ?(+7 44(6 4)+77). K7(7((+

-/(+)- /,-6+() -+?<(</(+ 6+*'*+(+ /,+4'(/4))4( +4')/ /)').

P+*'*+(+ /,+4'(/4))4( +4')/ /)') (/(+ &))/*4) , 6+*'*+(+ >*'(

C(+4*+7 ?(+7 (+C*4+?( -+?<(</(+ 6+*'*+(+ 4/(+(+ &('(. S-*(

( 4'<*4 (/(+ -'(+7(+7 -/(+)- /,-6+() +*',,'-,+(

6'4) 6+7(/4)(+ )4- ('( )-6(4) &(+ )4- RAA 9'+)+(+7),4+)+

(&,4',+;.



P+7(/4)(+ )4- ('( )-6(4) (/(+ -+)+7/(4/(+ /,+4'(/4))4( C(+4*+7

)+77( -+&/(4) +,'-(. H( )4* 4'C(&) /('+( ('( )-6(4) -+7*('/(+

+*',4'(+-)4' 9+,'6)+')+NE; ?(+7 -+)+7/(4/(+ 6'-(<))4( %(2

--<'(+. H( 4'<*4 -+)+7/(4/(+ )+Q*/ %(2 &(+ --6'/*(4

6('4))6() %(2 &((- 6', /,+4'(/) . S()+ )4* 4)-*() )-6(4) C*7( -+?<(</(+ (,/,+4')/) 6')' ?(+7 <'4*C*(+ -+>7(

6+*'*+(+ 4/(+(+ &('( <) (+C*4. D) )) ()+ 6+*'*+(+ >*'( C(+4*+7

-+?<(</(+ 6+*'*+(+ 6'*) C(')+7(+ ,'7(+ 4*<* ()++?(. S((

(4*+?( (&(( 7)+C(. P+*'*+(+ 6'*) &('( / 7)+C( -'(+7(+7 7)+C(

*+4*/ -+*'*+/(+ @4'() &(+ -+)+7/(4/(+ '(<,'<). P+)+7/(4(+

'(<,'<) )+)( ?(+7 -+?<(</(+ /+>)+7 6+&')4( <'/*'(+7 &(+

6+)+7/(4(+ /(&(' '*- *'*- 9$5 -7&; &) -(+( ('7( '*C*/(++?(

<(' 1050 -7&. W((*6*+ 4'C(&) 6+*'*+(+ @4'() 7,-'** &((-

/(&((+ -(+4(6 4(<) (C* @4'() /'(4)+)+ (-( &+7(+ (C* //')+?(.

H( )+)( ?(+7 -+?<(</(+ /(&(' /'(4)+)+ '*- 6+&')4( <(' 1#

-7& -() -+&/(4) <(4( +,'-( 9+,'-( 0$13 -7&;. K&*( ( &)

(4( -+*+C*//(+ (&(+?( 6+*'*+(+ *+7) 7)+C(. P+*'*+(+ 6'*) 7)+C(

C*7( -'(+7(+7 C*4(7,-'** *+4*/ -+/') '+)+. K-*&)(+

'+)+ -+7)&',)) (+7),4+)+,7+ -+C(&) (+7),4+)+ I ?(+7 (+C*4+?(

, (+7),4+)+ >,+'4)+7 +?- 9A%E; (/(+ &)*<( -+C(&) (+7),4+)+

II. A+7),4+)+ II /-*&)(+ &)4(+7/(6 , '64,'+?( &) 6-<** &('(

9(>*(' ATR1; &(+ 4'C(&) (,/,+4')/). B)( (+7),4+)+ II &)4')-( ,

'64,' /,'4/ (&'+( 9(&'+( ATR1; -(/( /,'4/ (&'+( (/(+

-+/') (&,4',+. A&,4',+ /-*&)(+ &))/(4 , '64,'+?( &)7)+C(. P', 4'<*4 --<*/( EN(% 96)4)( N( %(++; ?(+7

-+?<(</(+ 6+)+7/(4(+ '4+) N(. K('+( N( <')(4 '4+)

,-,4)/ 6+)+7/(4(+ N( (/(+ &))/*4) 6+)+7/(4(+ H2O. H() (/)' -*(

6', 4'<*4 (&(( 6+)+7/(4(+ ()'(+ &('( <()/ / C(+4*+7 (/)<(4

(&(+?( 6+)+7/(4(+ ,*- )+4'((/*'.

P(&( 4(&)*- (=( 7(7( C(+4*+7 -*( -/(+)- /,-6+()

+*',,'-,+( 4'<*4 --(+7 <'-(+((4. A/(+ 44(6) 6(&( 4(&)*-

(+C*4 -/(+)- 4'<*4 C*4'* -(/)+ --6'6('( 7(7( C(+4*+7 ?(+7

4'C(&) &(+ &(6(4 -+?<(</(+ 7(7( C(+4*+7 4(/ 4'/,-6+(). M+7(6(( 4'<*4 &(6(4 4'C(&)F P'4(-( 4( 4'6(C(+ &((- C(+7/( =(/4*

?(+7 (-( C(+4*+7 -+C(&) /*'(+7 4(+77(6 4'(&(6 NE. A/)'+?(

/,+4'(/4))4( C(+4*+7 /-<() -+*'*+. K&*( (/4))4( )-6(4) &(+ RAA

44(6 4'C(&). A/)<(4+?( (,/,+4')/) '4+) >()'(+ 6+)+7/(4(+ 6',(&

&(+ 6+)+7/(4(+ (4',(& 44(6 4'C(&). S +4')/ -(/)+

4'+77(+7 &(+ //*(4(+ /,+4'(/)+?( -(/)+ -+*'*+. V+4')/ /)')



-(/)+ 4)&(/ -(-6* --,-6( &('( / )4-)/. D('( -+C(&)

4'<+&*+7 &) (4')*- /)') -+?<(</(+ )6'4',@ (4')*- /)') 94 (4')*-

?6'4',6? LAH; <(7() -/(+)- /,-6+(). H)6'4',@ +4')/ (/(+

-+77' 4(/ -*>** 6(6)(') )+77( &(6(4 4'C(&) '7*'7)4() -)4'(

*+7),+( 94'&+7(' <(7() <))+7 6(+)4,)/ &) (6 ?(+7 -+C((' /(4'(;. H( )4* -(/)+ --6'<'(4 /'C( C(+4*+7 &(+ 6+(+&( (&(+?(

6-<('(+ C(+4*+7 9/('&),-7(); ()+ &)4*+C*//(+ , )>4* >,'&) ?(+7

<'7' / (4'( <(=( &(+ <(4( C(+4*+7 /)') <'7' / (4'( <(=(

'4( ,4, 4,'( %TR 0$0. L(-( /(-((+ (/(+ 4'C(&) /,+74) &) +(

6*-,+(). T/(+(+ )+4'((/*' +( 6*-,+() ?(+7 -(/)+ 4)+77)

-+?<(</(+ >()'(+ 4'&,',+7 /*(' &(+ 4'C(&)( &-( 6('*. E&-(

6('* -+?<(</(+ 6()+ ')+7 -'(( (/ +(6( ((4 <'(/4))4(

')+7(+ &(+ <'<(')+7 <(7() /,-6+() (/)<(4 *-+ <',+/* &(+ (,*

-+7>) ?(+7 -+?<(</(+ 6'4*/('(+ 7( 4'7(+77*. M*+7/)+ )4*

-+C(&) (( (4* 6+?<(< 6()+ */(' 4)&*'. P(&( &-( 6('* (,*

?(+7 4'7+(+7 >()'(+ 4'(+*&() ?(+7 -+)-<*/(+ *('( ',+/) <((

<(( (* ((4 (*/*4(). D) )) ()+ C(')+7(+ )4-)/ -(/)+

//*'(+7(+ O2 &(+ 6', -4(<,)- 6*+ <'*<( -+C(&) -4(<,)-

(+(',<. A/)<(4+?( 4'C(&) 6+)+7/(4(+ 6',&*/) ((- (/4(4 ?(+7

-+?<(</(+ ()&,) -4(<,)/. S()+ )4* 6(&( 7(7( C(+4*+7 /)') ()&,)

-4(<,)/ &)<(</(+ , ,/)7+() ('4') <'/*'(+7 &(+ 6+)+7/(4(+

6-<+4*/(+ ((- &) &((- &('( (/)<(4 (&(+?( 6+*'*+(+ 6'4*/('(+ O2

&(+ %O2 &) &((- (,* 6('*. P+)+7/(4(+ ),+ )&',7+ H -'(+7(+7

/-,'64,' +4'( )+77( 4'C(&) )6'+4)().P(&( 6()+ &)4-*/(+ (&(+?( ()&,) -4(<,)/ 4'/,-6+(). K,+&)) )+)

-+77(-<('/(+ (&(+?( 6+*'*+(+ 6H (/)<(4 6+*'*+(+ /(&(' H%O3

&((- &('( &(+ 4'/,-6+() , 6+)+7/(4(+ +4)() 6('*

9)6'+4)(); ?(+7 (/(+ -+*'*+/(+ P%O2 &(+ 6+(-<((+ <)/,<('<,+(4

<('* / &((- >()'(+ /4'(*' , 7)+C(. K(&((+ )6'+4)() 6(&(

6()+ &(6(4 &)4*+C*//(+ , (&(+?( '6)'(4),+ '(4 <(' 32 /()-+)4.

P+(4((/(+((+ ?(+7 &(6(4 &)<')/(+ 6(&( 6()+ (&(( 6-<')(+

+,&)(4,' &(+ (,&)(4,' *+4*/ -+*'*+/(+ 6',(& &(+ (4',(&. S()+

)4* 6()+ C*7( 6'* &)<') ,<(4,<(4(+ )+,4',6)/ 6'4) &)7)4() *+4*/-+)+7/(4/(+ /,+4'(/4))4( C(+4*+7. T'(6) +,+('-(/,,7) 6(&( 6+&')4(

&(6(4 &)(/*/(+ <'*6( -+7*'(+7) (*6(+ -(/ 7('(- '( -)+*-(+

(,/, -+7*'(+7) (4(* -+*'*+/(+ <'(4 <(&(+ (4)(+ (4(* ,( '(7(

&(+ <'+4) -',/,/.



BAB IV

PENUTUP

A. "esim!ulan

1. P()+ /-*+7/)+(+ -+&')4( 7(7( C(+4*+7 /)') (/*4 (/)<(4 )6'4+)?(+7 &)&')4(+?(. P()+ -+7((-) /('&),-7() &(+ 6+*'*+(+ *+7)

7)+C( (/*4.

2. P+(4((/(+((+ 6'* &)<')/(+ &)+) -*+7/)+ (7(' 4)&(/ 4'C(&)

/,-6)/() ?(+7 <) 6('( 6'4) 7(7( C(+4*+7 /,+74) (4(* ?,/

/('&),7+)/.

3. T'(6) &)<')/(+ >('( ('-(/,,7) &(+ +,+('-(/,,7).

B. #aran

1. P+&')4( <()/+?( -(/*/(+ 4'(6) +,+('-(/,,7) 6'4) &)4 '+&(

7('(- C)/( +)4) 4'(&(6 7('(- -+7*'(+7) <'(4 <(&(+ C)/( -+7((-)

,<)4( -+7)+&(') -(/ <'<) -+7*'(+7) 4' 6)/) -+7)+&(')

',/,/ ,('(7( 4'(4*'.

2. T'(6) ('-(/,,7) ?(+7 <)( &)<')/(+ (&(( <,>/' 7,,+7(+

/('&),4) 6'4) (4+,, &)*'4)/ *+4*/ -+7*'(+7) 4)-<*+(+ >()'(+

&)7)4() / >6(4 9&)7,)+; *+4*/ -+)+7/(4/(+ /,+4'(/4))4( &(+ C)/(

6'* &)<')/(+ 7,,+7(+ %( (+4(7,+) *+4*/ -+7*'(+7) )-6* ('(.

DATAR PUSTAKA

B*'+&)& JW. M>G?++ TJ. 1""5. D)(7+,) ))/. A) B((( : L*-(+4,

H++?. J(/('4( : EG%. - 2#$

G'(? HH &//. 2005. L>4*' N,4 ,+ %('&),,7? ,*'4 E&)4),+. A)

B((( : A=(' A7, &(+ A') D=) R. J(/('4( : E'(+77(.

J,, HA. S4)(+4) B*&). 2003. H)6'4+) S/*+&'. D((- : B*/* AC('

K('&),,7). E&)4,' : R)(+4, LI &//.J(/('4( : K UI. - 20$208

OD,++ MM. %('4,+ P. 200$. D)*+7) M/(+) J(+4*+7 &(+ B(+4*(+

S)'/*(). D((- : P(4,@),,7) K,+6 K)+) P',P', P+?(/)4 E&)) $

V,*- I. E&)4,' : P')> SA. W),+ LM. A) B((( : P+&)4 BU &//.

J(/('4( : EG%. - $32$3"

S'=,,& L(*'(. 2001. )),,7) M(+*)( : &(') S / S)4-. A) B(((

: P+&)4 BU. J(/('4( : EG%. - 2$$20

S)4,-6* B(')4(. S*7+7 JI. 2003. G(7( J(+4*+7. D((- : B*/* AC('

K('&),,7). E&)4,' : R)(+4, LI &//. J(/('4( : K UI. - 115125

S*4&C, A.Y. 200. B*/* S(/* M+7+( P+?(/)4 M(*) H() P-')/((+



L(<,'(4,')*-. Y,7?(/('4(: A-('( B,,/.

T(7,' GM.H. 2003. H)6'4+) E)(. D((- : B*/* AC(' K('&),,7). E&)4,' :

R)(+4, LI &//. J(/('4( : K UI. - 1"205

Y,7)(+4,', M,(--(&. 200$. H)6'4+) E+)(. D((- : B*/* AC(' I-*

P+?(/)4 D((- E&)) IV J))& I. E&)4,' : S*&,?, AW &//. J(/('4( : K UI. -5""$08

W),+ LM. 200$. G(+77*(+ A(- B((. D((- : P(4,@),,7) K,+6 K)+)

P',P', P+?(/)4 E&)) $ V,*- I. E&)4,' : P')> SA. W),+ LM. A)

B((( : P+&)4 BU &//. J(/('4( : EG%. - 38#385

gagal jantung kiri

Documents