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PAP(Penyakit
Arteri Perifer)Refeksi Kasus
Dokter Muda:
Haniah Khoirunnisa
20110310108
Dokter Pembimbin:
dr! "idodo Rahar#o$ %&!PD
'K(K )M*
R%)D K+,- %-.-,(/-
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STATUS PASIEN
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ama : ,n! %enis Keamin : .aki4aki )sia : 30 ,ahun -amat :
an#aran$ enik Peker#aan : uru
teknik5eektro -ama : (sam %tatus : Menikah Masuk R% : 20
-&ri 2016
o! 7M : 16133191
(D,(,-%
P-%(
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Mendadak n;eri kaki kanan
Keuhan )tama
,iba4tiba kaki kanan n;eri se&erti ditarik$ tam&ak
&udisi&idemia?$ &en;akit #antun$ in#a$ disanka
RPD
Hi&ertensi dan DM di keuara disanka
RPK
Kebiasaan merokok
,ukan ser@i
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PA! '(%(K
K): 7M$ tam&ak emas Bita %in ,D: 13351 mmH= : 1C8A5mnt= %:
367= %&+2
sistemik: 9E= %&+2distais ekstr in dA >2242-&r 2016?:
96E 0E 9CE 89E 88E89E
%tatus .okais ( : Pedis deAtra tam&ak &u
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PA! P)-/
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PA! Radiooi >2250C52016? PA! )%/ Do&&er eAtremitas
ineriordeAtra Hasi :,ak tam&ak soft tissue edema di
reio&edis dA -! &o&itea tibiais anterior et
&osteriordA tak tam&ak keainan,am&ak
ambaranplaque&d a! dorsais&edis dA ; ham&ir menutu&
semuaumen arteri Pd Color Doppler tam&ak Farna merahminima
intraumen
Pd 7'M tam&ak ambaran skip wave Kesan: ,am&ak
ambaranplaque5okusi
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DiagnosisKerja Peripheralarterial
occlusivedisease>P+-D? &edisdeAtra
Diagnosi
sBanding
0euro&atiDM
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P:
0-,-.-K%-0--0(n! R. 20 t&m
(n#! Ketoroa< 3 A 1 am&u
(n#! Ranitidin 2 A 1 am&u
(n#! -riAtra 1 A 2!G m >sub
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TINJAUANPUSTAKA
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--,+M( '(%(+.+/(
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Sistem Sirkuasi Arteri Utama
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D(-,% M..(,)%Pen;akit metaboik
Hi&erikemia Keainan sekresi insuin 5 ker#a insuin
KasiIkasi DM menurut -D- 2010
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-ur &eneakkan
dianosis DM
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Kom&ikasi DMPen;uit akut >kom&ikasi metaboik
akut?
Ketoasidosis diabetik >K-D?
Hi&erosmoar hi&erikemia koma non ketotik
>HHK?Hi&oikemia
Pen;uit menahun >kom&ikasi @askuer kronik?Mikro@askuar:
retino&ath;$ ne&hro&ath;$
neuro&ath;Makro@askuar: 7HD$
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Penataaksanaan DMdukasi $
,era&i iJi medis$
.atihan #asmani$ dan(nter@ensi armakoois!
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P*-K(, -R,R(
PR('RPeripheral Occlusive Arterial Disease >P+-D?
atau Peripheral Vascular Disease >PBD? ti&eoranik
>&erubahan struktur &embuuh darah?
Penuranan airan darah &d arteri &erier$arteri seain
&d ke&aa >otak? dan #antun
P-P eAtremitas baFah
Maniestasi ateroskerosis sistemik
menurunn;a airan darah arteria ke tunkaibaFah seama atihan
mau&un istirahat
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&idemiooi P-P
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'aktor risiko P-P)sia G0 tahun$ dn diabetes dan saah satu
risiko
ateroskerosis >merokok$ disi&idemia$ hi&ertensi$atau
hi&erhomosisteinemia?
)sia G0469 tahun dn riFa;at merokok dan diabetes)sia L 0
tahun
/e#aa saat berakti@itas >meru#uk &d kaudikasio?atau
ischemic rest pain
Pemeriksaan &usasi ekstremitas inerior ;abnorma
RiFa;at ateroskerosis koroner$
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Maniestasi kinis P-PKhas: kaudikasio intermitenRasa kaku$
terbakar5 ata terutama &ada tunkai atas$ timbu
&d Faktu ber#aan terutama mendaki$ ; seera hian biaberhenti
ber#aan sekitar 10E dari seuruh kasus P-P
/e#aa &d tunkai ; ati&ika:Kaki dinin$ n;eri nokturna
n;eri &d istirahat sekitar 32E
,an&a e#aa5 asim&tomatik sebaian besar P-P >G9E?
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PA! IsikKaki men#adi &u
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TE!I"AKASI#$
