Referat Dr Ihsanil

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Text of Referat Dr Ihsanil

REFARATCRISIS HYPERTENSION

ARRANGED BY:Salman Saisar Hidayat 2011730095

PRESEPTOR :dr Ihsanil Husna, Sp.PD

STASE ILMU PENYAKIT DALAM RSIJ CEMPAKA PUTIHPROGRAM STUDI KEDOKTERANFAKULTAS KEDOKTERAN DAN KESEHATANUNIVERSITAS MUHAMMADIYAH JAKARTA2016KATA PENGANTAR

AssalamualaikumWr. Wb.Alhamdulillah, Puji syukur penyusun panjatkan kehadiran ALLAH SWT atas terselesaikannya tugas Refarat Krisis Hipertensi.Makalah refreshing ini disusun dalam rangka untuk dapat lebih mendalami dan memahami mengenai Krisis Hipertensi . Tujuan khususnya adalah sebagai pemenuhan tugas kepaniteraan Stase Ilmu Penyakit Dalam. Semoga dengan adanya laporan kasus ini dapat menambah khasanah ilmu pengetahuan dan berguna bagi penyusun maupun peserta didik lainnya.Penyusun menyadari bahwa laporan kasus ini masih jauh dari kesempurnaan, oleh karena itu penyusun sangat membutuhkan saran dan kritik untuk membangun laporan kasus yang lebih baik di masa yang akan datang.Terimakasih.WassalamualaikumWr. Wb

Jakarta, Mei 2016

Penulis

a. Definition Hypertensive crises are defined as levels of systolic blood pressure >180 mmHg and/ or levels of diastolic blood pressure >120 mmHg and are mainly found in patients with essential artery hypertension.

b. Epidemiology In an Italian multicenter study of 1,546 patients with hypertensive crises, 13 % of men and 9 % of women reported not taking antihypertensive drugs. Hypertensive emergencies represented 25 % of crises. Approximately 25 % of adults with chronic hypertension were unaware of their disease. In the US parallels the distribution of essential hypertension with a twofold higher incidence in AfricanAmericans than in whites.

c. Classification Hypertensive urgency is a situation with a severe increase in blood pressure without progressive dysfunction of target organs.Hypertensive emergencies are life threatening states because their outcome is complicated by acute damages of target organs.

d. Etiology Undiagnosed or untreated hypertension is the most important risk factor to be crises hypertension. Genetic factor, lifestyle, diet, acute physical stress, chronic physiological stress can be the causes of hypertension. So the primary treatment is to change the risk factor that can make hypertension.

e. PathophysiologyPathophysiology of hypertensive crises is still unclear. From the aspect of pathophysiology, the disorder of systemic blood flow auto regulation on the level of arterioles is considered to be a cause for both forms of hypertensive crisis.

f. Clinical manifestaionsHypertensive urgency is a situation with severe increase in blood pressure without progressive dysfunction of vital organs. The most common symptoms are headache, dyspnea, nausea, vomiting, epistaxis, and pronounced anxiety.Hypertensive emergencies include hypertensive encephalopathy, hypertensive acute left ventricular relaxation associated with acute myocardial infarction or unstable angina, aortic dissection, subarhnoic hemorrhage, ischemic stroke, and severe preeclampsia or eclampsia.

g. Supporting examinationsRecommended testing includes the following: Hematologic routine Blood glucose Total cholesterol serum Serum uric acid Creatinin serum Kalium serum Urinalisis Electrocardiogram

h. Treatment

References Monnet, Xavier, Paul E. Marik. 2015. Whats new with hypertensive crises?. Intensive Care Med. 41:127130 Salkic, Sabina, Olivera Batic-Mujanovic, Farid Ljuca, Selmira Brkic. 2014. Clinical Presentation of Hypertensive Crises in Emergency Medical Services. Mater Sociomed. 26(1): 12-16 Salkic, Sabina, Selmira Brkic, Olivera Batic-Mujanovic, Farid Ljuca, Almedina Karabasic, Sehveta Mustafic. 2015. Emergency Room Treatment of Hypertensive Crises. Med Arh, 69(5); 302-306 Current Medical Diagnosis & Treatment. Systemic Hypertension. Sutters, Michael.MD. 2016. 435-467 American Journal of Emergency Medcine. The Relationship between vascular inflammation and target organ damage in hypertensive crises. Karaback, Mustafa MD. 2015; 497-500 Jose Roesma. Krisis Hipertensi. Sudoyo, Idrus Alwi editor. Buku Ajar Ilmu Penyakit Dalam Jilid II Edisi VI. Pusat penerbitan departemen penyakit dalam FKUI.2014

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