PATHOFISIOLOGI KELAINAN

SISTEM KERDIOVASKULER

Ns. YUNIE ARMIYATI., M.Kep., Sp.KMB

 THE CARDIOVASCULAR SYSTEM

 A closed system of the heart and

blood vessels
 The heart pumps blood
 Blood vessels allow blood to circulate to all
parts of the body
 The function of the cardiovascular
system is to deliver oxygen and
nutrients and to remove carbon
dioxide and other waste products
BLOOD CIRCULATION
PERUBAHAN KARDIOVASKULER DENGAN BERTAMBAHNYA USIA
CARDIOVASCULAR DISEASES (CVDS) ARE A GROUP OF
DISORDERS OF THE HEART AND BLOOD VESSELS

CORONARY HEART DISEASE

CEREBROVASCULAR DISEASE
PERIPHERAL ARTERIAL DISEASE
RHEUMATIC HEART DISEASE
CONGENITAL HEART DISEASE
DEEP VEIN THROMBOSIS & PULMONARY EMBOLISM
1. Coronary heart disease  disease of the blood vessels
supplying the heart muscle
2. Cerebrovascular disease  disease of the blood vessels
supplying the brain
3. Peripheral arterial disease  disease of blood vessels
supplying the arms and legs
4. Rheumatic heart disease  damage to the heart muscle
and heart valves from rheumatic fever, caused by
streptococcal bacteria
5. Congenital heart disease  malformations of heart
structure existing at birth.
6. Deep vein thrombosis and pulmonary embolism  blood
clots in the leg veins, which can dislodge and move to the
heart and lungs.
 FACT
• CVDs are the number one cause of death
globally: more people die annually from CVDs
than from any other cause;
• Over 80% of CVD deaths take place in low-
and middle-income countries and occur
almost equally in men and women;
• By 2015, almost 20 million people will die
from CVDs, mainly from heart disease and
stroke. These are projected to remain the
single leading causes of death.
 CAUSE
• The causes of CVDs  unhealthy diet, physical
inactivity and tobacco use. These are called
‘modifiable risk factors’.
• The effects of unhealthy diet and physical
inactivity  raised blood pressure, raised
blood glucose, raised blood lipids, and
overweight and obesity; these are called
‘intermediate risk factors’.
 CAUSE
• The major modifiable risk factors are responsible
for about 80% of coronary heart disease and
cerebrovascular disease.
• There are also a number of underlying
determinants of chronic diseases, or, if you like,
"the causes of the causes". These are a reflection of
the major forces driving social, economic and
cultural change – globalization, urbanization, and
population ageing. Other determinants of CVDs are
poverty and stress.
PATOFISIOLOGI
HIPERTENSI
 PATOPHYSIOLOGY
BLOOD CARDIAC PERIPHERAL
= X
PRESSURE OUTPUT RESISTENCE

HEART RATE X
STROKE VOLUME

HUMORAL SYMPATHETIC LOCAL

CONTROL NERVOUS SYS CONTROL
CONTROL
 CONTROL SYSTEM IN MAINTAINING
BLOOD PRESSURE
• THE ARTERIAL BARORECEPTOR SYSTEM
• THE REGULATION OF BODY FLUID VOLUME
• THE RENIN-ANGIOTENSIN-ALDOSTERON SYSTEM
• VASCULAR AUTOREGULATION
 ANGIOTENSINOGEN
DECREASED
VASCULAR TONE CONVERTING
Sympathetic JG CELLS RENIN
ENZYME
stimulation
ANGIOTENSIN 1 ANGIOTENSIN 2

ANGIOTENSIN 3

VASOCONSTRICTION  ALDOSTERON

Na RETENTION

FEEDBACK INCREASED
BLOOD PRESURE
 PATOFISIOLOGI
MIOCARD INFARC
GAMBARAN EKG ISKEMI, INJURY, INFARK
 ISCHEMIC CYCLE
Ischemia / infarction

Diastolic Dysfunction Systolic Dysfunction

chest pain

pulmonary LV diastolic pressure cardiac output

congestion
pO2

wall tension catecholamines

(heart rate, BP)
MVO2
PATOFISIOLOGI
PERICARDITIS
• Idiopathic or nonspecific causes
• Infection: usually viral (eg, Coxsackie, influenza); rarely bacterial and
mycotic (fungal)
• Disorders of connective tissue: SLE, rheumatic fever, rheumatoid
arthritis, polyarteritis
• Hypersensitivity states: immune reactions, medication reactions
• Disorders of adjacent structures: myocardial infarction, dissecting
aneurysm, pleural and pulmonary disease (pneumonia)
• Neoplastic disease: caused by metastasis from lung cance or breast
cancer, leukemia
• Radiation therapy
• Trauma: chest injury, cardiac surgery, cardiac catheterization, pacemaker
implantation
• Renal failure and uremia
• Tuberculosis
 PATOFISIOLOGI
LEFT HEART FAILURE
 PATOFISIOLOGI
CARDIOGENIC SHOCK
KELAINAN DARAH DAN
PEMBULUH DARAH
 THE VASCULAR SYSTEM

Figure 11.8b

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

 PATOFISIOLOGI
CORONARY ARTERY
DISEASE
 CORANARY ARTERIAL DISEASE
• Pada keadaan normal terdapat keseimbangan
antara aliran darah arteri koronaria dengan
kebutuhan miokard.
• Pada CAD menunjukkan ketidakseimbangan
antar alirandarah arterial dan kebutuhan
miokardium.
Keseimbangan ini dipengaruhi oleh
CORONARY ARTERY DISEASE
HEMOSTASIS
THANK YOU