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Cardovascular
a. Stable Angina
Pain in the chest that subsides when resting and triggered with
Pain that does not disappear when resting and can arise at any time. c. Acute myocardial infarction
Pain such as squeezing and radiating to the arms and neck, appears
e. Pericardiac
will increase when supine, when coughing, inspiration and will improve if
Tearing of the aorta is caused by various things such as trauma, hypertension. Pain felt on the chest can
spread to the back. 2. Repiratory
a. Pulmonary Embolism
physical edema usually occurs in the legs, dipsnue and there can be pain
c. Pneumothorax
d. Pneumonia
in severe pneumonia patients, there can be pain in the chest. On physical examination can be found
crackles and fever. 3. Gastro Intestinal
a. Gastro Esophageal Reflux Disease
Pain often arises after eating and will increase pain when
burning, sore, nausea and vomiting and bitter taste in the mouth. b. Peptic Ulcer Disease
NSAIDs and herbal entertainment. Pain can occur after eating or even
4. Musculoskeletal
a. Costhocondritis
The presence of inflammation in the cost bone causes chest pain. And pain
5. Devotion
Like other organs, the coronary arteries in the body also experience the aging process. Where there is a
process such as thickening of the intima layer, reduced elasticity of calcium buildup, and increased
diametration of the intima layer.
At the age of 10 years coronary arteries are still in normal condition, along with eating time fat lines will
be formed, added by risk factors then the fat line will become a fibrus plaque, then into complex lesions,
there will be grafted fibrus plaque
If myocardial oxygen demand increases, the supply of oxygen must also increase. To increase the supply
of adequate amounts of oxygen, coronary artery flow must be increased, because myocardial oxygen
extraction from arterial blood is almost maximal, at rest. Normal coronary vessels can widen and
increase blood flow around 5-6x above the resting level. However, the blood vessels that are disrupted
cannot widen, resulting in a lack of oxygen if the oxygen demand increases over the capacity of the
vessels to increase flow
3. Ischemia occurs
6. Pain.
Cardiogenic shock occurs when pump work or the heart becomes inefficient so that cardiac output
decreases and tissue perfusion is inadequate. Classic cardiogenic shock is associated with systolic
dysfunction or the inability of the heart to pump blood. The result, is a decrease in volume as soon as
possible and then the cardiac output will decrease. The work of the heart can be inefficient due to
various things including myocardial infarction (in particular, any significant disturbance in the left
ventricular myocardium, especially in patients with ischemic heart disease) and pulmonary embolism.
Symptoms vary according to circumstances that cause pumping failure. Because of reduced cardiac
output, stimulation of the sympathetic nervous system and decreased peripheral perfusion the
nonspecific symptoms include cold and wet skin, decreased pulse pressure with a weak peripheral pulse,
feelings of fatigue, weakness and hypotension. (Oman Kathleen. S, et al. (2002). Emergency Nursing
Study Guide Jakarta: Medical Book EGC)
It is known that smoking triggers atherosclerotic plaques. This plaque triggers hypertension and
occlusion of the heart blood vessels including the coronary arteries. Myocardial ischemia occurs which
will eventually cause pain in the chest through the mechanism described above.
Previously it was known that thrombosis is a term commonly used for blood vessel blockage, both
arteries and veins. Nicotine activates platelets with the result of platelet adhesion (clotting) to the walls
of blood vessels.
The contents of cigarettes: cigarettes contain thousands of chemical compounds that are toxic,
carcinogenic, and terotogenik. The chemical compounds contained in cigarettes include nicotine, tar,
caffeine, diethyl ether, polyphenols, naphthalene, and other dangerous compounds. Chemical
compounds in cigarettes reduce HDL in the body resulting in atherosclerotic plaques, for example in the
coronary arteries. This plaque easily triggers thrombosis that forms a thrombus resulting in myocardial
ischemia which causes chest pain.