aging of cardiovascular system.pdf
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ProsesAging
A maturational process that includes a series of
genetically programmed events that are influenced by
external factors
Kemajuan medisusia harapan hidup bertambah
Peran PMR mempertahankan dan restorasi fungsi dari
pasien yang sudah menua
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Downey, Darling;Physiological Basis of Rehabilitation Medicine,3rd ed.New York;2001
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Aging Sistem Kardiovaskuler
Jantung
Penebalan dinding ventrikel kiri (>> pada hipertensi )
Pembesaran ukuran sel otot jantung (myocyte)
Pembuluh Darah
Dinding aorta lebih kaku
Aorta terdilatasi dan memanjang (elongasi)
perubahan elastin dan kolagen, deposit kalsium
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Downey, Darling;Physiological Basis of Rehabilitation Medicine,3rd ed.New York;2001
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Carotid barochemoreceptor pathological findings
regarding carotid plaque status and aging
Jos Milei, MD PhD,1Anna M Lavezzi, MD PhD,2Barbara Bruni,MD,2Daniel R Grana, VMD,1Francisco Azzato, MD,1and Luigi Matturri,
MD PhD
2
METHODS:
Patients (n=23) who had suffered and died from stroke, with and withoutcomplicated internal carotid atheromatosis, were divided by age (group 1:older than 80 years; group 2: 65 to 80 years; and group 3: younger than 65
years). Carotid segments were obtained at autopsy. The specimens were
stained for light microscopy and immunohistochemistry.
RESULTS:
Carotid glomus presented from moderate-to-severe atrophy and fibrosis. Afocal decrease in vascularization (CD34-positive) of the glomus (greater than50%) was observed in areas of atrophy and fibrosis. Damaged nerve endings
(S100 protein-positive) were observed at the media of the carotid sinus.Morphometric data showed no differences between groups for glomus area,number of type 1 and 2 cells, and the wall to lumen arteriole ratio. Nostatistical differences were demonstrated in the pathological findings of thecarotid glomus when comparing complicated with noncomplicated plaques orage groups.
5/30/2014Aging of Cardiovascular System
http://www.ncbi.nlm.nih.gov/pubmed/?term=Milei%20J[auth]http://www.ncbi.nlm.nih.gov/pubmed/?term=Lavezzi%20AM[auth]http://www.ncbi.nlm.nih.gov/pubmed/?term=Bruni%20B[auth]http://www.ncbi.nlm.nih.gov/pubmed/?term=Grana%20DR[auth]http://www.ncbi.nlm.nih.gov/pubmed/?term=Azzato%20F[auth]http://www.ncbi.nlm.nih.gov/pubmed/?term=Matturri%20L[auth]http://www.ncbi.nlm.nih.gov/pubmed/?term=Matturri%20L[auth]http://www.ncbi.nlm.nih.gov/pubmed/?term=Azzato%20F[auth]http://www.ncbi.nlm.nih.gov/pubmed/?term=Grana%20DR[auth]http://www.ncbi.nlm.nih.gov/pubmed/?term=Bruni%20B[auth]http://www.ncbi.nlm.nih.gov/pubmed/?term=Lavezzi%20AM[auth]http://www.ncbi.nlm.nih.gov/pubmed/?term=Milei%20J[auth] -
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Efek pada Latihan
Kapasitas latihan max dan VO2 max pada geriatri
akan
Geriatri dengan kondisi fisik yang baik dapat memiliki
kapasitas aerobik = lebih muda
Kapasitas aerobik dapat ditingkatkan dengan latihan
endurance
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Perubahan akibatAgingpada
Aorta dan ArteriPenebalan fibrous yang progresifpada tunika intima
Fibrosis dan timbulnya skar padaotot atau elastic media
Bertumpuknya substansi yangkaya mukopolisakarida
Fragmentasi pada elastik lamina
Efek dari perubahan ini =kekuatandan elastisitas dinding pembuluh
darah.
Dilatasi progresif merupakan fenomenapenuaan pada aorta dan pembuluhdarah koroner.
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Underwood and Cross;General and Systemic pathology 5th ed;2009
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Penyakit Jantung Koroner (1)
Penyakit jantung koroner = penyakit yangdisebabkan kegagalan arteri koroner untukmenyuplai darah ke otot jantung sehinggakebutuhan O2 tidak terpenuhi.
Penyakit jantung koroner terjadi karena adanya
penyempitan/penyumbatan di dinding arterikoroner .
Penyakit jantung koroner bisa menyebabkaniskemik miokard yang bisa menyebabkan infarkmiokard.
Penyakit multifaktorial yg dipengaruhi olehproses aging intrinsik, faktor lingkungan dangenetik.
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Penyakit Jantung Koroner (2)
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Teori terbentuknya
Atherosklerosis
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Pembentukan Aterosklerosis
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Faktor Risiko
Mayor :
Merokok
Hipertensi
Diabetes Mellitus
Hiperkolesterol
Familial
Minor :
Obesitas
Low exercise
Stress
Usia Lanjut
Pemakaian obat-obatantertentu (steroid)
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Association of Cardiovascular Burden with Mobility Limitation
among Elderly People: A Population-Based Study
Anna-Karin Welmer,1,2,*Sara Angleman,1Elisabeth Rydwik,1,3LauraFratiglioni,1,4andChengxuan Qiu1,*
Background : Cardiovascular risk factors (CRFs) such as smoking and diabetes have
been associated with mobility limitations among older adults. We seek to examine towhat extent individual and aggregated CRFs and cardiovascular diseases (CVDs) areassociated with mobility limitation.
Methods : The study sample included 2725 participants (age 60 years, mean age 72.7years, 62% women) in the Swedish National Study on Aging and Care in theKungsholmen district of central Stockholm, Sweden, who were living either at their ownhome or in institutions. Data on demographic features, CRFs, and CVDs were collected
through interview, clinical examination, self-reported history, laboratory tests, andinpatient register. Mobility limitation was defined as walking speed
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Gejala Penyakit
Nyeri dada dengan perasaan berat, seperti ditindih,
dada seperti terbakar.
Gejala lain :
Nafas pendek
Palpitasi
Lemah, pusing
Nausea
Berkeringat
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Gejala pada Geriatri
Pasien geriatri memiliki gejala PJK yang atipikal dibanding pasienyang lebih muda. Nyeri dada yang khas seringkali tidakdidapatkan melainkan yang sering dikeluhkan pernafasan yangsedikit memberat, nyeri abdomen, fatigue, confusion, malaise
Gejala atipikal
penatalaksanaan yang tidak sesuai dalammedikasi, kateterisasi, dan mortalitas dan morbiditas meningkat
Worcester Heart Attack Studypasien > 75 years of age,keterlambatanpre hospital, banyak diluar Golden Hour (6 jam)untuk terapi fibrinolitik
Warning system impaireddelay dalam gejala PJK
Delay prognosis lebih jelek
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Hazzards Geriatric Medicine and Gerontology, 6th ed.
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TERIMA KASIH
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