Manajemen Syok Kardiogenik pada Diseksi Aorta

Abstract

Pendahuluan: Diseksi aorta merupakan kegawatdaruratan akibat robekan tunika intima aorta yang menyebabkan perdarahan ke dalam tunika media. Komplikasi syok terjadi pada lebih dari 20% kasus dan akan meningkatkan mortalitas. Kasus: Wanita 72 tahun dirujuk ke IGD dengan keluhan nyeri dada dan rasa tidak nyaman di perut dan punggung, disertai lemas, gelisah, dan klinis syok. Pada foto toraks didapatkan kesan aneurisma aorta. CT scan menunjukkan diseksi aorta asenden, arkus aorta, aorta desenden, aorta abdominalis, berlanjut sampai ke arteri iliaka eksterna, dan trombus di arkus aorta. Pasien dan keluarga menolak tindakan operasi; pasien diterapi secara konservatif.

Introduction: Aortic dissection is the result of aortic intima tear that leads to bleeding within the tunica media. Shock occurs in up to 20% patients and is associated with increased mortality. Case: A 72-year-old woman was referred to ED with chest pain and discomfort in the stomach and back, accompanied by weakness, anxiety, and clinical presentation of shock. Chest X-ray examination gave an impression of aortic aneurysm. CT scan showed dissection of the aorta ascendens, arcus aorta, aorta descendens, abdominal aorta, continues until the external iliac artery, and thrombus in the aortic arch. Patient and families reject surgical management; the patient was treated conservatively