Evaluasi Nyeri Dada Bagi Dokter Umum: Suatu Tinjauan Sistematis

  • Sidhi Laksono Faculty of medicine of UHAMKA
  • Rami Pratama Putra
  • Ilham Roza

Abstract

Pendahuluan: Pedoman praktik klinis untuk evaluasi nyeri dada ini memberikan rekomendasi dan algoritma bagi dokter umum untuk menilai dan mendiagnosis nyeri dada pada pasien dewasa. Tujuan: Membantu dokter umum mengevaluasi pasien-pasien yang datang dengan keluhan nyeri dada. Metode: Pencarian literatur secara komprehensif yang mencakup uji coba acak dan tidak acak, studi observasional, pendaftar, ulasan, dan bukti lain yang dilakukan pada subjek manusia yang diterbitkan dalam bahasa Inggris dari PubMed, EMBASE, Cochrane Kolaborasi, laporan Badan Penelitian dan Kualitas Kesehatan, dan database lain yang relevan. Studi tambahan yang relevan, yang diterbitkan hingga April 2021, juga dipertimbangkan. Hasil: Ditemukan 5 artikel tentang evaluasi nyeri dada pada pasien yang datang dengan keluhan nyeri dada serta 13 artikel tentang pemeriksaan penunjang lainnya yang dapat membantu mengevaluasi pasien dengan nyeri dada. Kesimpulan: Evaluasi nyeri dada diperlukan anamnesis dan pemeriksaan fisik tentang gejala pasien yang untuk dapat membedakan nyeri dada kardiak atau non-kardiak yang kemudian dapat dilanjutkan dengan pemeriksaan lain seperti EKG dan dipertimbangkan pemeriksaan jantung lainnya.

References

1. Gulati M, Levy PD, Mukherjee D, Amsterdam E, Bhatt DL, Birtcher KK, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol [Internet]. 2021 Nov 30 [cited 2022 Jun 7];78(22):e187–285. Available from: http://www.ncbi.nlm.nih.gov/pubmed/34756653
2. Azar RR, Sarkis A, Giannitsis E. A Practical Approach for the Use of High-Sensitivity Cardiac Troponin Assays in the Evaluation of Patients With Chest Pain. Am J Cardiol [Internet]. 2021 Jan 15 [cited 2022 Jun 7];139:1–7. Available from: https://pubmed.ncbi.nlm.nih.gov/33164762/
3. Anderson JL, Heidenreich PA, Barnett PG, Creager MA, Fonarow GC, Gibbons RJ, et al. ACC/AHA statement on cost/value methodology in clinical practice guidelines and performance measures: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures and Task Force on Practice Guidelines. J Am Coll Cardiol [Internet]. 2014 Jun 3 [cited 2022 Jun 7];63(21):2304–22. Available from: https://pubmed.ncbi.nlm.nih.gov/24681044/
4. Arnett DK, Goodman RA, Halperin JL, Anderson JL, Parekh AK, Zoghbi WA. AHA/ACC/HHS strategies to enhance application of clinical practice guidelines in patients with cardiovascular disease and comorbid conditions: from the American Heart Association, American College of Cardiology, and U.S. Department of Health and Human Services. J Am Coll Cardiol [Internet]. 2014 Oct 28 [cited 2022 Jun 7];64(17):1851–6. Available from: https://pubmed.ncbi.nlm.nih.gov/25219921/
5. Rui P, Kang K, Ashman JJ. National Hospital Ambulatory Medical Care Survey: 2016 Emergency Department Summary Tables [Internet]. 2016. Available from: https://www.cdc.gov/nchs/data/ahcd/2016_NHAMCS_ED_PRF_Sample_Card.pdf.
6. Fanaroff AC, Rymer JA, Goldstein SA, Simel DL, Newby LK. Does This Patient With Chest Pain Have Acute Coronary Syndrome?: The Rational Clinical Examination Systematic Review. JAMA [Internet]. 2015 Nov 10 [cited 2022 Jun 7];314(18):1955–65. Available from: https://pubmed.ncbi.nlm.nih.gov/26547467/
7. Gräni C, Senn O, Bischof M, Cippà PE, Hauffe T, Zimmerli L, et al. Diagnostic performance of reproducible chest wall tenderness to rule out acute coronary syndrome in acute chest pain: a prospective diagnostic study. BMJ Open [Internet]. 2015 [cited 2022 Jun 7];5(1). Available from: https://pubmed.ncbi.nlm.nih.gov/25631316/
8. Amsterdam EA, Wenger NK, Brindis RG, Casey DE, Ganiats TG, Holmes DR, et al. 2014 AHA/ACC Guideline for the Management of Patients with Non-ST-Elevation Acute Coronary Syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol [Internet]. 2014 Dec 23 [cited 2022 Jun 7];64(24):e139–228. Available from: https://pubmed.ncbi.nlm.nih.gov/25260718/
9. Truong QA, Rinehart S, Abbara S, Achenbach S, Berman DS, Bullock-Palmer R, et al. Coronary computed tomographic imaging in women: An expert consensus statement from the Society of Cardiovascular Computed Tomography. J Cardiovasc Comput Tomogr [Internet]. 2018 Nov 1 [cited 2022 Jun 7];12(6):451–66. Available from: https://pubmed.ncbi.nlm.nih.gov/30392926/
10. Twerenbold R, Boeddinghaus J, Nestelberger T, Wildi K, Rubini Gimenez M, Badertscher P, et al. Clinical Use of High-Sensitivity Cardiac Troponin in Patients With Suspected Myocardial Infarction. J Am Coll Cardiol [Internet]. 2017 Aug 22 [cited 2022 Jun 7];70(8):996–1012. Available from: https://pubmed.ncbi.nlm.nih.gov/28818210/
11. Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, et al. Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association. Circulation [Internet]. 2018 Mar 1 [cited 2022 Jun 7];137(12):E67–492. Available from: https://pubmed.ncbi.nlm.nih.gov/29386200/
12. Konstantinides S v., Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galiè N, et al. 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J [Internet]. 2014 Jul 31 [cited 2022 Jun 7];35(43):3033–80. Available from: https://pubmed.ncbi.nlm.nih.gov/25173341/
13. Hoorweg BBN, Willemsen RTA, Cleef LE, Boogaerts T, Buntinx F, Glatz JFC, et al. Frequency of chest pain in primary care, diagnostic tests performed and final diagnoses. Heart [Internet]. 2017 Nov 1 [cited 2022 Jun 7];103(21):1727–32. Available from: https://pubmed.ncbi.nlm.nih.gov/28634285/
14. Juarez-Orozco LE, Saraste A, Capodanno D, Prescott E, Ballo H, Bax JJ, et al. Impact of a decreasing pre-test probability on the performance of diagnostic tests for coronary artery disease. European heart journal Cardiovascular Imaging [Internet]. 2019 Nov 1 [cited 2022 Jun 7];20(11):1198–207. Available from: https://pubmed.ncbi.nlm.nih.gov/30982851/
15. Maron DJ, Hochman JS, Reynolds HR, Bangalore S, O’Brien SM, Boden WE, et al. Initial Invasive or Conservative Strategy for Stable Coronary Disease. N Engl J Med [Internet]. 2020 Apr 9 [cited 2022 Jun 7];382(15):1395–407. Available from: https://pubmed.ncbi.nlm.nih.gov/32227755/
16. Bhatt DL. Assessment of Stable Coronary Lesions. N Engl J Med [Internet]. 2017 May 11 [cited 2022 Jun 7];376(19):1879–81. Available from: https://pubmed.ncbi.nlm.nih.gov/28317425/
17. Hoffmann U, Ferencik M, Udelson JE, Picard MH, Truong QA, Patel MR, et al. Prognostic Value of Noninvasive Cardiovascular Testing in Patients With Stable Chest Pain: Insights From the PROMISE Trial (Prospective Multicenter Imaging Study for Evaluation of Chest Pain). Circulation [Internet]. 2017 Jun 13 [cited 2022 Jun 7];135(24):2320–32. Available from: https://pubmed.ncbi.nlm.nih.gov/28389572/
18. AlBadri A, Bairey Merz CN, Johnson BD, Wei J, Mehta PK, Cook-Wiens G, et al. Impact of Abnormal Coronary Reactivity on Long-Term Clinical Outcomes in Women. J Am Coll Cardiol [Internet]. 2019 Feb 19 [cited 2022 Jun 7];73(6):684–93. Available from: https://pubmed.ncbi.nlm.nih.gov/30765035/
19. Ford TJ, Stanley B, Sidik N, Good R, Rocchiccioli P, McEntegart M, et al. 1-Year Outcomes of Angina Management Guided by Invasive Coronary Function Testing (CorMicA). JACC Cardiovasc Interv [Internet]. 2020 Jan 13 [cited 2022 Jun 7];13(1):33–45. Available from: https://pubmed.ncbi.nlm.nih.gov/31709984/
Published
2022-10-28
Section
Literature Review