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Keywords : Aterosklerosis, Penyumbatan koroner akut, Sirkulasi kolateral di dalam jantung , Faktor-faktor resiko

Aterosklerosis
Kolesterol dalam jumlah banyak berangsur menumpuk di bawah lapisan intima arteri. Kemudian daerah ini dimasuki oleh jaringan fibrosa dan sering mengalami kalsifikasi. Selanjutnya akan timbul “plak aterosklerotik” dan akan menonjolke dalam pembuluh darah dan menghalangi sebagian atau seluruh aliran darah.

Penyumbatan koroner akut
Plak aterosklerotik dapat menyebabkan suatu bekua darah setempat atau trombus dan akan menyumbat arteria.
Trombus dimulai pada tempat plak ateroklerotik yang telah tumbuh sedemikian besar sehingga telah memecah lapisan intima, sehingga langsung bersentuhan dengan aliran darah. Karena plak tersebut menimbulkan permukaan yang tidak halus bagi darah, trombosit mulai melekat, fibrin mulai menumpuk dan sel-sel darah terjaring dan menyumbat pembuluh tersebut. Kadang bekuan tersebut terlepas dari tempat melekatnya (pada plak ateroklerotik) dan mengalir ke cabang arteria koronaria yang lebih perifer pada arteri yang sama.

Sirkulasi kolateral di dalam jantung
Bila arteria koronaria perlahan-lahan meyempit dalam periode bertahun-tahun, pembuluh-pembuluh kolateral dapat berkembang pada saat yang sama dengan perkembangan arterosklerotik. Tetapi, pada akhirnya proses sklerotik berkembang di luar batas-batas penyediaan pembuluh kolateral untuk memberikan aliran darah yang diperlukan. Bila ini terjadi, maka hasil kerja otot jantung menjadi sangat terbatas, kadang-kadang emikian terbatas sehingga jantung tidak dapat memompa jumlah aliran darah normal yang diperlukan.

Faktor-faktor resiko
  • Tidak dapat dirubah: Jenis kelamin, Umur, Keturunan.
  • Dapat dirubah :
    Kelebihan lemak, seperti: hiperkolesterol, hiperlipidemia, hiperglitriserida.
    Perokok, hiprtensi, kegemukan/obesitas, diabetus militus, stres, kurang aktivitas fisik.

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