ADVANCE ENGLISH

GROUP 1:

ABNITA KARUNIA PUTRI 1614401110001

AHMAD FAUZINOR 1614401110002

AHMAD NOR MAULANA AFSAN 1614401110003

AKHMAD NAZARUDIN 1614401110004

ALDI RIJALDI 1614401110005

ALMA AISYAH PUTRI 1614401110006

PROGRAM STUDI D3 KEPERAWATAN KELAS REGULER

FAKULTAS KEPERAWATAN DAN ILMU KESEHATAN

UNIVERSITAS MUHAMMADIYAH BANJARMASIN

TAHUN AKADEMIK 2018 / 2019

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 CHAPTER I
INTRODUCTION

1. Background

Heart disease and stroke is a disease that is very frightening figure. Even today in
Indonesia,heart disease ranks first as a cause of death.

Heart disease and stroke is often considered a disease of the elderly monopoly. I used to be
such diseases suffered by the elderly especially those aged 60 years and over, because age is
also a risk factor for heart disease and stroke. But now there is a trend also suffered by
patients under the age of 40. This can occur because of lifestyle changes, especially in the
modern urban youth.

When the era of globalization has increasingly easy to obtain information, developing
countries can quickly imitate western habits are considered a mirror of modern lifestyle.
Some behaviors such as eating fast food (fast food) that contain high levels of saturated fats,
smoking, alcohol, overwork, lack of exercise, and stress, has become a way of life humans,
especially in urban areas. Yet all these behaviors can be causative factors for heart disease
and stroke.

2. Problem Formulation

2.1. What exactly is heart disease?

2.2. What are the anatomical structure of the heart?

2.3. Why is heart disease that could happen?

2.4. What are the different types of heart penyaklit kind?

2.5. What are the characteristics of people with heart disease?

2.6. What are the tips that make your heart healthy?

2.7. What foods are good luck heart?

2.8. How do I prevent heart disease?

2.9. What are the best exercise for the heart?

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3. Objectives of writing

3.1. Can know about heart disease

3.2. to determine the anatomical structure of the heart

3.3. to determine the cause of heart disease

3.4. Can know the types of heart disease

3.5. Can know what are the characteristics of people who have heart disease

3.6. Can know tips to make heart-healthy

3.7. Can know the food is good for the heart

3.8. Can know how penyegahan heart disease

3.9. Can know the best exercise for the heart

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 CHAPTER II
DISCUSSION

1. Definition of heart disease

The heart (Latin, cor) is a hollow, hollow, muscular organ that pumps blood through the
blood vessels by repeated rhythmic contractions. The term cardiac means related to the heart,
from the Greek cardia for the heart.
The heart is one organ that plays a role in the circulatory system.
A heart attack is a condition that causes heart was not functioning. This condition usually
occurs suddenly, and is often called congestive heart failure. Causes of heart failure vary, but
usually the main cause is impaired blood supply to the heart muscles, because the blood
vessels that normally drain blood to the heart muscles are blocked or hardened, either
because of fat and cholesterol, or because of substance chemical substances such as excessive
use of drugs containing Phenol Propano Alanine (ppa) are commonly found in drugs such as
Decolgen, and nicotine.
Lately also often found in sudden cardiac arrest when a person is on the move, such as
those attacked some football athletes in the world-renowned soccer field.Usually it is caused
by the imposition of heart activity that exceeds a threshold, or the lack of warming up before
exercise.

2. Structure of the anatomy of the heart

2.1 Heart valve
Heart valve is a membrane or membranes that play a role in the regulation of
blood flow in the heart. Heart valve is automatic, the valve will only open in a specific
direction (the direction of blood flow) and closed in the other direction.Heart valves
totaled four pieces. Two of them are known by the name atrioventrikuler valve
(antrioventricular valve). Both valve is located between the indoor atrium and ventricle
of the heart. Meanwhile, two other valves known as semilunar valves (semilunar valve).
These valves are between the ventricles and the arteries (blood vessels that drain
blood from the heart). Right semilunar valve lies between the right ventricle and the

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 pulmonary artery (the artery that connects to the lungs) is called pulmonary valve
(pulmonary valve), while the left semilunar valve lies between the left ventricle and the
aorta (the main artery) is called the aortic valve (aortic valve).
Atrioventrikuler valve separates the heart's chambers. These valves are of two
kinds, namely valves and valve mitralis trikuspidalis. Mitralis valve is the valve that
separates the left atrium and left ventricle. Mitralis valve prevents backflow of blood
from the left ventricle back into the left atrium.
While trikuspidalis valve is the valve that separates the right atrium and right
ventricle. Triukuspidalis valve function is to prevent the backflow of blood from the right
ventricle back into the right atrium.
Other heart valves are semilunar valves. This valve consists of three leaflets that
resemble a crescent moon. This amounted to two semilunar valves, the aortic valve and
the pulmonary valve. Aortic valve connects the left ventricle to the aorta, while the
pulmonary valve connects the right ventricle to the pulmonary artery.
Both valves will be open during ventricular contraction or perform blood
pumping and closes to prevent back flow of blood into the ventricles (Smeltzer & Bare,
2001).

2.2 Walls and Cardiac Muscles

Heart wall consists of unique cells called myocardium containing the heart
muscles. This muscle is the only type found in the body. Therefore, these muscles must
have oxygen all the time to stay alive, to the heart through the coronary arteries takes
place continuously. This is a narrowing of the coronary arteries is very dangerous to the
heart.
When the arteries narrow, things happened that are not desirable, from chest pain
to heart attacks potentially sudden death.
The cavity or space within the heart is divided into two spaces above (called the auricle
or the right and left atria) and two lower chamber (or chambers of the heart called the
right and left ventricles). The rooms are separated by a thick muscular wall called the
septum.

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 The heart muscle is muscle tissue that surrounds the heart and form the heart wall.
Heart wall formed by the myocardium has a different thickness on each part. The room
walls atrium that serves to accommodate the blood from outside the heart are much
thinner than the walls of the ventricular pumping function of the heart.
The heart muscle is composed of muscle cells similar to striated muscle, but the
heart muscle has branching. Cardiac muscle cells have many nuclei and is located in the
center of the fiber.
Heart muscle working out regularly, not fast, and do not follow our will.The heart
muscle is a muscle that has privileges. Physically, striated shapes, but functionally, works
such as smooth muscle, which is outside of awareness or outside the brain commands.
Muscle work is influenced by the autonomic nerves. Cardiac muscle forms the walls of
the heart, so the heart of the work of human life.

2.3 Pericardium
The pericardium is a bag that has two layers of the heart. The first layer on the
inside of the pericardium is called the epicardium. This layer is part of the pericardium in
direct contact with the heart muscle.
Meanwhile, the outer layer of the pericardium is the layer in direct contact with the breast
bone and other structures in the chest cavity.
This layer serves to maintain the heart in place.
The pericardium normally contains very small amounts of fluid. Pericardial fluid can
prevent friction between the two layers of the pericardium when the heart contracts. The
outer layer of the pericardium is attached to the connective tissue lining the lungs, so that
the heart remains in the right location within the chest cavity.
If the volume of fluid than "full" at the level of the pericardium, the pericardial
effusion resulting in pressure on the heart and cardiac tamponade occurred (cardiac
tamponade), which is the compression of the heart caused by blood or fluid builds up in
the space between the myocardium and pericardium. Compression causes decreased heart
function.
Conflicts that occur in the chest can lead to rupture of blood vessels in the pericardium,
blood accumulates in the pericardial space surrounding the heart.This can cause the heart

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 submerged fluid collected in the pericardial space, so the heart sounds heard dimmed.
The liquid contained in the pericardial cavity also causes the heart to contract and can not
be suppressed completely.

2.4 Endocardial
Endocardium is a thin membrane of tissue that protects the glossy white inner
cavity of the heart. Endocardial endothelium is a thin layer, a unique epithelial tissue that
lines the inside of the entire circulatory system. This layer is located in the deepest part.
This layer also serves to help the blood to flow smoothly and prevent the attachment of
blood on the wall of the heart.

2.5 Coronary Artery Disease (Coronary Artery)

All the tissues of the human body needs oxygen for metabolic processes, as well
as the heart. These organs need oxygen sufficient to prevent ischemia in the myocardium.
Supply of cardiac oxygen demand channeled through the coronary arteries.
Thus, it can be defined that the coronary arteries are the arteries that supply blood
to serve the heart muscles. Coronary artery-shaped fibers of blood vessels that supply
oxygen and nutrients to the heart muscle. Over time, if the arteries clogged by fat and
cholesterol that builds up, it causes the heart does not receive an adequate blood supply,
causing ischemic heart disease or coronary artery disease.

3. Causes of heart disease

Exposed to risk factors that cause heart disease as where noted cardiologist in One Congress
in Munich Germany are:
3.1 Smoking
3.2 High blood pressure
3.3 Disease sugar or Diabetes
3.4 One-sharing schemes fat = waist to hip ratio
3.5 Eating the wrong
3.6 Excessive physical activity
3.7 Consume Alcohol

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 3.8 The amount of fat in the blood
3.9 Psychosocial factors

However, there are four main factors causing heart disease, namely:
smoked too much over the years
levels of blood fats (cholesterol) levels
high blood pressure
diabetes

4. Type of heart disease

Many kinds of heart disease. The sufferer also often exposed to more than one disorder
(complication). Here are some types of heart disease that you need to know. This list is just
some of the dozens of other types of heart problems that can threaten us.
4.1 Atherosclerosis.
Atherosclerosis is the thickening of the inner walls of the arteries due to plaque deposits
(fat, cholesterol and other cell waste) that inhibit and block the blood supply to the
muscle cells. Atherosclerosis can occur in all parts of the body. In the event of the arterial
walls of the heart, it is called coronary heart disease (coronary artery disease) or ischemic
heart disease.Atherosclerosis ongoing chronic and cause many disorders. Atherosclerosis
begins lesions and cracks in the walls of blood vessels, mainly due to the strong pressure
on the heart vessels. In the next phase, the body tries to recover by putting the fatty
substances in the blood vessel to close the rift.
Gradually, as the repeated fracturing and closure, fatty substances that can close the heart
vessels. One of the symptoms of heart atherosclerosis is Angina pectoris, ie pain /
discomfort in the heart and chest area due to reduced blood supply to the heart muscle.
Angina can occur either physical exertion or at rest. If continued, angina can progress to
acute myocardial infarction dangerous.
4.2 Acute Myocardial Infarction
Myocardial infarction is the death of heart muscle due to a blockage in the coronary
arteries. Heart muscles are not blood tersuplai will suffer damage or sudden death.
4.3 Cardiomyopathy

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 Cardiomyopathy is a damage / disorder of the heart muscle that causes the heart's walls
do not move perfectly in sucking and pumping blood. People with cardiomyopathy are
often at risk of arrhythmia and sudden cardiac arrest. Cardiomyopathy is still subdivided
into species kardiomipati congestive, hypertrophic, restrictive and peripartum.
4.4 Arrhythmias
Arrhythmias mean abnormal heart rhythm, which can be caused by impaired cardiac
excitatory stimulation and delivery of mild or severe.
4.5 Congestive Heart Failure.
Heart failure is the inability of the heart to pump blood effectively throughout the body.
The heart is said to fail not because it stopped working, but because it was not pumping
as strong as it should be. As a result, blood can be turned into the lungs and other body
parts.
4.6 Atrial Fibrillation
Atrial fibrillation is a heart rhythm disorders that interfere with atrial electric. Disruption
of electrical impulses cause the heart muscle contraction is irregular and does not pump
blood efficiently. As a result, cardiac atria is not completely emptied of blood leading to
the porch (the ventricles). Atrial fibrillation is usually associated with many other
disorders, including cardiomyopathy, coronary, ventricular hypertrophy, etc..
Hyperthyroidism and alcohol poisoning can also cause atrial fibrillation.
4.7 Heart Inflammation
Heart inflammation may occur in the wall of the heart (myocarditis), the membrane that
surrounds the heart (pericarditis), or the inside (endocarditis). Inflammation of the heart
can be caused by toxins or infections.
4.8 Rheumatic Heart Disease
Rheumatic heart disease is damage to the heart valves due to rheumatic fever, caused by
streptococcal bacteria.
4.9 Heart Valve Disorders
Heart valve serves to control the direction of blood flow in the heart. Abnormalities of
the heart valves that can interfere with the flow, partly because of the downsizing
(stenosis), leaking (regurgiasi), or does not close properly (prolapsis). Valve

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 abnormalities may occur as congenital or due to infection and side effects of treatment.

5. Characteristics of people suffering from heart disease

Sweating so much at night time chest and the back felt "depressed" making it difficult to
breathe front chest feels like "pins and needles 2" is anggina pectoris inner arm from the
armpit to the elbow-2, and even spread to the finger-2 was CRAMPS / tingling shoulder to
the back of the neck, radiating to the jaw feels "stiff and cramping" headache that does not go
seconlower abdominal "cramps" crotch of the inner thighs, spreading to the inner calf,
tingling and cramping always Simptoment / signs indicate "something with a heart" you. Do
not be put immediately to the doctor. Based on laboratory tests - urine and blood - the doctor
will tell you whether or not heart disease. Please note: that high blood pressure and
cholesterol Very high is the "cause" of heart disease / cardiac infarction.

6. Tips that make your heart healthy

 Eating nuts, about 25 grams of walnuts and peanuts because it can help lower
cholesterol and rich in protein.
 Eating foods rich in protein, such as fish. Fatty acids found in fish prevents the
formation of blood clots.
 Drinking statin 10 mg tablet daily in the evening (especially for those aged over 40
years and especially diabetics), this practice helps to reduce cholesterol and reduce
the risk of heart attack.
 Perform general check-up after the age of 25, let alone have a family history of heart
disease cases.
 Avoid extreme weather. In cold weather makes the blood pressure soaring blood
vessels so as to encourage a heart attack.
 Meditation. This has a direct impact on a person's blood pressure, these measures can
provide a significant reduction in blood pressure levels and is key to a healthy heart.
 Starting today, take a spoonful of honey. It can reduce the cholesterol in the arteries
and prevent heart attacks.
 Walking on dew with bare feet. Walking restore a sense of balance and bring peace of
mind, because it is good for the heart.

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  Maintaining oral hygiene. Research shows, gingivitis may increase the risk of heart
disease and stroke because of the high levels of bacteria found in the mouth of an
infected person.
 Brisk walking for at least 30 minutes in the morning, because it reduces the pollution
that affects the heart, which are more likely to do during the evening hours.
 Listening to soft music, gurbani, sholkas, and so on, because it has a beneficial effect
on lowering blood pressure to maintain a healthy heart.

7. The food was good for the heart

7.1 Oatmeal
Rich in omega-3 fatty acids, folate and potassium. In addition, fiber-rich foods can also
reduce levels of bad LDL cholesterol and prevent the formation of plaque in artery walls
7.2 Salmon
Fish rich in omega-3 fatty acids is effective in lowering blood pressure and prevent blood
clots. Try to eat two servings of salmon per week.
This method can reduce the risk of dying from heart attack by 33 percent.
"Salmon contains the carotenoid astaxanthin, which is a powerful antioxidant," says
cardiologist Stephen T. Sinatra, MD, author of Lower Your Blood Pressure in Eight
Weeks, as quoted by website health.com
7.3 Avokat
Try taking avokat to add healthy fats to your diet. Foods rich in unsaturated fats can help
lower LDL cholesterol and increase good cholesterol HDL in the body.
"Avokat very well. Foods allows the absorption of other carotenoids, especially beta-
carotene and lycopene, which is very important for heart health," said Sinatra
7.4 Olive oil
Olive oil is rich in unsaturated fats. Healthy oils helps menuruunkan LDL cholesterol and
lower your risk of heart disease. So try replacing butter with oil this one
7.5 Nuts
Nuts, such as walnuts and almonds are rich in omega-3 fatty acids and unsaturated fats
doubles. In addition, the light Sinatra, beans also increase the intake of fiber to the diet.
"And like olive oil, nuts are a source of healthy fat."

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 7.6 Berries
Blueberries, raspberries, strawberries and other berries are rich in type anti-
inflammatories. Inflammatory component of this work in the fruit reduces the risk of
heart disease and cancer.
7.7 Peas
Try to increase the intake of legumes, such as kidney beans and black beans. Nuts are
rich in omega-3 fatty acids, calcium and soluble fiber
7.8 Spinach
Spinach is rich in healthy components such as lutein, folate, potassium and fiber. Increase
the intake of green vegetables may help improve heart health. A study found that people
who ate at least 2.5 servings of spinach per day have a reduced risk of heart disease by 25
percent.
7.9 Linseed
Flaxseeds are rich in fiber and omega-6 fatty acids. Eating flaxseed mixed with oatmeal
can help maintain heart health.
7.10 Soybean
Soy beans can help lower cholesterol levels as low in saturated fat. Food is a source of
protein, the right choice for a healthy heart

8. How to Prevention of heart disease

Prevention efforts to prevent heart disease and stroke begins to improve the lifestyle and
controlling risk factors that reduce the chance of developing the disease. For the prevention
of heart disease and stroke to avoid obesity / overweight and high cholesterol. Start by eating
more vegetables, fruits, grains, canola and fish. Less meat, small meals (snacks), and high-
calorie foods that contain a lot of saturated fat and more. Foods that contain lots of
cholesterol accumulate in blood vessel walls and cause atherosclerosis that trigger heart
disease and stroke.
Quitting smoking is the target to be achieved, also avoid cigarette smoke from the
environment. Smoking causes reduced elasticity of blood vessels, thus increasing the
hardening of the arteries, and increased blood clotting factors that trigger heart disease and

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 stroke. Smokers have the chance of stroke and coronary heart disease approximately two-fold
higher compared with nonsmokers.
Reduce drinking alcohol. The more consumption of alcohol, especially the type of
hemorrhagic stroke likely higher. Alcohol can raise blood pressure, weakens the heart, blood
thicken and cause arterial spasm. Perform Sports / physical activity. Exercise can help reduce
body weight, controlling cholesterol, and lowering blood pressure is another risk factor for
heart disease and stroke affected Control high blood pressure and blood sugar levels.
Hypertension is a major factor of stroke and coronary heart disease. Diabetes also
increases the risk of stroke from 1.5 to 4-fold, especially if the blood sugar is not under
control. Avoid the use of illegal drugs such as heroin, cocaine, amphetamines, drugs because
drugs can increase the risk of stroke 7-fold compared with non-drug users.
Preventing Heart Disease and Stroke with Plant Medicines
Several types of herbs that can be used to prevent heart disease and stroke has the effect of
blood circulation and as an anticoagulant that prevents blood clots, heart disease and stroke is
the main cause of vascular disorders.

9. Exercises that multiply to heart

The fast pace equal to train the heart to become healthier.
Working harder is no longer a secret to ward off metabolic syndrome, a combination of risk
factors - including obesity and high blood pressure - which increases the risk of
cardiovascular disease, according to a new study in BMJ Open.
Ten years after collecting the basics of one's exercise habits - including the duration and
intensity of exercise - researchers found that those who reported jogging or brisk walking 2
to 4 hours per week reduces the risk of developing metabolic syndrome by 35 - 50%.
Impact of high-intensity cardiovascular workout in the exercise versus light has been a long
debate, says cardiologist Eric Topol, MD, director of the Scripps Translational Science
Institute and a health adviser. "High-intensity exercise does have a different impact on the
overall physiology of the body," said Dr. Topol. Everything will be worse: your heart rate
becomes higher, the more your blood vessels dilate, and you improve your cardiovascular
system as you are a car, Dr. Topol said.

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 The results of the study are consistent with past studies on the topic: There are some
businesses that need to do the extra to see the change in you. And maybe that intense exercise
triggers changes in lipid metabolism, glucose and blood pressure, lowering the risk factors
that lead to metabolic syndrome, says David Maron, MD, a cardiologist at Vanderbilt
University Medical Center.
But do not be trivial to you on a leisurely stroll in the evening. A recent study in
Circulation found that only 2.5 hours of moderate exercise a week can reduce the
inflammation in your body that is considered to be a major risk factor for heart disease. The
key: Make sure that your heart rate increases to about 120 beats per minute, and a
recommended exercise for 2.5 hours a week.
Research shows that mild physical activity does not reduce the risk of heart disease -
even if they are running for 2 hours during the week - but a brisk walk can be categorized as
high-intensity exercise. If it is difficult for you to walk fast, make a notch. "Aerobics is the
best tight," said Topol. So, if you enjoy your stroll at night, make sure you also sweat in the
morning.

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 CHAPTER III
CLOSING

1. Conclusion
Based on the exposure can be concluded that heart disease is a condition that causes the heart
can not carry out their duties properly. These things include:
A weak heart muscle. It is a congenital abnormality. A weak heart muscle can not make
people do excessive activity, because the imposition of excessive cardiac performance will
cause pain in the chest, and sometimes can cause the body to appear bluish. People with
weak heart muscle is easy to faint. The gap between the right atrium and left the porch,
because of incomplete formation of a separate layer between the second platform when the
patient is still in the womb. This causes the blood clean and dirty blood mixed. This disease
also makes people unable to perform strenuous activities, as heavy activity almost certainly
will make the patient's body turned blue and shortness of breath, although not cause pain in
the chest. There are also variations of the disease, namely a person really only has one porch.
2. Advice
There is no better response to prevent disease and heart attacks, in addition to a healthy
lifestyle (such as frequent waking early, not often stay up too late at night, and avoiding
cigarettes and alcoholic beverages), healthy diet (emphasis on eating fibrous foods and
bersayur, and do not eat too much fatty food and high cholesterol), and regular exercise, and
not excessive, the above is a good suggestion to run for each person to maintain health,
especially heart.

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