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Erschienen in:

01.09.2008 | Schwerpunkt

Interventionelle Therapie des akuten Herzinfarkts

verfasst von: Prof. Dr. R. Zahn, U. Zeymer

Erschienen in: Die Innere Medizin | Ausgabe 9/2008

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Zusammenfassung

Der akute Myokardinfarkt wird heute in einen ST-Hebungsinfarkt (STEMI) und einen Nicht-ST-Hebungsinfarkt (NSTEMI) eingeteilt. Für die Praxis bedeutsamer, da sich alle Empfehlungen der Leitlinien bzgl. des invasiven Vorgehens danach richten, ist aber die Einteilung in ein akutes Koronarsyndrom mit ST-Hebungen (STE-ACS = STEMI) und eines ohne ST-Hebungen (NSTE-ACS). Letzteres wird nochmals unterteilt in ein NSTE-ACS mit oder ohne Risikomerkmale. Für das NSTE-ACS mit Risikomerkmalen wird allgemein eine frühe invasive Abklärung innerhalb von 72 h nach Diagnosestellung empfohlen, während das NSTE-ACS ohne Risikomerkmale zunächst rein medikamentös konservativ behandelt werden kann. Bezüglich des STEMI ist die Primärdilatation eindeutig Mittel der Wahl, wenn sie innerhalb von 2 h nach Diagnosestellung an einem erfahrenen Interventionszentrum mit kurzen Pforte-Ballon-Zeiten durchgeführt werden kann. Da dies in Deutschland prinzipiell flächendeckend möglich ist, ist es zurzeit die primäre Aufgabe, lokale Netzwerke zu errichten, um dies zu gewährleisten.

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Titel: Interventionelle Therapie des akuten Herzinfarkts
verfasst von: Prof. Dr. R. Zahn
U. Zeymer
Publikationsdatum: 01.09.2008
Verlag: Springer-Verlag
Erschienen in: Die Innere Medizin / Ausgabe 9/2008
Print ISSN: 2731-7080
Elektronische ISSN: 2731-7099
DOI: https://doi.org/10.1007/s00108-008-2075-2

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