Management des akuten ST-Strecken-Hebungsinfarktes

作者: S. Birkmeier , H. Thiele , R. Dörr

DOI: 10.1007/S00059-013-3941-9

关键词:

摘要: In diesem CME-Beitrag werden die aktuellen Leitlinien zur Diagnostik und Therapie des akuten ST-Strecken-Hebungsinfarktes (STEM) entsprechend den 2012 aktualisierten der Europaischen Gesellschaft fur Kardiologie dargelegt. Zur sicheren Diagnosestellung wird zudem auf aktuelle universelle Definition Myokardinfarktes eingegangen, definiert ist durch eine Myokardnekrose. Die Kriterien sind erfullt bei Nachweis eines Anstiegs oder Abfalls kardialen Biomarkers, bevorzugt Troponin, in Verbindung mit Symptomen Myokardischamie, neuen Erregungsruckbildungsstorungen neuem Linksschenkelblock, Ausbildung von pathologischen Q-Zacken, Darstellung Wandbewegungsstorungen Vitalitatsverlust dem intrakoronarer Thromben Koronarangiographie Autopsie. Anschliesend Empfehlungen primaren Diagnose Behandlung ersten medizinischen Kontakt sowie Entscheidung uber zeitgerechte Reperfusionsstrategie zusammengefasst. primare perkutane Koronarintervention bleibt bevorzugte allerdings engeren Zeitvorgaben Reperfusion. Netzwerkbildung dabei starker betont. Ein besonderes Augenmerk liegt im Folgenden plattchenhemmenden Rahmen Koronarsyndroms, sich vergangenen Jahren einige wichtige Anderungen ergeben haben Bevorzugung Prasugrel Ticagrelor vor Clopidogrel.

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