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Therapie des kardiogenen Schocks

Eine Erfolgsgeschichte der deutschen Kardiologie
  • R. Erbel
  • M. Buerke
  • S. Mohr-Kahaly
  • H. Oelert
  • R. Uebis
Schwerpunkt
  • 23 Downloads

Zusammenfassung

Gegenüber der Situation in den 60er- und 70er-Jahren des vergangenen Jahrhunderts ist das Letalitätsrisiko für Patienten mit Herzinfarkt, insbesondere für solche mit kardiogenem Schock („myocardial infarction with cardiogenic shock“, MICS), deutlich gesunken. Von einem MICS sind etwa 5–10 % der Patienten mit Myokardinfarkt betroffen; ihr Letalitätsrisiko liegt zwischen 30 und 50 %. Die primäre perkutane Koronarintervention mittels Stentimplantation soll so schnell wie möglich durchgeführt werden, um die Letalität auf rund 20 % zu reduzieren. Dieser Beitrag liefert einen Überblick über die derzeit verfügbaren Optionen zur konservativen und zur fibrinolytischen Behandlung des MICS, zur interventionellen Therapie des kardiogenen Schocks in der Zeit der intravenösen und intrakoronaren Infarkttherapie sowie ohne Thrombolyse. Außerdem werden die aktuell einsetzbaren mechanischen Unterstützungssysteme sowie die Möglichkeiten zur Überwachung und zum Monitoring der Patienten vorgestellt.

Schlüsselwörter

Kardiogener Schock Myokardinfarkt Medikamentöse Therapie Koronare Intervention Stent Implantation 

Therapy of cardiogenic shock

A success story of German cardiology

Abstract

In contrast to the situation in the 1960s and 1970s, the mortality risk for patients with myocardial infarction has been clearly reduced, particularly for those with myocardial infarction with cardiogenic shock (MICS). Approximately 5‑10 % of patients with a myocardial infarction are affected by a MICS and the mortality risk is between 30 % and 50 %. The primary percutaneous coronary intervention with stent implantation should be carried out as quickly as possible in order to reduce the mortality to around 20 %. This article gives an overview of the currently available options for conservative and fibrinolytic treatment of MICS, of the interventional treatment of cardiogenic shock in the era of intravenous and intracoronary infarct treatment as well as without thrombolysis. In addition, the currently available mechanical support systems and the possibilities for surveillance and monitoring of patients are presented.

Keywords

Cardiogenic shock Myocardial infarction Medical therapy Coronary Intervention Stent Implantation 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

R. Erbel, M. Buerke, S. Mohr-Kahaly, H. Oelert und R. Uebis geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  • R. Erbel
    • 1
  • M. Buerke
    • 2
  • S. Mohr-Kahaly
    • 3
  • H. Oelert
    • 4
  • R. Uebis
    • 5
  1. 1.Institut für Medizinische Informatik, Biometrie und EpidemiologieUniversitätsklinikum Essen, Universität Duisburg-EssenEssenDeutschland
  2. 2.Klinik für Kardiologie, Angiologie und Internistische IntensivmedizinMarien KlinikenSiegenDeutschland
  3. 3.Praxis für Innere Medizin, Kardiologie und Klinische PharmakologieWiesbadenDeutschland
  4. 4.MainzDeutschland
  5. 5.Praxis für Innere Medizin und KardiologieAschaffenburgDeutschland

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