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Therapie des akuten Myokardinfarkts in der Prähospitalphase

Therapy of acute myocardial infarction in the prehospital setting

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Zusammenfassung

Die Prähospitalphase des akuten Myokardinfarkts ist entscheidend für die Prognose des Patienten. Einerseits besteht die Gefahr des plötzlichen Herztods durch Kammerflimmern, andererseits können bei Einschaltung des Rettungsdienstes bereits frühzeitig die Weichen für eine optimale Reperfusionsstrategie gestellt werden. Das durch große randomisierte Studien und Register gesicherte breite Spektrum therapeutischer Möglichkeiten hinsichtlich Thrombolyse, Thrombozytenhemmung und Antikoagulation sollte in diese Entscheidung ebenso eingehen wie die Patientenbedingungen, die Logistik und Zeitschienen sowie die verfügbaren lokalen Ressourcen.

Abstract

The time period from symptom onset to hospital admission is of outstanding importance for the prognosis of a patient with an acute myocardial infarction. He is threatened by sudden cardiac death triggered by ventricular fibrillation on the one hand and on the other hand this period offers the chance for a timely decision on the optimal reperfusion strategy. A broad spectrum of therapeutic opportunities regarding thrombolysis, antiplatelets and anticoagulation has been proven to be effective in large randomised trials and registries. These results should influence the individual decision on reperfusion treatment as well as the patient’s conditions, time lines, logistics and local resources.

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  1. Kardiopulmonologie, Charité, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Deutschland

    H.R. Arntz

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Arntz, H. Therapie des akuten Myokardinfarkts in der Prähospitalphase. Internist 49, 1023–1030 (2008). https://doi.org/10.1007/s00108-008-2073-4

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