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Das akute Koronarsyndrom

Eine in der Praxis unscharf gehandhabte Diagnose

Acute coronary syndrome

A diffuse diagnosis

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Zusammenfassung

Das akute Koronarsyndrom stellt einen Hauptgrund für eine Vorstellung in einer Notaufnahme dar. Darüber hinaus ist das akute Koronarsyndrom mit seinen Komplikationen noch immer die häufigste Todesursache. Beim Begriff „akutes Koronarsyndrom“ handelt es sich jedoch zum einen um den Oberbegriff, welcher die 3 Entitäten „instabile Angina pectoris“, „Nicht-ST-Hebungsinfarkt“ und „ST-Hebungsinfarkt“ zusammenfasst. Zum anderen dient der Begriff vor allem in der Notfallmedizin als Arbeitsdiagnose für Patienten mit (noch) unklarem, akutem Brustschmerz. Obwohl sich die zugrunde liegende Erkrankung nicht geändert hat, wurde insbesondere durch die Einführung der Troponine und die Änderungen des Referenzwerts der Begriff und die Bedeutung des akuten Myokardinfarkts stark verändert. Im vorliegenden Artikel soll die aktuelle Nomenklatur und deren Bedeutung für die adäquate Diagnostik und Therapie weiter erläutert werden.

Abstract

Acute coronary syndrome is one of the most common reasons for a presentation in an emergency room. The biggest component of the overall mortality in adults is acute coronary syndrome or in this context its complications. The term “acute coronary syndrome” comprises on one hand 3 entities – unstable angina pectoris, Non-ST-elevation myocardial infarction and ST-elevation myocardial infarction. On the other hand particularly in emergency medicine the term is used as a working diagnosis for patients with unclear, acute chest pain. Although the underlying disease has not changed, especially with the introduction of troponins and the changes of their reference values the concept and importance of acute myocardial infarction has changed. This article emphazises on the current nomenclature and its importance for the adequate diagnosis and treatment are explained.

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  1. II. Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz, Langenbeckstraße 1, 55101, Mainz, Deutschland

    F. Post &  T. Münzel

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Post, F., Münzel, T. Das akute Koronarsyndrom. Internist 51, 953–962 (2010). https://doi.org/10.1007/s00108-009-2536-2

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