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Erschienen in: Notfall +  Rettungsmedizin 4/2013

01.06.2013 | Konzepte - Qualitätsmanagement

Diagnostische Abklärung des akuten Koronarsyndroms bei älteren Patienten in der Notaufnahme

verfasst von: FESC Dr. P. Bahrmann, S. Popp, T. Bertsch, C.C. Sieber, M. Christ

Erschienen in: Notfall + Rettungsmedizin | Ausgabe 4/2013

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Zusammenfassung

Abklärungsalgorithmus in der Notaufnahme

Ältere Patienten, die sich mit akuten Thoraxschmerzen in der Klinik vorstellen, müssen zeitnah und strukturiert abgeklärt werden. Die Abklärung eines akuten Koronarsyndroms umfasst neben einer ausführlichen Erhebung der Krankenbeschwerden die körperliche Untersuchung, die Aufzeichnung eines 12-Kanal-Elektrokardiogramms (EKG), die Bestimmung von kardialen Biomarkern, meist von Troponin T oder I und eine echokardiographische Untersuchung. Häufig schließt sich eine mehrstündige Beobachtungsphase mit EKG- und Troponin-Monitoring und ggf. einem Belastungstest an.

Diagnose

Unter Zusammenschau aller Befunde kann die Diagnose eines akuten Myokardinfarkts gestellt werden. Die Diagnosestellung bei älteren Patienten ist häufig schwierig, da sie vielfach atypische Beschwerden aufweisen. Patienten, die aufgrund entsprechender Befunde ein hohes oder intermediäres Risiko für zukünftige kardiovaskuläre Ereignisse haben, müssen einer invasiven Diagnostik zugeführt werden. Patienten mit niedrigem Risiko haben eine günstige Prognose und können ambulant weiterbetreut werden. Dieser Beitrag beinhaltet eine Übersicht zur strukturierten Abklärung des akuten Koronarsyndroms bei älteren Patienten.
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Metadaten
Titel
Diagnostische Abklärung des akuten Koronarsyndroms bei älteren Patienten in der Notaufnahme
verfasst von
FESC Dr. P. Bahrmann
S. Popp
T. Bertsch
C.C. Sieber
M. Christ
Publikationsdatum
01.06.2013
Verlag
Springer-Verlag
Erschienen in
Notfall + Rettungsmedizin / Ausgabe 4/2013
Print ISSN: 1434-6222
Elektronische ISSN: 1436-0578
DOI
https://doi.org/10.1007/s10049-012-1622-5