Aktuelle Kardiologie 2017; 6(01): 53-58
DOI: 10.1055/s-0042-123186
Übersichtsarbeit
Georg Thieme Verlag KG Stuttgart · New York

Invasive Koronardiagnostik im Rahmen einer Postreanimationsbehandlung nach außerklinischem Herzstillstand

Invasive Cardiac Procedures in Post-Cardiac Arrest Care
Reimer Riessen
1   Internistische Intensivstation, Universitätsklinikum Tübingen
,
Hans-Jörg Busch
2   Universitäts-Notfallzentrum, Universitätsklinikum Freiburg
,
Michael Haap
1   Internistische Intensivstation, Universitätsklinikum Tübingen
› Author Affiliations
Further Information

Publication History

Publication Date:
24 February 2017 (online)

Zusammenfassung

Ein akutes Koronarsyndrom ist die häufigste Ursache für einen außerklinischen Herzstillstand. In den letzten Jahren sind einige Empfehlungen und Leitlinien zum Einsatz einer invasiven kardiologischen Diagnostik und einer perkutanen Koronarintervention unter diesen Bedingungen veröffentlicht worden. Danach ist es Konsens, dass Patienten, bei denen im Rahmen einer strukturierten Initialdiagnostik und Risikostratifikation ein akutes Koronarsyndrom als gesicherte oder wahrscheinliche Ursache für den Herzstillstand angenommen wird, prognostisch von einer perkutanen Koronarintervention profitieren können. Die initiale Evaluation und interdisziplinäre Festlegung der Behandlungsstrategie muss jedoch die Abklärung nicht kardialer Ursachen ebenso wie Kriterien für eine sehr ungünstige Prognose beinhalten.

Abstract

An acute coronary syndrome is the most common cause for an out-of-hospital cardiac arrest. In the recent years several recommendations and guidelines have been published regarding the use of emergent cardiac procedures in such patients. There is an agreement that patients may prognostically benefit from an early percutaneous coronary intervention when a structured initial diagnostic workup and risk stratification results in a high likelihood for an acute coronary syndrome. The initial evaluation and interdisciplinary consultation, however, also must consider non-cardiac causes for a cardiac arrest as well as criteria of futility.

 
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