Zusammenfassung
Das akute Koronarsyndrom ist in vielen Fällen die erste klinische Manifestation der
zugrunde liegenden Atherosklerose und stellt häufig eine Notfallsituation dar. In
kurzer Zeit müssen die Ursache und ggf. mögliche Differenzialdiagnosen erkannt und
zügig gehandelt werden. Die richtige Interpretation von Anzeichen und Symptomen und
die entsprechende Auswahl der diagnostischen Methode sind die Basis für die weitere
Therapie.
Abstract
Acute coronary syndrome is one of the most important differential diagnostic considerations
in emergency medicine. It describes the constellation of newly occurring clinical
symptoms, often accompanied by typical 12-lead ECG changes and the release of cardiac
troponins. The spectrum includes unstable angina pectoris, non-ST-segment elevation
myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI).
It is important to consistently carry out the diagnostic steps that are crucial for
further therapeutic procedures to avoid delaying life-saving invasive coronary diagnostics,
without losing sight of the diverse, sometimes time-critical differential diagnoses.
Anamnesis and clinical examination form the basis of the further procedure. Further
developments of biomarker assays with personalized limit values, new imaging modalities
with ever higher resolution and faster imaging methods as well as advances in automated
ECG analysis with integration of all findings through artificial intelligence will
continue to offer many optimization options in the future diagnosis of acute coronary
syndrome.
Schlüsselwörter
akutes Koronarsyndrom - Diagnose - Notfall - Bildgebung - kardiale Biomarker
Keywords
acute coronary syndrome - diagnosis - emergency - imaging - cardial biomarkers
