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Notfallmedizin up2date 2015; 10(04): 321-336
DOI: 10.1055/s-0041-109242
Spezielle Notfallmedizin
Georg Thieme Verlag KG Stuttgart · New York

Chest Pain Units

Julia Windolph
,
Ingo Eitel
,
Holger Thiele
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Publication History

Publication Date:
22 December 2015 (online)

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Kernaussagen

  • Ziel von Chest Pain Units (CPU) ist es, schnell und sicher die Genese von thorakalen Beschwerden, inklusive der Patienten mit Verdacht auf ein akutes Koronarsyndrom (ACS), abzuklären, um eine schnelle und optimierte Therapie bei Patienten mit ACS/AMI (= akuter Myokardinfarkt) zu gewährleisten.

  • Das ACS setzt sich aus dem STEMI, NSTEMI und der instabilen Angina pectoris (AP) zusammen.

  • Ein Myokardinfarkt wird definiert durch eine Erhöhung der kardialen Troponine in Zusammenhang mit typischen pektanginösen Beschwerden und/oder infarkttypischen EKG-Veränderungen.

  • Kardiale Troponine können selbst geringe Myokardschäden mit hoher Sensitivität detektieren und haben somit höchste prognostische Aussagekraft und therapeutische Konsequenz im Rahmen eines ACS.

  • Neben dem EKG und kardialen Biomarkern (insbesondere Troponin) dienen diverse Risikoscores zur optimierten Risikostratifizierung eines ACS-Patienten.

  • Die Etablierung einer CPU mit optimierten diagnostischen und therapeutischen Prozessen dient nachhaltig einer Verkürzung des stationären Aufenthalts, der Reduktion der Kosten und hat in ersten Studien auch eine Reduktion der Mortalität gezeigt.

 

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