Akutes Koronarsyndrom in der Praxis – Was sollte der Hausarzt tun?

Abstract

Acute myocardial infarction is the second most common cause of mortality in Germany after chronic ischemic cardiac disease. It is essential to think of acute coronary syndrome also in patients who do not present with typical signs (pressure, tightness, pain, or a squeezing or aching sensation in the chest or arms that may spread to the neck, jaw or back) in the general practitioner’s practice. Vital signs (blood pressure, heart rate and oxygen saturation) must be measured; an ECG should be recorded and analyzed within ten minutes of first medical contact. The patient should be sedated, head and shoulders should be supported and an intravenous access should be established. Emergency medication that should be administered in practice is acetylsalicylic acid, an ADP receptor antagonist, morphine, nitrates, low molecular weight heparin and where necessary tranquilizers and oxygen (if peripheral saturation is below 90%). Monitored transport to the nearest clinic with percutaneous coronary intervention standby must be organized and this clinic must be informed about the arriving patient.

Nach der chronischen ischämischen Herzkrankheit ist der akute Myokardinfarkt für die meisten Todesfälle in Deutschland verantwortlich [1]. Die koronare Herzkrankheit kann klinisch in vielen Varianten auftreten: Von der stillen Ischämie über stabile und instabile Angina pectoris bis hin zum akuten Myokardinfarkt und plötzlichen Herztod. Eine frühe Diagnostik und rasches Einleiten einer adäquaten Therapie sind essenziell für eine optimale Prognose für den Patienten. Dabei fällt dem Hausarzt eine wichtige Rolle zu.

Schlüsselwörter

akutes Koronarsyndrom - Praxis - Erstmaßnahmen

Keywords

acute coronary syndrome - practice - first aid treatment

• Literatur

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