Nachsorge der Patienten nach infarktbedingtem kardiogenem Schock

Der infarktbedingte kardiogene Schock (IKS) ist die schwerste Verlaufsform eines akuten Koronarsyndroms (ACS), mit sehr hohem Ressourcenverbrauch – insbesondere bei Einsatz temporärer mechanischer Unterstützungssysteme – und weiterhin sehr hoher Sterblichkeit zwischen 40 und 50 %. Die Langzeitprognose jedoch ist gut, wenn sowohl die intensivmedizinische Nachsorge, medikamentöse Therapiemaßnahmen und später auch Lebensstiländerungen greifen.

Abstract

Infarction-related cardiogenic shock is the most severe complication of an acute coronary syndrome, that still bears a high mortality up to 50 % and wastes a lot of resources of an intensive care unit, especially if extracorporeal assist devices are used.

In contrast to the adverse short-term outcome, patients fare a surprisingly well in the long range, both for survival and quality of life. Same as for the acute disease, which needs specific cardiologic and intensive care measures, long-term follow-up care needs a lot of medical and lifestyle interventions and treatments to obtain the best possible result for the patients. Since there is good evidence for cardiologic therapies from randomized controlled trials, high quality data to treat long-term sequalae of the stay on intensive care unit, are sparse.

Overall, follow-up care of survivors of infarction related cardiogenic shock includes the best available treatment of the coronary artery disease, intensified heart failure therapy of left and right heart dysfunction and evaluation for the risk of sudden cardiac death and treatment of sequelae of the intensive-care-unit stay.

Schlüsselwörter

infarktbedingter kardiogener Schock - Nachsorge - Herzinsuffizienz-Therapie - kardiovaskuläre Risikoreduktion

Key words

infarction-related cardiogenic shock - follow up - heart failure - cardiovascular risk reduction

Publication History

Article published online:
07 September 2022

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