Invasive Koronardiagnostik im Rahmen einer Postreanimationsbehandlung nach außerklinischem Herzstillstand

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.

Schlüsselwörter

perkutane Koronarintervention (PCI) - außerklinischer Herz-Kreislauf-Stillstand - akutes Koronarsyndrom - Postreanimationsbehandlung

Key words

percutaneous coronary intervention - out-of-hospital cardiac arrest (OHCA) - acute coronary syndrome (ACS) - post-cardiac arrest care

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