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Dtsch Med Wochenschr 2020; 145(09): 624-632
DOI: 10.1055/a-1106-3325
Übersicht

Infarktbedingter kardiogener Schock

Cardiogenic Shock Complicating Myocardial Infarction
Danilo Obradovic
,
Anne Freund
,
Steffen Desch
,
Holger Thiele
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Abstract

In patients admitted with acute myocardial infarction, cardiogenic shock remains the most common cause of death. Multidisciplinary care in a specialized center and guideline-compliant treatment of cardiogenic shock are crucial for the survival and prognosis of affected patients. Hemodynamic monitoring and stabilization by volume expansion, vasopressors and inotropes represent initial steps in the management of patients with cardiogenic shock. Nevertheless, early revascularization of the culprit-lesion is proved to be the most important treatment modality. Although the use of active mechanical circulatory support appears to be a promising therapeutic concept to improve clinical outcome in patients with infarct-related cardiogenic shock, in the few previous randomized trials mechanical circulatory support failed to show beneficial effects on short-term and long-term survival.

Der kardiogene Schock ist die häufigste Todesursache bei Patienten mit akutem Myokardinfarkt im Krankenhaus. Ein frühzeitiges Erkennen und die rasche Leitlinien-konforme Therapie sind Prognose-entscheidend; dabei ist neben der Basistherapie die unverzügliche Revaskularisierung der „Culprit“-Läsion anzustreben. Welche Rolle eine mechanische Kreislaufunterstützung bei Patienten mit kardiogenem Schock spielt, ist noch unklar.

Schlüsselwörter

kardiogener Schock - akuter Myokardinfarkt - Revaskularisation - Prognose - mechanische Kreislaufunterstützung

Key words

cardiogenic shock - acute myocardial infarction - revascularization - prognosis - mechanical circulatory support


Publication History

Article published online:
29 April 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

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