Therapie der akuten Herzinsuffizienz und des kardiogenen Schockes

Zusammenfassung

Die akute Herzinsuffizienz (aHF) ist ein lebensbedrohliches Krankheitsbild. Im Gegensatz zur chronischen Herzinsuffizienz ist jedoch die Therapie der aHF deutlich weniger gut untersucht. Wichtig ist zunächst eine rasche Diagnostik, begleitet von einer symptomatischen Therapie. Beim kardiogenen Schock, der extremsten Form der aHF, gilt das Gleiche. Neben der Therapie mit Katecholaminen gibt es hier auch die Möglichkeit des Einsatzes von Kreislaufunterstützungssystemen, die eine hohe Expertise erfordern und deren Stellenwert wissenschaftlich noch nicht ausreichend gesichert ist. Hier ist die frühe Verlegung an ein Zentrum, das diese Möglichkeiten vorhält, immer zu erwägen.

Abstract

Acute heart failure (aHF) is a life-threatening disease. In contrast to chronic heart failure, therapy for aHF is less well established. Besides a rapid diagnostic work-up a symptomatic therapy has to be given. The same is true for cardiogenic shock, the most extreme form of aHF. Therapy with vasopressors can be supported by the use of mechanical circulatory support systems (MCS). However, their use requires a high personal and hospital expertise and their role is scientifically less well established. In all patients with cardiogenic shock, a transfer to a referral centre that has all MCS possibilities should be considered.

Schlüsselwörter

akute Herzinsuffizienz - kardiogener Schock - mechanische Kreislaufunterstützungssysteme

Key words

acute heart failure - cardiogenic shock - mechanical circulatory support

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