Zusammenfassung
Die akute Herzinsuffizienz ist das plötzliche Auftreten von Symptomen einer Herzinsuffizienz bzw. deren Verschlechterung, die einer notfallmäßigen Therapie bedürfen. Zu den Symptomen gehören Ruhe- oder Belastungsdyspnoe, Volumenüberladung (pulmonalvenöse Stauung, periphere Ödeme), körperliche Erschöpfung, funktionelle oder strukturelle Störung des Herzens in Ruhe. Klinische Zeichen der Herzinsuffizienz sind Rasselgeräusche beim Lungenödem, das Auftreten eines 3. oder 4. Herztones, gefolgt von Jugularvenenstauung, Leberstauung, positivem hepatojugulären Reflux und peripheren Ödemen. Ein 12-Kanal-EKG gehört zur Basisdiagnostik, daneben sind klinische Untersuchung (Rasselgeräusche oder S3-Galopp), Echokardiographie, Röntgen-Thorax und Labor von Bedeutung. Je nach Symptomatik und Therapie benötigen die Patienten eine nicht invasive, invasive und/oder hämodynamische Überwachung. Die Behandlung beruht im Wesentlichen auf der ursachen- (koronare Reperfusion beim akuten Myokardinfarkt) und symptomorientierten Therapie. Die symptomorientierte Therapie besteht aus Sauerstoffgabe, Analgosedierung und hämodynamischer Stabilisierung (Diuretika, Vasodilatatoren, positiv inotrope Substanzen, Vasopressoren, mechanische Kreislaufunterstützungssysteme).
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Link, A., Böhm, M. (2014). Akute Herzinsuffizienz. In: Lehnert, H., et al. SpringerReference Innere Medizin. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54676-1_176-1
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DOI: https://doi.org/10.1007/978-3-642-54676-1_176-1
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