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Plötzlicher Herztod

  • D. Kalusche

Zusammenfassung

Ca. jeder fünfte Todesfall in den westlichen Industriestaaten ist unter die Rubrik „plötzlicher Herztod“ einzuordnen. Betrachtet man die erwachsene Bevölkerung insgesamt, so besteht eine Inzidenz von ca. 0,1 bis 0,2% pro Jahr, Unverändert ist die koronare Herzerkrankung die wichtigste und quantitativ bei weitem führende Erkrankung, die mit Auftreten des plötzlichen Herztodes verknüpft ist. Beim Großteil der Betroffenen ist der akute Herz-Kreislauf-Stillstand die Erstmanifestation der Erkrankung. Die Prophylaxe des plötzlichen Herztodes ist immer auch eine Prävention der koronaren Herzerkrankung. Seit 1980 ist insbesondere in den Vereinigten Staaten eine Trendwende bei der Prävalenz der koronaren Herzerkrankung zu verzeichnen. Dies macht verständlich, daß z. B. in Seattle (USA-Staat Washington) im gleichen Zeitraum ein kontinuierlicher Rückgang an Kammerflimmern außerhalb des Krankenhauses zu verzeichnen ist. Das folgende Kapitel soll zum einen Krankheitsbilder neben der Koronararteriosklerose beschreiben, die in einem höheren Ausmaß mit dem Auftreten plötzlicher Todesfälle verknüpft sind und insbesondere bei jüngeren Betroffenen in die Differentialdiagnose miteinbezogen werden müssen. Ferner soll das therapeutische Vorgehen nach erfolgreicher Reanimation bei „Überlebenden des plötzlichen Herztodes“ zusammenhängend dargestellt werden.

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