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Elektrokardiographische Muster eines drohenden, unabhängig von instabiler pektanginöser Symptomatik auftretenden Koronarverschlusses

  • Conference paper
Prädisponierende Bedingungen für akute Ischämiesyndrome

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Zusammenfassung

Die konservative Revaskularisation durch Thrombolytika oder Ballondilatation (PTCA) führt, als Teil des therapeutischen Effektes, zu einem instabilen Koronarsitus. Thrombolytika lösen zwar den Thrombozyten-Fibrin-Pfropf auf, beeinflussen aber den darunterliegenden rupturierten Plaque nicht, der zunächst die thrombosierende Kettenreaktion ausgelöst hat. Das Aufblähen des PTCA-Ballons bricht und zerreißt die durch den Plaque belegte Koronarintima und die Entblößung von frischem Kollagen ruft einen Entzündungsherd hervor. Um den Erfolg oder Mißerfolg der intrakoronar erfolgten Intervention durch Thrombolytika oder PTCA festzustellen, wird üblicherweise eine angiographische Untersuchung vorgenommen. Dieser primär anatomische Parameter ist jedoch nicht immer zuverlässig, und bei 2–30% der „erfolgreich“ dilatierten oder reperfundierten Patienten kann sich klinisch stumm oder auch symptomatisch die Interventionsstelle wieder verschließen, während die Patienten sich auf der Intensivstation erholen [1–11]. Auf diese Weise kann der Übergang des Koronarherdes von einem relativ stabilen in einen instabilen Zustand untersucht werden. Zusätzlich können patienten-und koronarsitusspezifische Daten für jeden einzelnen Patienten während des Ereignisses gesammelt werden, entweder während des Herzinfarktes bei der Einlieferung oder während des transitorischen Koronarverschlusses bei der PTCA. Dieses Referenzereignis kann eine weitere Einsicht in die Muster geben, die bei rezidivierender Instabilität vorliegen.

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Authors and Affiliations

  1. Duke University Medical Center, Durham, North Carolina, USA

    Mitchell W. Krucoff M.D. & Y. R. Jackson

  2. Georgetown University Hospital, Washington, D.C., USA

    K. S. Stark & K. M. Kent

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  1. Mitchell W. Krucoff M.D.
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  2. Y. R. Jackson
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  3. K. S. Stark
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  4. K. M. Kent
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Editor information

Editors and Affiliations

  1. I. Med. Klinik, Krankenanstalten Rotes Kreuz, Nymphenburger Str. 163, 8000, München 19, Deutschland

    Th. v. Arnim (Chefarzt) (Chefarzt)

  2. Cardiovascular Unit Royal Postgraduate Medical School, Hammersmith Hospital, Ducane Road, W12 OHS, London, UK

    A. Maseri

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© 1989 Springer-Verlag Berlin Heidelberg

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Krucoff, M.W., Jackson, Y.R., Stark, K.S., Kent, K.M. (1989). Elektrokardiographische Muster eines drohenden, unabhängig von instabiler pektanginöser Symptomatik auftretenden Koronarverschlusses. In: v. Arnim, T., Maseri, A. (eds) Prädisponierende Bedingungen für akute Ischämiesyndrome. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-662-12731-5_11

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  • DOI: https://doi.org/10.1007/978-3-662-12731-5_11

  • Publisher Name: Steinkopff, Heidelberg

  • Print ISBN: 978-3-7985-0819-4

  • Online ISBN: 978-3-662-12731-5

  • eBook Packages: Springer Book Archive

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