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Das akute Aortensyndrom

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Weiterbildung Intensivmedizin und Notfallmedizin

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Zusammenfassung

Das akute Aortensyndrom (AAS) stellt eine lebensbedrohende Erkrankung dar. Entscheidend ist eine schnelle und genaue Diagnosestellung. Die Patienten sollten unverzüglich schon bei Verdacht auf ein AAS in ein Kompetenzzentrum verlegt werden. Plötzlich einsetzende reißende Brustschmerzen, ein verbreitertes Mediastinum in der Thoraxröntgenaufnahme und Puls-/Blutdruckunterschiede weisen auf eine Aortendissektion hin. Zur Diagnostik ist die Computertomographie Mittel der Wahl, alternativ kann bei hämodynamisch instabilen Patienten der Echokardiographie der Vorzug gegeben werden. Innerhalb der ersten Tage geht das AAS mit einer sehr hohen Mortalität einher. Bei allen Patienten mit AAS sollte daher dringend ein chirurgisches Konsil veranlasst werden. Die anfängliche medikamentöse Therapie zielt auf Schmerzlinderung und Senkung der Aortenwandbelastung ab. Bei einer Aortendissektion unter Beteiligung der Aorta ascendens sollte direkt operiert werden. Ist die Aortendissektion auf die Aorta descendens oder thoracoabdominalis begrenzt, sollte initial medikamentös therapiert werden. Treten jedoch Komplikationen auf, wird eine endovaskuläre Behandlung empfohlen. Ein symptomatisches intramurales Hämatom, ein penetrierendes athe- rosklerotisches Ulkus oder eine drohende Aortenruptur gehen mit einem erheblichen Risiko einher. Daher gilt hier die Empfehlung einer chirurgischen oder endovaskulären Therapie.

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Author information

Authors and Affiliations

  1. Department Operative Medizin, Universitätsklinik für Herzchirurgie, Herzchirurgie

    S. Semsroth, J. Dumfarth, -T. Schachner & M. Grimm

  2. Universitätsklinik für Notfallmedizin, Medizinische Universität Wien, Wien

    H. Domanovlts

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  1. S. Semsroth
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  2. J. Dumfarth
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  3. -T. Schachner
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  4. M. Grimm
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  5. H. Domanovlts
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Editor information

Editors and Affiliations

  1. Klinik für Innere Medizin, St. Antonius-Hospital, Dechant-Deckers-Str. 8, 52249, Eschweiler

    U. Janssens

  2. Univ.-Klinik für Innere Medizin I, Universitätsklinikum Innsbruck, Aichstr. 35, A-6020, Innsbruck

    M. Joannidis

  3. Med. Klinik und Poliklinik II, Universitätsklinikum Gießen, Klinikstr. 36, 35392, Gießen

    K. Mayer

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Semsroth, S., Dumfarth, J., Schachner, T., Grimm, M., Domanovlts, H. (2015). Das akute Aortensyndrom. In: Janssens, U., Joannidis, M., Mayer, K. (eds) Weiterbildung Intensivmedizin und Notfallmedizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46521-9_7

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  • DOI: https://doi.org/10.1007/978-3-662-46521-9_7

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-46520-2

  • Online ISBN: 978-3-662-46521-9

  • eBook Packages: Medicine (German Language)

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