Akute perioperative Rechtsherzinsuffizienz View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-02

AUTHORS

B. Schäfer, C.-A. Greim

ABSTRACT

Das akute Rechtsherzversagen wird als Ursache einer kardiopulmonalen Insuffizienz häufig übersehen. Die verschiedenen Krankheitsbilder, die dem Rechtsherzversagen ätiologisch auf den Ebenen der Nach‑, Vorlast und Kontraktilität zugrunde liegen, können mithilfe einer zielgerichteten Diagnostik abgeklärt werden. Neben klinischen Symptomen und laborchemischen Parametern ist v. a. die Echokardiographie für die Diagnosestellung relevant. Die symptomatische Behandlung des akut vital bedrohten Patienten ist essenziell. Im Vordergrund stehen die Senkung des rechtsventrikulären Drucks und der Nachlast, eine Korrektur der systemischen Hypotension und die positiv-inotrope Unterstützung des Ventrikels. Mechanische Organersatz- bzw. Unterstützungsverfahren kommen zunehmend bei anhaltendem Rechtsherzversagen zum Einsatz und erweitern die Behandlungsmöglichkeiten. Prognostisch entscheidend ist eine auf die auslösende Grunderkrankung abgestimmte kausale Therapie. More... »

PAGES

91-108

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  • Journal

    TITLE

    Der Kardiologe

    ISSUE

    1

    VOLUME

    12

    Author Affiliations

    Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s12181-018-0231-z

    DOI

    http://dx.doi.org/10.1007/s12181-018-0231-z

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1100713753


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    90 schema:description Das akute Rechtsherzversagen wird als Ursache einer kardiopulmonalen Insuffizienz häufig übersehen. Die verschiedenen Krankheitsbilder, die dem Rechtsherzversagen ätiologisch auf den Ebenen der Nach‑, Vorlast und Kontraktilität zugrunde liegen, können mithilfe einer zielgerichteten Diagnostik abgeklärt werden. Neben klinischen Symptomen und laborchemischen Parametern ist v. a. die Echokardiographie für die Diagnosestellung relevant. Die symptomatische Behandlung des akut vital bedrohten Patienten ist essenziell. Im Vordergrund stehen die Senkung des rechtsventrikulären Drucks und der Nachlast, eine Korrektur der systemischen Hypotension und die positiv-inotrope Unterstützung des Ventrikels. Mechanische Organersatz- bzw. Unterstützungsverfahren kommen zunehmend bei anhaltendem Rechtsherzversagen zum Einsatz und erweitern die Behandlungsmöglichkeiten. Prognostisch entscheidend ist eine auf die auslösende Grunderkrankung abgestimmte kausale Therapie.
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