Sep 1, 2005

Acute coronary syndrome in the prehospital phase

Der Anaesthesist
J-H SchiffB W Böttiger


Cardiovascular diseases are the number one cause of death in Germany. In 2002 about 70,000 people died of acute myocardial infarction (AMI) and of these 37% died before arrival at hospital which underlines the relevance of adequate prehospital care. The generic term acute coronary syndrome (ACS) was introduced because a single pathomechanism accounts for the different forms and comprises unstable angina pectoris (iAP), non-ST-elevation myocardial infarction (NSTEMI), ST-elevation myocardial infarction (STEMI) and sudden cardiac death (SCD). Characteristic features are retrosternal pain, vegetative symptoms and radiation of pain into the adjoining regions. Further differentiation can only be achieved by the 12-lead ECG, as cardiac-specific enzymes do not play a role in prehospital decisions. Prehospital delays should be avoided, history and physical examination should be brief but focused, vital parameters should be assessed and monitored. Basic treatment for ACS should comprise inhalative oxygen, nitrates, morphine, aspirin and beta-blockers. If STEMI is diagnosed, patients with symptoms <12 h should undergo fibrinolytic therapy unless there is primary percutaneous coronary intervention (PCI) available within 90 min or if contr...Continue Reading

  • References137
  • Citations2


Mentioned in this Paper

Enzymes, antithrombotic
Emergency Care
Morphine Measurement
Myocardial Infarction
Acute Disease
Cardiovascular Diseases
Cell Differentiation Process
12 Lead ECG
Angina Pectoris

Related Feeds

Antianginal Drugs: Mechanisms of Action

Antianginal drugs, including nitrates, beta-blockers, and calcium channel blockers, are used in the treatment of angina pectoris. Here is the latest research on their use and their mechanism of action.

Related Papers

Acta Medica Croatica : C̆asopis Hravatske Akademije Medicinskih Znanosti
Vjeran Nikolić HeitzlerSime Mihatov
Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors
Daniel P DavisDennis R Leahy
© 2020 Meta ULC. All rights reserved