循環器ジャーナル65巻1号

2017年01月発行

特集 Clinical Scenarioによる急性心不全治療 Ⅵ．Clinical Scenario 4：急性冠症候群（ACS）に伴う急性心不全

血行動態が破綻した心不全を伴うACSの治療戦略

著者： 秋山英一¹ 木村一雄¹

所属機関： ¹横浜市立大学附属市民総合医療センター心臓血管センター

ページ範囲：P.116 - P.124

Point
・「急性冠症候群（ACS）による急性心不全（CS4）」は「冠動脈疾患を合併した急性心不全」と異なり，早期の冠動脈造影検査，血行再建術を念頭に早急に治療を開始する必要がある．
・ST上昇型急性心筋梗塞（STEMI）はプラーク破綻により生じた血栓が冠動脈を完全閉塞することにより心筋壊死が急速に進むため，梗塞サイズ縮小を目指したprimary PCIや血栓溶解薬による再灌流療法の適応となる．
・非ST上昇型ACS（NSTEACS）の治療方針，冠動脈造影検査の施行時期はリスクの層別化に基づき決定する．

参考文献

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