[Treatment of acute coronary heart disease in medical practice].
Despite the recent advances in cardiac intensive care, which have reduced hospital mortality for acute myocardial infarction to below 15%, a substantial decline in overall mortality from myocardial infarction has not been achieved by these therapeutic measures. More effective management of patients with advanced coronary heart disease would include better detection of high risk subgroups, especially of patients with unstable angina, better treatment with rapid adjustment of doses and combination of anti-anginal drugs, and better organisation of medical care in order to reduce hospitalisation delay in patients with impending or suspected myocardial infarction and avoid unnecessary hospital admissions in those with effort angina responsive to medical treatment. We propose a treatment scheme for unstable angina which, for out-patients with recent onset or crescendo angina on effort, is based on betablockers combined with calcium channel blockers and long-acting nitrates as second and third step respectively. In every case an anti-platelet aggregating agent should be added. If medical treatment fails to abolish the ischemic symptoms within days, surgical treatment should be considered.
D000208:Acute Disease; D000553:Ambulatory Care; D000789:Angina, Unstable / Q000628:therapy; D003131:Combined Modality Therapy; D003327:Coronary Disease / Q000628:therapy*; D006801:Humans; D009203:Myocardial Infarction / Q000628:therapy
Die Behandlung der akuten koronaren Herzkrankheit in der ärztlichen Praxis.