Mortality Reduction in a Coronary Care Unit

Abstract

The methods and results of observation and treatment of the first 150 patients with acute myocardial infarction admitted to a special coronary care unit are presented. Seven patients resuscitated from cardiac arrest survived their period in hospital and were still alive four months to two years after the first episode of arrest. Four other patients were successfully resuscitated but died later in hospital ; three of these patients had complete asystole. The seven survivors and one who died later in hopital had ventricular fibrillation. Ventricular fibrillation tended to be the cause of cardiac arrest in milder cases. Asystole occurred in the more severely ill patients with cardiac failure and “ cardiogenic shock.” It is suggested that mortality reduction is also achieved, or death delayed, in a coronary care unit through earlier detection and control of cardiac failure, hypotension, and arrhythmias. Potentially serious arrhythmias were detected in 60 of the 150 patients. It is suggested that in selected patients with cardiac failure and serious arrhythmias continued special care is required for two to three weeks from the onset of infarction to reduce later deaths. A coronary care unit is an important factor in reducing mortality from myocardial infarction. Such units should be established in all large hospitals dealing with acute cases. © 1966, British Medical Journal Publishing Group. All rights reserved.