The Coronary Care Unit Revisited

Three Years' Experience in a Community Hospital

¹ Chairman, Coronary Care Unit Committee, Baptist Hospital, Pensacola, Florida

Reappraisal of a community coronary care unit (CCU) after three years of operation revealed an overall mortality rate of 14.4 percent in 319 patients with myocardial infarction. The incidence of primary cardiac arrest was reduced from 8.6 percent to 2.9 percent and the majority of patients were successfully revived. Cardiogenic shock and heart failure accounted for 60 percent of all deaths. Tachyarrhythmias occurred most frequently in the group that died. Emphasis has been placed on early and aggressive treatment of all arrhythmias as well as early treatment of heart failure. Prevention of sudden death must be the goal not only of the CCU but also of the emergency room and medical floor through the application of extended monitoring and improved nursing care. The community CCU can operate effectively with results comparable to larger medical centers.