Acute Myocardial Infarction: The Course of the Illness following Discharge from the Coronary Care Unit

A Description of the Intermediate Coronary Care Unit

¹ Director, Department of Medicine, St. Vincent's Hospital and Medical Center of New York; Professor of Clinical Medicine, NYU-Bellevue Medical Center
² Assistant Attending Physician, Department of Medicine, St. Vincent's Hospital and Medical Center of New York

One hundred seventeen consecutive patients with acute transmural myocardial infarction were observed with intermittent ECG rhythm strip monitoring for 12 days after discharge from the coronary care unit (CCU). The patients were in a special room equipped for electrocardiography and for resuscitation if necessary. Here, a rhythm strip was recorded every four hours on all patients. This ECG strip was promptly examined by a physician. This system is referred to as the intermediate coronary care unit (ICCU). Fourteen patients had to be returned to the CCU, nine for arrhythmia and six for recurrent chest pain. There were three deaths in the ICCU; one each from A/V block and ventricular fibrillation, and one from congestive heart failure. One patient died from CHF after return to the CCU. Over this same length of time eight deaths had been anticipated.