Document Detail

50th anniversary historical article. Myocardial infarction and coronary care units.
MedLine Citation:
PMID:  10588193     Owner:  NLM     Status:  MEDLINE    
The results of treatment of 250 patients with established acute myocardial infarction in a coronary care unit in a university hospital are described. The criteria for diagnosis have been carefully defined. In 62 percent of patients admitted with a tentative diagnosis of acute infarction, the initial impression was confirmed. Fifteen percent of patients admitted to the unit were classified as having possible infarction; in this group, the mortality rate was 3 percent. A classification of functional severity based on clinical evidence of heart failure or shock is presented. Morbidity and mortality in acute myocardial infarction are related to the functional severity of the illness. Although arrhythmia is common, the overriding importance of five life-threatening arrhythmias is emphasized. Mortality of patients in the coronary care unit was not improved in comparison to those treated under regular care until strong central direction of therapeutic programs, immediate treatment of arrhythmia in cardiac arrest, and delegation of some medical authority to trained nurses was accomplished. The change in concept of the purposes and practices of special coronary care from resuscitation to prevention of arrhythmia is emphasized. The mortality in myocardial infarction complicated by shock remains high. In the absence of shock, aggressive medical treatment in the coronary care unit reduced mortality from 26 to 7 percent. The implications of these data in the management of patients admitted to a hospital with a diagnosis of acute myocardial infarction are discussed.
V Fuster
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Publication Detail:
Type:  Historical Article; Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  34     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1999 Dec 
Date Detail:
Created Date:  1999-12-17     Completed Date:  1999-12-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1851-3     Citation Subset:  AIM; IM; Q    
Cardiovascular Institute, Mount Sinai Medical Center, New York City, New York 10029-6574, USA.
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MeSH Terms
Anniversaries and Special Events
Cardiology / history
Coronary Care Units / history*
History, 20th Century
Myocardial Infarction / history*
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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