Skip to main content
NCBI home page
Canadian Family Physician logoLink to Canadian Family Physician
. 1984 Nov;30:2345–2352.

Hearts Too Good to Die: An Evaluation of Coronary Care

Anthony S Dixon
PMCID: PMC2154116  PMID: 21279061

Abstract

Intensive coronary care has become the standard treatment for acute myocardial infarction, and no self-respecting hospital would be without its coronary care unit. However, literature review to evaluate the contribution of coronary care shows that its promise may have been overstated and its benefits overestimated.

Full text

PDF
2345

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Astvad K., Fabricius-Bjerre N., Kjaerulff J., Lindholm J. Mortality from acute myocardial infarction before and after establishment of a coronary care unit. Br Med J. 1974 Mar 23;1(5907):567–569. doi: 10.1136/bmj.1.5907.567. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. BROWN K. W., MACMILLAN R. L., FORBATH N., MELGRANO F., SCOTT J. W. CORONARY UNIT: AN INTENSIVE-CARE CENTRE FOR ACUTE MYOCARDIAL INFARCTION. Lancet. 1963 Aug 17;2(7303):349–352. doi: 10.1016/s0140-6736(63)93011-3. [DOI] [PubMed] [Google Scholar]
  3. Bernard R. Acute myocardial infarction: coronary care unit, hospital ward or home management? Acta Cardiol. 1979;34(4):269–278. [PubMed] [Google Scholar]
  4. Bishop L. F., Reichert P. The psychological impact of the coronary care unit. Psychosomatics. 1969 May-Jun;10(3):189–192. doi: 10.1016/S0033-3182(69)71754-6. [DOI] [PubMed] [Google Scholar]
  5. Bruhn J. G., Thurman A. E., Jr, Chandler B. C., Bruce T. A. Patients' reactions to death in a coronary care unit. J Psychosom Res. 1970 Mar;14(1):65–70. doi: 10.1016/0022-3999(70)90071-1. [DOI] [PubMed] [Google Scholar]
  6. Campbell T. W. Death anxiety on a coronary care unit. Psychosomatics. 1980 Feb;21(2):127, 131, 135-6. doi: 10.1016/S0033-3182(80)73710-6. [DOI] [PubMed] [Google Scholar]
  7. Campion E. W., Mulley A. G., Goldstein R. L., Barnett G. O., Thibault G. E. Medical intensive care for the elderly. A study of current use, costs, and outcomes. JAMA. 1981 Nov 6;246(18):2052–2056. [PubMed] [Google Scholar]
  8. Christiansen I., Iversen K., Skouby A. P. Benefits obtained by the introduction of a coronary-care unit. A comparative study. Acta Med Scand. 1971 Apr;189(4):285–291. doi: 10.1111/j.0954-6820.1971.tb04377.x. [DOI] [PubMed] [Google Scholar]
  9. Corday E. The coronary care area: a tiger by the tail. Am J Cardiol. 1965 Sep;16(3):466–468. doi: 10.1016/0002-9149(65)90743-5. [DOI] [PubMed] [Google Scholar]
  10. DAY H. W. AN INTENSIVE CORONARY CARE AREA. Dis Chest. 1963 Oct;44:423–426. doi: 10.1378/chest.44.4.423. [DOI] [PubMed] [Google Scholar]
  11. Day H. W. Acute coronary care--a five year report. Am J Cardiol. 1968 Feb;21(2):252–257. doi: 10.1016/0002-9149(68)90326-3. [DOI] [PubMed] [Google Scholar]
  12. Fuchs R., Scheidt S. Improved criteria for admission to cardiac care units. JAMA. 1981 Nov 6;246(18):2037–2041. [PubMed] [Google Scholar]
  13. Gordis L., Naggan L., Tonascia J. Pitfalls in evaluating the impact of coronary care units on mortality from myocardial infarctions. Johns Hopkins Med J. 1977 Dec;141(6):287–295. [PubMed] [Google Scholar]
  14. Gould K. L. Coronary reperfusion: medical, surgical, or not at all? JAMA. 1982 Sep 17;248(11):1362–1363. [PubMed] [Google Scholar]
  15. Grace W. J. Mortality rate from acute myocardial infarction--what are we talking about? Am J Cardiol. 1967 Sep;20(3):301–303. doi: 10.1016/0002-9149(67)90049-5. [DOI] [PubMed] [Google Scholar]
  16. Griner P. F. Medical intensive care in the teaching hospital: costs versus benefits. The need for assessment. Ann Intern Med. 1973 Apr;78(4):581–585. doi: 10.7326/0003-4819-78-4-581. [DOI] [PubMed] [Google Scholar]
  17. Hackett T. P., Cassem N. H., Wishnie H. A. The coronary-care unit. An appraisal of its psychologic hazards. N Engl J Med. 1968 Dec 19;279(25):1365–1370. doi: 10.1056/NEJM196812192792504. [DOI] [PubMed] [Google Scholar]
  18. Hampton J. R. The end of clinical freedom. Br Med J (Clin Res Ed) 1983 Oct 29;287(6401):1237–1238. doi: 10.1136/bmj.287.6401.1237. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Hay D., Oken D. The psychological stresses of intensive care unit nursing. Psychosom Med. 1972 Mar-Apr;34(2):109–118. doi: 10.1097/00006842-197203000-00004. [DOI] [PubMed] [Google Scholar]
  20. Hill J. D., Hampton J. R., Mitchell J. R. A randomised trial of home-versus-hospital management for patients with suspected myocardial infarction. Lancet. 1978 Apr 22;1(8069):837–841. doi: 10.1016/s0140-6736(78)90190-3. [DOI] [PubMed] [Google Scholar]
  21. Hill J. D., Hampton J. R., Mitchell J. R. Home or hospital for myocardial infarction--who cares? Am Heart J. 1979 Nov;98(5):545–547. doi: 10.1016/0002-8703(79)90277-1. [DOI] [PubMed] [Google Scholar]
  22. Hofvendahl S. Influence of treatment in a coronary care unit on prognosis in acute myocardial infarction. A controlled study in 271 cases. Acta Med Scand Suppl. 1971;519:9–78. [PubMed] [Google Scholar]
  23. JARVINEN K. A. Can ward rounds be a danger to patients with myocardial infarction? Br Med J. 1955 Feb 5;1(4909):318–320. doi: 10.1136/bmj.1.4909.318. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. KOUWENHOVEN W. B., JUDE J. R., KNICKERBOCKER G. G. Closed-chest cardiac massage. JAMA. 1960 Jul 9;173:1064–1067. doi: 10.1001/jama.1960.03020280004002. [DOI] [PubMed] [Google Scholar]
  25. Klaus A. P., Sarachek N. S., Greenberg D., Pekover J., Cooper J. K. Evaluating coronary care units. Am Heart J. 1970 Apr;79(4):471–480. doi: 10.1016/0002-8703(70)90252-8. [DOI] [PubMed] [Google Scholar]
  26. LOWN B., AMARASINGHAM R., NEUMAN J. New method for terminating cardiac arrhythmias. Use of synchronized capacitor discharge. JAMA. 1962 Nov 3;182:548–555. [PubMed] [Google Scholar]
  27. Loop F. D., Proudfit W. L., Sheldon W. C. Coronary bypass surgery weighed in the balance. Am J Cardiol. 1978 Jul;42(1):154–156. doi: 10.1016/0002-9149(78)91001-9. [DOI] [PubMed] [Google Scholar]
  28. Lown B., Fakhro A. M., Hood W. B., Jr, Thorn G. W. The coronary care unit. New perspectives and directions. JAMA. 1967 Jan 16;199(3):188–198. [PubMed] [Google Scholar]
  29. Lown B., Selzer A. The coronary care unit. Am J Cardiol. 1968 Oct;22(4):597–602. doi: 10.1016/0002-9149(68)90167-7. [DOI] [PubMed] [Google Scholar]
  30. Lown B., Vasaux C., Hood W. B., Jr, Fakhro A. M., Kaplinsky E., Roberge G. Unresolved problems in coronary care. Am J Cardiol. 1967 Oct;20(4):494–508. doi: 10.1016/0002-9149(67)90027-6. [DOI] [PubMed] [Google Scholar]
  31. Lynch J. J., Thomas S. A., Paskewitz D. A., Katcher A. H., Weir L. O. Human contact and cardiac arrhythmia in a coronary care unit. Psychosom Med. 1977 May-Jun;39(3):188–192. doi: 10.1097/00006842-197705000-00004. [DOI] [PubMed] [Google Scholar]
  32. Marshall R. M., Blount S. G., Jr, Genton E. Acute myocardial infarction. Influence of a coronary care unit. Arch Intern Med. 1968 Dec;122(6):472–475. doi: 10.1001/archinte.122.6.472. [DOI] [PubMed] [Google Scholar]
  33. Martin S. P., Donaldson M. C., London C. D., Peterson O. L., Colton T. Inputs into coronary care during 30 years. A cost effectiveness study. Ann Intern Med. 1974 Sep;81(3):289–293. doi: 10.7326/0003-4819-81-3-289. [DOI] [PubMed] [Google Scholar]
  34. Mather H. G., Morgan D. C., Pearson N. G., Read K. L., Shaw D. B., Steed G. R., Thorne M. G., Lawrence C. J., Riley I. S. Myocardial infarction: a comparison between home and hospital care for patients. Br Med J. 1976 Apr 17;1(6015):925–929. doi: 10.1136/bmj.1.6015.925. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Mather H. G., Pearson N. G., Read K. L., Shaw D. B., Steed G. R., Thorne M. G., Jones S., Guerrier C. J., Eraut C. D., McHugh P. M. Acute myocardial infarction: home and hospital treatment. Br Med J. 1971 Aug 7;3(5770):334–338. doi: 10.1136/bmj.3.5770.334. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. McIntosh H. D., Buccino R. A. Emergency coronary artery revascularization of patients with acute myocardial infarction: you can ... but should you? Circulation. 1979 Aug;60(2):247–250. doi: 10.1161/01.cir.60.2.247. [DOI] [PubMed] [Google Scholar]
  37. Mitchell J. R. "But will it help my patients with myocardial infarction?" The implications of recent trials for everyday country folk. Br Med J (Clin Res Ed) 1982 Oct 23;285(6349):1140–1148. doi: 10.1136/bmj.285.6349.1140. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Mulley A. G., Thibault G. E., Hughes R. A., Barnett G. O., Reder V. A., Sherman E. L. The course of patients with suspected myocardial infarction. The identification of low-risk patients for early transfer from intensive care. N Engl J Med. 1980 Apr 24;302(17):943–948. doi: 10.1056/NEJM198004243021704. [DOI] [PubMed] [Google Scholar]
  39. Norris R. M., Brandt P. W., Lee A. J. Mortality in a coronary-care unit analysed by a new coronary prognostic index. Lancet. 1969 Feb 8;1(7589):278–281. doi: 10.1016/s0140-6736(69)91036-8. [DOI] [PubMed] [Google Scholar]
  40. Oliver M. F., Julian D. G., Donald K. W. Problems in evaluating coronary care units. Their responsibilities and their relation to the community. Am J Cardiol. 1967 Oct;20(4):465–474. doi: 10.1016/0002-9149(67)90024-0. [DOI] [PubMed] [Google Scholar]
  41. Petch M. C. Active management of myocardial infarction. Br Med J (Clin Res Ed) 1983 Jun 11;286(6381):1841–1842. doi: 10.1136/bmj.286.6381.1841. [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Phillips S. J., Kongtahworn C., Zeff R. H., Benson M., Iannone L., Brown T., Gordon D. F. Emergency coronary artery revascularization: a possible therapy for acute myocardial infarction. Circulation. 1979 Aug;60(2):241–246. doi: 10.1161/01.cir.60.2.241. [DOI] [PubMed] [Google Scholar]
  43. Phillips S. J., Zeff R. H., Kongtahworn C., Skinner J. R., Iannone L., Brown T. M., Wickemeyer W., Gordon D. F. Surgery for evolving myocardial infarction. JAMA. 1982 Sep 17;248(11):1325–1328. [PubMed] [Google Scholar]
  44. Pozen M. W., D'Agostino R. B., Mitchell J. B., Rosenfeld D. M., Guglielmino J. T., Schwartz M. L., Teebagy N., Valentine J. M., Hood W. B., Jr The usefulness of a predictive instrument to reduce inappropriate admissions to the coronary care unit. Ann Intern Med. 1980 Feb;92(2 Pt 1):238–242. doi: 10.7326/0003-4819-92-2-238. [DOI] [PubMed] [Google Scholar]
  45. ROBINSON J. S., SLOMAN G., MATHEW T. H., GOBLE A. J. SURVIVAL AFTER RESUSCITATION FROM CARDIAC ARREST IN ACUTE MYOCARDIAL INFARCTION. Am Heart J. 1965 Jun;69:740–747. doi: 10.1016/0002-8703(65)90448-5. [DOI] [PubMed] [Google Scholar]
  46. Rawles J. M., Kenmure A. C. The coronary care controversy. Br Med J. 1980 Sep 20;281(6243):783–786. doi: 10.1136/bmj.281.6243.783. [DOI] [PMC free article] [PubMed] [Google Scholar]
  47. Restieaux N., Bray C., Bullard H., Murray M., Robinson J., Brigden W., McDonald L. 150 Patients with cardiac infarction treated in a coronary unit. Lancet. 1967 Jun 17;1(7503):1285–1289. doi: 10.1016/s0140-6736(67)91589-9. [DOI] [PubMed] [Google Scholar]
  48. Rose G. The contribution of intensive coronary care. Br J Prev Soc Med. 1975 Sep;29(3):147–150. doi: 10.1136/jech.29.3.147. [DOI] [PMC free article] [PubMed] [Google Scholar]
  49. SCHNUR S. Mortality rates in acute myocardial infarction. I. The normal yearly variation, and the effect of hospital admission policy. Ann Intern Med. 1953 Nov;39(5):1014–1017. doi: 10.7326/0003-4819-39-5-1014. [DOI] [PubMed] [Google Scholar]
  50. Sloman G., Stannard M., Goble A. J. Coronary care unit: a review of 300 patients monitored since 1963. Am Heart J. 1968 Jan;75(1):140–143. doi: 10.1016/0002-8703(68)90126-9. [DOI] [PubMed] [Google Scholar]
  51. Steel K., Gertman P. M., Crescenzi C., Anderson J. Iatrogenic illness on a general medical service at a university hospital. N Engl J Med. 1981 Mar 12;304(11):638–642. doi: 10.1056/NEJM198103123041104. [DOI] [PubMed] [Google Scholar]
  52. Stross J. K., Willis P. W., 3rd, Reynolds E. W., Jr, Lewis R. E., Schatz I. J., Bellfy L. C., Copp J. Effectiveness of coronary care units in small community hospitals. Ann Intern Med. 1976 Dec;85(6):709–713. doi: 10.7326/0003-4819-85-6-709. [DOI] [PubMed] [Google Scholar]
  53. Vanson R. J., Katz B. M., Krekeler K. Stress effects on patients in critical care units from procedures performed on others. Heart Lung. 1980 May-Jun;9(3):494–497. [PubMed] [Google Scholar]
  54. Wenger N. K., Hellerstein H. K., Blackburn H., Castranova S. J. Physician practice in the management of patients with uncomplicated myocardial infarction: changes in the past decade. Circulation. 1982 Mar;65(3):421–427. doi: 10.1161/01.cir.65.3.421. [DOI] [PubMed] [Google Scholar]
  55. Wheeler D. J. Unresolved questions concerning coronary care units. Clin Invest Med. 1981;4(1):13–22. [PubMed] [Google Scholar]
  56. ZOLL P. M., LINENTHAL A. J., GIBSON W., PAUL M. H., NORMAN L. R. Termination of ventricular fibrillation in man by externally applied electric countershock. N Engl J Med. 1956 Apr 19;254(16):727–732. doi: 10.1056/NEJM195604192541601. [DOI] [PubMed] [Google Scholar]

Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada

RESOURCES