Coronary care unit
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A '''coronary care unit''' (CCU) is a hospital ward specialized in the care of [[patient]]s with [[myocardial infarction|heart attack]]s, [[unstable angina]] and (in practice) various other cardiac conditions that require continuous monitoring and treatment.
==Characteristics==
The main feature of coronary care is the availability of [[telemetry]] or the continuous monitoring of the cardiac rhythm by [[Electrocardiogram|electrocardiography]]. This allows early intervention with [[medication]], [[cardioversion]] or [[defibrillation]], improving the prognosis. As [[cardiac arrhythmia|arrhythmias]] are relatively common in this group, patients with myocardial infarction or unstable angina are routinely admitted to the coronary care unit. For other indications, such as [[atrial fibrillation]], a specific indication is generally necessary, while for others, such as [[heart block]], coronary care unit admission is standard.
==Local differences==
In the United States, coronary care units are usually subsets of [[intensive care unit]]s (ICU) dedicated to the care of critically ill cardiac patients. These units are usually present in hospitals that routine engage in cardiothoracic surgery. Invasive monitoring such as with [[pulmonary artery catheter]]s is common, as are supportive modalities such as [[mechanical ventilation]] and [[intra-aortic balloon pump]]s (IABP).
Certain hospitals, such as Johns Hopkins [http://www.hopkinsmedicine.org/cardiology/ccu.htm], maintain mixed units consisting of both Acute care units for the critically ill, and intermediate care units for patients who are not critical.
===Acute coronary care===
Acute coronary care units (ACCU), also called "critical coronary care units" (CCCU) is equivalent to intensive care in the level of service provided. Patients with acute myocardial infarction, [[cardiogenic shock]], or post-operative "open-heart" patients commonly abide here.
===Subacute coronary care===
Subacute coronary care units (SCCU), also called Progressive care units (PCU), Intermediate coronary care units (ICCU), or stepdown units, and provide a level of care intermediate to that of the intensive care unit and that of the general medical floor. These units typically serve patients who require cardiac telemetry such as those with [[unstable angina]].
==History==
Coronary care units developed in the 1960s when it became clear that close monitoring by specially trained staff, [[cardiopulmonary resuscitation]] and medical measures could reduce the mortality from complications of cardiovascular disease. The first description of a CCU was given in 1961 to the [[British Thoracic Society]], and early CCUs were located in [[Sydney]], [[Kansas]] and [[Philadelphia]]. Studies published in 1967 revealed that those observed in a coronary care setting had consistently better outcomes.<ref>{{cite journal |author=Mehta NJ, Khan IA |title=Cardiology's 10 greatest discoveries of the 20th century |journal=Tex Heart Inst J |volume=29 |issue=3 |pages=164–71 |year=2002 |pmid=12224718 |pmc=124754}}</ref> The first coronary care unit was opened in [[Kansas]] by Dr Hugh Day, and he coined the term.<ref>{{cite journal |author=Day HW |title=A cardiac resuscitation program |journal=J Lancet |volume=82 |issue= |pages=153–6 |year=1962 |month=April |pmid=13884060}}</ref><ref>{{cite journal |author=Julian DG |title=The evolution of the coronary care unit |journal=Cardiovasc. Res. |volume=51 |issue=4 |pages=621–4 |year=2001 |month=September |pmid=11530092 |doi= |url=http://cardiovascres.oxfordjournals.org/cgi/content/full/51/4/621}}</ref>
==References==
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[[Category:Cardiology]]
[[Category:Hospital departments]]