Effectiveness and limitation of the current coronary care unit in treatment of patients with complications following acute myocardial infarction.
For an appraisal of effectiveness and limitation of the current coronary care unit (CCU) in treatment of patients with complications following acute myocardial infarction (MI), consecutive 557 patients hospitalized to our CCU during five years were studied. In order to assess the severity of complicating pump failure, patients were divided into four classes according to Killip's classification. Number of patients, total mortality (%) and mortality due to pump failure (%) were as follows; 333 (6%, 2%) in class I, 118 (17%, 8%) in class II, 42 (19%, 17%) in class III and 55 (84%, 80%) in class IV. Warning arrhythmias, cardiac rupture and interventricular septal perforation complicated in 184 patients, 11 and 10, respectively, and mortality due to these complications was 2%, 91% and 84% in the order. Right ventricular infarction complicated in 54 patients, but only one patient died from right heart failure. Post-MI angina manifested in 156 patients and six of them died postoperatively. Our data indicate that improvement in mortality due to pulmonary edema and arrhythmias and reduction in incidence of cardiac rupture are evident effectiveness of the CCU, and that there is no improvement in survival rate of patients with cardiogenic shock even under the use of newly introduced vasodilator and catecholamine therapy or intraaortic balloon pumping.
D000787:Angina Pectoris / Q000209:etiology; D001145:Arrhythmias, Cardiac / Q000209:etiology; D002395:Catecholamines / Q000627:therapeutic use; D003325:Coronary Care Units; D006333:Heart Failure / Q000209:etiology* / Q000401:mortality; D006341:Heart Rupture / Q000209:etiology* / Q000401:mortality; D006439:Hemodynamics; D006760:Hospitalization; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality / Q000503:physiopathology
D002395:Catecholamines