The history of the coronary care unit.
The first coronary care units were established in the early 1960s in an attempt to reduce mortality from acute myocardial infarction. Pioneering cardiologists recognized the threat of death due to malignant arrhythmias in the postinfarction setting, and developed techniques for successful external defibrillation. The ability to abort sudden death led to continuous monitoring of the cardiac rhythm and an organized system of cardiopulmonary resuscitation, incorporating external defibrillation with cardiac drugs and specialized equipment. Arrhythmia monitoring and cardiopulmonary resuscitation could be performed by trained nursing staff, which eliminated delays in treatment and significantly reduced mortality. These early triumphs in aborting sudden death led to the development of techniques to treat cardiogenic shock, limit infarct size and initiate prehospital coronary care, all of which laid the foundation for the current era of interventional cardiology.
Khush
Kiran K
KK
Division of Cardiology, San Francisco General Hospital, Department of Medicine, University of California, San Francisco 94110, USA.
Rapaport
Elliot
E
Waters
David
D
D001145:Arrhythmias, Cardiac / Q000266:history / Q000628:therapy; D002309:Cardiology / Q000191:economics / Q000266:history; D003325:Coronary Care Units / Q000191:economics / Q000266:history* / Q000458:organization & administration; D005060:Europe; D049673:History, 20th Century; D006801:Humans; D009656:North America