[Coronary care units-early discharge and telemetry]

Abstract

Data of 170 consecutive patients admitted to a coronary care unit (CCU) with acute myocardial infarction (AMI) are reviewed and nature, incidence and time of occurrence of complications are studied. 94 of 170 patients had complications during the day of admission, while 7 of the remaining 76 experienced problems on the second day. On the third day only 3 patients had complications. Patients with complications on the day of admission are at high risk for severe complications and have a hospital mortality of 42%. Patients without complications during first 24 hours rarely have complications later and have a hospital mortality of 4%. It is concluded that patients with uncomplicated AMI can be transferred to a general ward after a 24 hour period of monitoring in CCU. These patients need supervision of myocardial function and rhythm over the next days. Checking of myocardial function has to be done clinically, while rhythm monitoring continuous telemetry of the ECG signal is suitable.