A coronary care unit in a small hospital.

The first effective breakthrough in the treatment of coronary thrombosis occurred with the realization that the arrhythmias were a major factor in the high mortality figures.Drugs have been used to control anomalous rhythms with considerable success for a number of years. A safe and very effective instrument was added to our armamentarium by the discovery of an electrical defibrillator, soon combined with the monitor, pacemaker and synchronizer.To use this equipment more intelligently and effectively the attending personnel require extra training in the recognition and prompt treatment of arrhythmias, mouth to mouth breathing, external cardiac massage, the use of the cardiac monitor and defibrillation unit, etc.During the course of their illness, at least 75 percent of all patients who have suffered a myocardial infarction, develop significant arrhythmias. Early recognition and control of benign disturbances of rhythm will frequently prevent the occurrence of major arrhythmias. It is in this area that recent developments have opened a vista in which we can hope to witness a change in the alarming mortality figures of myocardial infarction.The author gives a statistical resumé of his Unit's experience with 98 patients.