Cardiac Resuscitation in Coronary Artery Disease

Resuscitating a Circulation Abstract to Celebrate the 50th Anniversary of the Coronary Care Unit Concept

“…Recent developments in cardiac resuscitative technique have brought into clearer focus medicine's potential in preventing such deaths. 16 Clark Gable finished filming The Misfits with Marilyn Monroe on November 4, 1961, four days before John Kennedy was elected president. But the fifty-nine-year-old actor had no chance to celebrate the movie's completion or visit a voting booth.…”

“…Recent developments in cardiac resuscitative technique have brought into clearer focus medicine's potential in preventing such deaths. 16 …”

“…Arguing that the approach could transform the “early stages of death [into] a twoway threshold,” they proclaimed, “The present practice of random assignment of patients with acute coronary disease to various locations in the hospital is, therapeutically, an antiquated procedure.” 16 Their concept and paper received favorable reviews. For example, a 1964 report by the American College of Chest Physicians’ Subcommittee on Closed-Chest Cardiac Resuscitation concluded, “Sudden death in some of the patients recovering from acute myocardial infarction could become reversible if these patients were monitored and cardiac resuscitation was promptly performed.…”

Effect of coronary care on myocardial infarct mortality.

“…There is little published evidence that the mortality rate of acute myocardial infarction is lower for patients treated in a coronary care unit than for those treated elsewhere, in groups of patients shown otherwise to have a similar probability of dying (Lindholm et al, 1976;Peterson, 1978). This is in spite of the fact that the earliest coronary care units were established over a decade and a half ago (Brown et al, 1963;Day, 1963;Wilburne and Fields, 1963), and notwithstanding numerous reports on the subject. Furthermore, while it seems that most cardiologists believe that coronary care units do improve the overall prognosis of acute myocardial infarction, it is also commonly believed that any reduction in mortality is greatest in patients with mild or only moderately severe Received for publication 20 December 1978 infarcts, but small or non-existent in those with very severe infarcts (Chapman, 1970).…”