During the 25 years since acute coronary care was focused into Coronary Care Units there have been three major Phases: I. prevention of death caused by arrhythmias; II. prevention of death due to myocardial failure; and III. limitation of infarct size. In the latter two Phases, there has been infringement upon the time honored concept of a prolonged period of rest for the patient in general and the heart in particular to minimize myocardial metabolic demands. During the second Phase of coronary care, patients with myocardial failure received aggressive measures to increase cardiac work via...

When a patient develops symptoms suggestive of and infarction, this section is emphasized. There acute coronary insufficiency, the health care sys are brief sections on prediction and prevention of tem is presented with a challenging diagnostic ischemic events, methods of diagnosing and siz and management problem. During the past 20 ing infarcts, and methods of monitoring the pa years, hospitals have been developing coronary tient with myocardial ischemia. A major focus of care units as the specialized inhospital facilities for the text is on "coronary care. " As indicated above, such...