Coronary Care Units (CCU) have existed for over ten years and are now to be found in most major hospitals, but their role in the management of acute myocardial infarction remains controversial. Comparisons of CCU with general ward treatment and with home management in properly controlled trials have been difficult to accomplish.1 At present the evidence suggests that once a patient with infarction has been admitted to hospital, the mortality in a CCU is about 15% while that in a general ward is 20 – 40%.2 3 Some evidence also suggests that for some patients treatment at home is as good as, or better than treatment in a CCU.4 The question that remains therefore is which patients benefit from being admitted to a CCU. This article discusses some of the factors to be considered in the choice. Of course when the diagnosis of myocardial infarction is in doubt the patient may anyway need admission to hospital for investigation.
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