The main feature of coronary care is the availability of telemetry or the continuous monitoring of the cardiac rhythm by electrocardiography. This allows early intervention with medication, cardioversion or defibrillation, improving the prognosis. As arrhythmias are relatively common in this group, patients with myocardial infarction or unstable angina are routinely admitted to the coronary care unit. For other indications, such as atrial fibrillation, a specific indication is generally necessary, while for others, such as heart block, coronary care unit admission is standard.
Coronary care units developed in the 1960s when it became clear that close monitoring by specially trained staff, cardiopulmonary resuscitation and medical measures could reduce the mortality from complications of cardiovascular disease. The first description of a CCU was given in 1961 to the British Thoracic Society, the first CCU was located at the Toronto General Hospital in 1965. Early CCUs were also located in Sydney, Kansas City and Philadelphia. Studies published in 1967 revealed that those observed in a coronary care setting had consistently better outcomes. The first coronary care unit was opened at Bethany Medical Center in Kansas City, Kansas by Dr Hugh Day, and he coined the term. Bethany Medical Center is also where the first “crash carts” were developed.