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TAKE HEART: THE CORONARY CARE UNIT

Your admission to hospital was probably unexpected; you may have had a fast and disturbing trip and been suddenly confronted with a number of unfamiliar faces and strange pieces of equipment.

When you arrived in the Coronary Care Unit it was our aim to:

relieve your pain

establish the correct diagnosis

observe you closely in order to treat or prevent complications

administer thrombolytic therapy. The medications Streptokinase or TPA if given within 4 to 24 hours of the onset of pain may dissolve the blood clot blocking the coronary artery, and may potentially reduce the damage to heart muscle

administer intravenous Heparin and intravenous GTN for 24 to 48 hours. The Heparin helps thin the blood

(so that another clot can't form) while the GTN attempts to keep coronary arteries open.

Monitoring

The Coronary Care Unit is a highly specialised area of the hospital. Here specially trained nurses and doctors use electronic equipment to recognise and treat promptly the early signs of complications which can occur after a heart attack.

'Complications' do not necessarily include the onset of a more severe attack or an unduly prolonged recovery. Most complications are of short duration and leave no after effects.

Irregular heart rhythm may occur 24 hours after a heart attak Doctors and nurses will detect this on the heart monitor and treat if necessary.

Excess fluid on the lungs could cause shortness of breath. This can be treated with medication which will increase the amount of urine passed.

Pericarditis may occur after a heart attack but generally disappears after a few days. Pericarditis is a short-term problem caused by inflammation of the 'pericardium' (the sac that encloses the heart). The pain may be severe and increase with respiration.

Bed Rest and Length of Stay

You will stay in the Coronary Care Unit until you are well enough to leave. This is usually 1 to 2 days.

Your initial rest in bed is necessary to start the healing process; however, you are allowed to do most things for yourself from the first day. We try to minimise loss of fitness after your heart attack by keeping you in bed for the shortest possible time.

It has been estimated that for every 24 hours spent in bed we lose 5% of our muscle strength. Most people know that a broken arm kept in plaster for several weeks becomes frail and weak, and requires gradual building up. This same 'deconditioning' process is the main reason you feel weak, easily tired, and sometimes 'woozy' in the head as you begin to move about again.

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