Immediate coronary care in general practice — a three-year review

The general practitioners in a rural practice in a three-year period were called to 101 patients (25% female) who suffered a myocardial infarction. The average response time was 15 minutes. Seventeen patients collapsed and died and the 84 who survived the initial period were given immediate coronary care and either cared for at home, admitted by cardiac ambulance to a coronary care unit, or admitted to a general medical ward with monitor facilities. The four-week mortality rates were 21.0%, 21.5% and 57.7% respectively. Thirty-six patients required treatment for arrhythmias in the initial care period, of whom nine required defibrillation. This survey supports the view that patients over the age of 60 years with uncomplicated myocardial infarction may be cared for successfully at home.