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January 20, 1984

Is It Good Practice to Treat Patients With Uncomplicated Myocardial Infarction at Home?

Author Affiliations

From the Department of Family Medicine, University of Washington, School of Medicine, Seattle.

JAMA. 1984;251(3):349-350. doi:10.1001/jama.1984.03340270027024

UNDER WHAT circumstances might a patient with an apparently uncomplicated myocardial infarction be treated at home? This question has never been satisfactorily answered. Recently, a 70-year-old man was initially seen at our office with a history and ECG consistent with a lateral-wall myocardial infarction with likely onset 72 hours before the visit. When hospitalization was recommended, the patient adamantly refused but wanted us to continue providing his medical care. He went home and had an uncomplicated recovery. He continues to do well and is at full activity 18 months after infarction. Perhaps our patient instinctively chose what was best for him. There is evidence to support his choice.

The original descriptions of the coronary care unit (CCU) were published in 1963. Brown and co-workers,1 describing an intensive care center for the treatment of myocardial infarction, noted that in the first year the mortality rate of those in the intensive