Comparison of the effects of treatment of acute myocardial infarction in a coronary unit and on a general medical ward.

During 1968, 400 cases of proven acute myocardial infarction were admitted to the Toronto General Hospital (mortality 25.0%).Approximately half the patients who survived their stay in the Emergency Department were admitted to the Coronary Unit (mortality 15.6%) while the other half, because of lack of beds in the Coronary Unit, were treated on a general medical ward (mortality 26.5%). More elderly patients (> 70) were admitted to the medical wards and contributed to the higher mortality.The frequency of successful resuscitation following cardiac arrest was twice as great in the Coronary Unit as on the medical wards. Antiarrhythmic drugs given in the Coronary Unit with the assistance of the electrocardiographic monitor did not influence the early mortality. Digitalis was used more frequently on the medical wards, but did not appear to exert an unfavourable effect on survival.