What Is a Cardiac Care Unit?

A cardiac care unit (CCU) is a specialized hospital ward designed to treat people with serious or acute heart problems. People who undergo heart surgery also are placed in the CCU as they recover.

These wards are equipped to provide specialized treatment for heart conditions and are staffed with medical personnel trained in cardiac care. In many hospitals, CCUs treat a growing number of patients who, in addition to cardiovascular disease, have other chronic health issues that require management.

For example, a 2017 retrospective review of 1042 patients admitted to a CCU revealed heart patients there also had other chronic health issues including:

• Sepsis
• Acute kidney injury
• Acute respiratory failure

Problems Managed in a CCU

Patients are admitted to the CCU for serious, acute, and/or unstable cardiac conditions that require round-the-clock monitoring and specialized cardiovascular therapy.

The most common of these is an acute heart attack or another form of acute coronary syndrome. People with these conditions are prone to rapid, unexpected changes in their condition and typically require ongoing therapy, such as targeted temperature management (inducing mild hypothermia).

Other patients who may require a stay in a CCU include those who:

• Are recovering from coronary bypass surgery 
• Have decompensated heart failure, especially if they're especially ill or unstable or need a balloon pump or LVAD
• Require close monitoring following severe heart failure, even if they've stabilized and are awaiting a heart transplant
• Have acute coronary syndromes, unstable angina, or life-threatening cardiac arrhythmias

According to the Centers for Disease Control and Prevention, about 805,000 people have heart attacks each year. In addition, as many as 200,000 Americans undergo coronary bypass surgery each year. Consequently, in most hospitals, a CCU tends to be a busy place.

What Happens in a CCU

Cardiac care units are specially staffed and equipped to treat and manage issues that are unique to heart patients, especially when continuous monitoring is required.

Nurses, technicians, and physicians who have been specially trained to take care of people with serious cardiac conditions attend to patients 24 hours a day, in a much higher staff-to-patient ratio than in a typical hospital unit.

All patients admitted to the CCU are placed on a cardiac monitor, which records and analyzes each beat of the heart and will sound an alarm to alert the staff if serious arrhythmias occur.

Some patients also have temporary catheters placed into a wrist artery to continuously monitor their blood pressure or into a pulmonary artery to monitor blood pressure within the hearts.

Those with severe heart failure may receive an intra-aortic balloon pump (IABP) or a left ventricular assist device (LVAD) to help their hearts pump blood.

Cardiac care units are equipped with ventilators for patients who experience severe breathing problems as a result of their heart condition.

People in a CCU frequently need specialized testing, and so CCUs are equipped to perform such tests in the ward. These include bloodwork, electrocardiograms, echocardiograms, and chest X-rays, among others.

A CCU is usually configured differently than a typical hospital ward. Most have a centralized nursing station, surrounded by eight to 12 single rooms, each having large glass windows so patients can be seen from the nursing station.

The nursing station itself will be fitted with monitoring screens which show continuous readouts for every patient. If there is any kind of emergency, it is detected immediately by trained medical personnel who can respond immediately.

Many patients in a CCU are on bed rest, but comfortable seating is available for those who are able to (and may benefit from) being up for a prescribed period of time each day.

Visitors

Although visitors to the CCU are encouraged to provide comfort and company to patients, they typically are restricted to immediate family members. Visiting hours often are limited to two or three short periods of time per day.

Food and other items brought from outside the hospital, such as plants and flowers, usually are prohibited, as patients in CCUs tend to be on supervised diets and plants can introduce infection-causing bacteria into the environment.

After the CCU

The average stay in a CCU is one to six days. Afterwards, most patients are transferred to what is called a cardiac “step-down unit,” where they will receive less intensive care.

Although continuous cardiac monitoring occurs in the step-down unit, patients are allowed (and encouraged) to begin walking and moving regularly. Often, physical therapists or exercise therapists work with patients in the step-down unit to help them progress with their ambulation and to coach them on which activities to avoid once they are allowed to go home.

Most cardiac patients are discharged to home directly from step-down care. They often are prescribed a cardiac rehabilitation program, in which they will learn more about necessary changes in their diet, exercise, and other lifestyle factors. These changes are very important for avoiding any further stays in a CCU.