What Happens in a Cardiac Care Unit?

Cardiac care units, or CCUs, are specialized hospital wards dedicated to treating people with serious or acute heart problems. These special units (also known as coronary care units, cardiac intensive care units, critical coronary care units or critical care unit), treat people who have had heart attacks, life-threatening cardiac arrhythmias, unstable angina, severe heart failure, people with acute coronary syndrome, or those recovering from cardiac surgery. 

In many hospitals, this unit may be referred to as the ICCU, (intensive cardiac care unit) or CICU (cardiovascular intensive care unit), as these wards are treating a growing number of patients with not only cardiovascular disease but other chronic disease (like respiratory failure, kidney failure and diabetes) that also require management.

The types of patients admitted to the CCU is changing. Today, patients tend to have more critical illnesses and comorbidities. In a recent retrospective review of 1042 patients admitted to a CCU, patients had acute coronary syndromes, severe heart failure, valve disease, pericardial disease, primary ventricular and bradyarrhythmias, acute aortic dissection, renal failure, and sepsis.

Doctor listening to his patients heartbeat
 Visoot Uthairam / Getty Images

Why a CCU Is Useful

A CCU is the place to be when you have heart problems because patients get constant and continuous monitoring. 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.

In addition to specialized staff, CCUs offer specialized equipment for monitoring, testing, and treating the heart.

All patients admitted to the CCU are placed on a cardiac monitor, which records and analyzes each beat of their heart rhythm, alerting the staff immediately if serious arrhythmias occur. Some patients will also have temporary catheters placed into a wrist artery to continuously monitor their blood pressure, or into their pulmonary artery to monitor the pressures within their 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. Because some cardiac conditions can lead to serious breathing problems, ventilators are also available.

People in a CCU will frequently need specialized testing, and commonly used tests often can be performed right in the CCU itself. These tests may include bloodwork, electrocardiograms, echocardiograms, and chest X-rays, among others.

Who Goes Into a CCU?

People are treated in a CCU if they have a serious, acute, or unstable cardiac condition that needs minute-to-minute monitoring, or that requires specialized cardiovascular therapy.

The most common reason for being admitted to a CCU is an acute heart attack or another form of acute coronary syndrome. People with these conditions often require ongoing therapy that may need to be adjusted frequently, and they are prone to rapid, unexpected changes in their condition. The close round-the-clock monitoring they receive in a CCU allows these changes to be detected immediately so that treatment can be adjusted right away.

In addition, CCUs are designed to administer the latest therapies, like "targeted temperature management" (inducing mild hypothermia in patients who have had a heart attack) which has been shown to provide significant protections to the brain after a heart attack.

Similarly, people recovering from coronary bypass surgery often spend a few days in the CCU. 

People who have decompensated heart failure are often treated in a CCU, especially if they are particularly ill or unstable, or if they need a balloon pump or LVAD to stabilize their cardiovascular condition. People may also be admitted to a CCU for close monitoring if they have stabilized but severe heart failure and they are awaiting an imminent heart transplant.

About 200,000 Americans undergo coronary bypass surgery each year. Consequently, in most hospitals, a CCU tends to be a busy place. As well, the CDC reports 735,000 suffer a first or subsequent heart attack, and 85.6 million people overall in the U.S. have some type of cardiovascular disease.

How Does a CCU Differ from the ICU?

A CCU is usually configured differently than a typical hospital ward. Most modern CCUs will have a centralized nursing station, surrounded by 8 to 12 single rooms with large glass windows so that each patient can be seen from the nursing station. The nursing station also will have several monitoring screens which show continuous readouts for every patient. If there is any kind of emergency, it is detected immediately — and trained personnel are only steps away.

Many patients in a CCU are on bed rest, but the CCU staff will try to get them out of bed and into a chair for a few hours a day unless their medical condition, or their treatment, precludes that.

Visitors Limited in CCU

As with any intensive care unit, CCUs are places for people who have potentially serious or unstable medical problems. Consequently, it is not unusual at any given time for one patient or another to have an acute issue that needs to be dealt with. This situation naturally places restrictions on visitors to a CCU.

While visitors are encouraged, they are typically restricted to immediate family members, and visiting hours are often limited to two or three short periods of time per day. Often, patients are hooked up to wires and tubes during their CCU stays, which can prove disconcerting to family members but is necessary for close monitoring. Food and other items brought from outside the hospital, such as plants and flowers, are usually prohibited as well. Patients in CCUs tend to be on supervised diets, and plants can introduce potential infection-causing bacteria into the environment.

Average Time in CCU

While the amount of time a person will stay in a CCU can vary from less than a day to several weeks, the majority of patients stay between 1 to 6 days. 

Typically, after leaving the CCU, patients are transferred to what is called a cardiac “step-down unit,” for less intensive care and monitoring. While continuous cardiac monitoring is still done on the step-down unit, patients are allowed to (and encouraged to) begin walking and moving regularly. Often, physical therapists or exercise therapists will visit people 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.

A Word From Verywell

A stay in a cardiac care unit can ensures that you receive the intensive monitoring and treatment you need after a heart attack, or if you are dealing with another serious cardiac condition. Skilled personnel and sophisticated equipment in a modern CCU allow for the most rapid recovery possible.

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