What Happens in a Cardiac Care Unit?

Doctor listening to his patients hearbeat

 Visoot Uthairam / Getty Images

Cardiac care units, or CCUs (which some hospitals call acute coronary care units, cardiac intensive care units, or critical coronary care units), are specialized hospital wards dedicated to caring for people with serious or acute heart problems.

Originally designed decades ago to care for people with acute heart attacks, CCUs now also routinely provide critical care to people with acute coronary syndrome, life-threatening cardiac arrhythmias, severe heart failure, and people recovering from cardiac surgery. 

Why a CCU Is Useful

A CCU is staffed around the clock by nurses, technicians, and physicians specially trained to take care of people with serious cardiac conditions. Typically, the staff-to-patient ratio is much higher in a CCU than in a typical hospital unit, so that each patient can be monitored closely and constantly.

CCUs also make specialized equipment for cardiac monitoring, testing and treatment readily available. All patients admitted to the CCU are placed on a cardiac monitor, which records and analyzes each beat of their heart rhythm, and alerts the staff immediately if serious arrhythmias occur. Some patients also will 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. Some people who have severe heart failure may receive an intraaortic balloon pump (IABP), or a left ventricular assist device (LVAD), to help their hearts to pump blood. Sometimes cardiac conditions can lead to serious breathing problems, so 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, including bloodwork, electrocardiograms, echocardiograms, and chest X-rays.

CCUs can be considered to be a more specialized subset of the more generalized intensive care unit, or ICU, which is mainly used to treat critically ill patients with conditions other than (or in addition to) heart disease.

Who Goes Into a CCU?

People are treated in a CCU if they have a serious, acute or unstable cardiac condition that requires 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.

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 imminent cardiac transplantation.

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.

What Is a CCU Like?

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, it is important to the smooth functioning of such a unit that visitors 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 average stay in a CCU is five 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 ambulating 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

Cardiac care units provide the intensive monitoring and treatment that people may need who have any one of several serious cardiac conditions, in particular, heart attacks. The skilled personnel and sophisticated equipment found in a modern CCU can help ensure the most rapid recovery possible.

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