UNSATISFACTORY MANAGEMENT OF PATIENTS WITH MYOCARDIAL-INFARCTION ADMITTED TO GENERAL MEDICAL WARDS

Patients admitted with acute myocardial infarction to general medical wards fared less well than those admitted over the same period to the coronary care unit. The median age of the 119 patients admitted to the general wards was 75 years, compared to 64 years for those on the cor onary care unit. Although 13 of the 119 fulfilled the local guidelines for thrombolysis, none received it, only 64% were given aspirin and 4 9% nitrates. The death rate for these patients was 29% compared to 12% of those given thrombolysis on the coronary care unit and 26% of thos e who were ineligible for thrombolysis but had been admitted to the co ronary care unit. Of the survivors on the general wards, 80% were give n aspirin as secondary prevention, and 37% were given a beta-adrenergi c blocker. None was referred to the hospital cardiac rehabilitation pr ogramme.