A-Z

Heart attack

The coronary care unit

Most of the people interviewed spent the first few days after their heart attack in the Coronary Care Unit (CCU) of the hospital where they could receive a high level of very specialised care. 

They described being attached to heart monitors and having all sorts of tubes and wires attached to them so that tests could be taken or injections given (see 'Diagnosing a heart attack' and 'Initial treatments for a heart attack').

 

Describes the monitoring and interventions during the first few hours in the coronary care unit.

Describes the monitoring and interventions during the first few hours in the coronary care unit.

Age at interview: 54
Sex: Male
Age at diagnosis: 54
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I mean just the unit itself, just gave an impression that this, that you were, that contingencies were there to be dealt with, you know. I mean it's rather a sort of intimidating number of things attached to you. 

And I'm someone that, you know, hadn't been near a hospital for, I mean the last time I'd received any real hospital treatment was for something like an appendix and you know, when I was about five, so maybe nearly fifty years ago.

So lots of high-tech interventions you know. I was attached to an ECG machine that was permanently operating, a blood pressure machine that kicked in every fifteen minutes. I had an oxygen mask on. I had a drip into my vein which was producing, which was providing long-term the drug which is, they called the clot buster. 

So I had lots of different things wired up to me but apart from that I felt okay. And you know, I mean, I was aware that I was going to be in this situation for quite sometime, i.e. monitored.

 

Describes what it was like on the coronary care unit.

Describes what it was like on the coronary care unit.

Age at interview: 63
Sex: Male
Age at diagnosis: 63
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So as soon as a bed became available early the following morning I was admitted to the cardiac ward at [the hospital]. And there I went into a section which is equipped with full monitoring equipment and I was on various drips and goodness knows what else. 

It's an intimidating place to find yourself in because all this monitoring equipment is all, emitting all strange sorts of bleep's and noises and it's very difficult to relax. It is also you know it struck me as unusual at the time, probably a very good reason for it, a mixed ward so you had ladies and gents all in together.  

But the one thing we, looking round the ward, all had, seemed to have in common is everybody looked most unlike heart problem people in that they all looked fit but to be there they had to be suffering from a heart problem.

And I suppose the one very distressing thing was that you soon became aware that not frequently but on a number of occasions during the time that I was there you know people were being admitted and they didn't make it and we had the all too familiar thing happen where all the curtains were drawn and you knew that somebody else hadn't made it and they were on their way.  

So yes that really took the, you know brought home to you the seriousness of the situation. But what seemed to be pretty common was that for the most of us the condition was so well controlled, and I was on medication and monitoring and all the rest of it, we didn't really feel ill so we amused ourselves by setting up an escape committee and deciding how we were going to get out of this place [laughs]. 

Being on a heart monitor meant that the nurses could see immediately if there were any disturbances in the heart rhythm. Another instrument took the blood pressure at regular intervals and gave a warning if it became abnormal.

 

The heart monitor was set off every time he breathed less. At first John was concerned until he...

The heart monitor was set off every time he breathed less. At first John was concerned until he...

Age at interview: 67
Sex: Male
Age at diagnosis: 67
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 So I was immediately wheeled in there. I was then wired up to an ECG monitor which monitored not only the heart but the breathing and blood pressure as well. So I was connected by all these wires for quite a while. And if the things went out of range then an alarm would go off but I very quickly realised that some of these alarms were quite unnecessary, well I mean they were necessary in one sense but for example I normally breathe quite slowly but the alarms are set, I think it’s to 12 breaths a second and when I’m concentrating I probably reduce to something like 6 breaths a second. The moment I’m starting to think about something I stop breathing. I breathe in quite deeply but then it stops and the alarms would go off which at first I found slightly concerning but then I worked out what it was I realised I only had to breathe again to get out of the situation.

 

Painkillers were given through a vein in the arm and the amount given increased or reduced until chest pain had eased. Some people said they found it intimidating being in this environment at first, but felt reassured that they were being so closely monitored and were surrounded by experts.

A few people found it difficult to sleep the first night on the CCU but this improved once they got used to the various noises.

A few, who had, had a severe heart attack, described the first 24 hours as being a bit hazy as they had drifted in and out of consciousness. But others who had had milder heart attacks felt well and said they began to wonder what all the fuss had been about.

At first, the nurses encouraged strict bed rest. One man, who felt well, was surprised when he walked across the ward and the nurse told him to get back in bed. But people also said that nurses encouraged them to become independent after the first days.

 

James talks about the practical help and encouragement he got from nurses.

James talks about the practical help and encouragement he got from nurses.

Age at interview: 63
Sex: Male
Age at diagnosis: 62
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How did you feel during the first few days in hospital in terms of the support given, the care given?
 
Yeah very, very good. I got to know a few of the nurses, first we got on first name terms and yes they were very, very helpful and kind. I found them very what should I say? They wanted me to do things for myself as well which was a good thing. You know I mean not too quickly but you know, like going to the toilet and this type of thing. And when you're first; they obviously helped me out of bed the first time as I was still probably a little bit dozy from all the bits and pieces but that was only once and from there I, I would get up, dress and sit for most of the day you know, that's why they moved me I think [laughs]. Yeah I found them very good, they, they're an excellent caring crew and you know people down cry them a bit but they should really think it's the job they have to do. It's a very difficult job and I'm very thankful to them for what they did for me.
 
 

 

Most people were in a four or six-bedded ward. One man who thought he would have preferred to be on his own, said it helped being with others in a similar situation. Another was surprised to be in a mixed ward*. Some younger people found it difficult that they were the youngest on the ward, and said it reinforced their feeling that they shouldn't be there.

Sometimes on the coronary care unit people die, or have a cardiac arrest and need to be resuscitated, and other patients are likely to hear this happen. To one man it brought home the seriousness of his situation. Another was upset and had an angina attack when a man on the ward, with whom he had become friendly, died suddenly.

 

He was very upset when one of the other patients died on the ward.

He was very upset when one of the other patients died on the ward.

Age at interview: 63
Sex: Male
Age at diagnosis: 53
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Then one night, one of the guys who I'd had the most fun with, he'd had a triple bypass, he had breathing problems and he was forever on one of these snorkel things. But he had a bad attack one night and panic alarm went and staff appeared from everywhere trying to look after him, but they, they just couldn't keep him going and he died. 

And I was upset about that, because he was a nice chap and we'd had some good fun and it just upset me to realise that just over there, the other side of the room, this, this guy had died. Now he certainly wasn't the first person I'd seen die, and so on. 

But the circumstances and the fact that it was his heart, alarmed me I suppose; just started bells ringing and within a couple of hours I had my first ever angina attack. 

As people recovered, the various monitors and drips were gradually removed. They could then walk to the bathroom to have a wash or a shower, or were taken there by a nurse.

 

The monitors and wires attached to him were gradually removed after the first two days in the...

The monitors and wires attached to him were gradually removed after the first two days in the...

Age at interview: 54
Sex: Male
Age at diagnosis: 54
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It was really just a question of waiting until such time as I was given greater freedom to move because I mean, I think I was very conscious of being very restricted. And that first night, the idea that one could sleep while having (a) all these things attached to one and also the machine that every fifteen minutes sort of pumped up, you know. So I didn't really get any sleep that first night. And also there was a lot of sounds of other people, some people in distress, lots of things going on.

So, but I remember actually being, what I really wanted to do more than anything else was just to be able to, you know, walk to the loo and walk to the shower and I wasn't allowed to do that for two days really. But for the first two days I was immobilised. There was a gradual loosening, if you like, of the frequency of the monitoring. 

As you know, the first positive stages when the mask came off, and I just had little tubes put in, and then really positive was when I didn't have any oxygen at all. And it was just, you know, that when the blood pressure monitors came off, and they were just looking at my blood pressure every few hours rather than constantly. But, you know, I was able to receive visitors, I could read, talk, do all those sort of things.  

Many were shocked at how weak they had become in just a few days, and simple tasks like walking to the loo, or washing their face were exhausting. One man, who had a massive heart attack and was in coronary care for 21 days, had felt very weak, without the energy to walk, talk or hold a pen.

 

She was shocked how weak she was at first after her heart attack.

She was shocked how weak she was at first after her heart attack.

Age at interview: 54
Sex: Female
Age at diagnosis: 53
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The only thing that was very scary was going to the toilet on my own. I mean the first couple of days, you're not allowed to obviously, you have to have a commode at the side of the bed and you get help but to go to the toilet on your own is quite scary because you've got to walk up there and back on your own. 

Just the effort of, it sounds stupid really now, just the effort of sitting down on the toilet and getting up again and washing your hands, I was exhausted, absolutely. One time I washed my hands and face and my daughter was with me, and I brushed my hair and I started to go all funny, and I said, 'you'll have to bring me the wheelchair in,' and she said, 'you've over done it' [laughs].

I couldn't believe you know, you could over do it just washing your face and brushing your hair.

Sometimes people have setbacks or another heart attack while on the coronary care unit and it then takes longer to recover. One man whose condition had not stabilised after a week was transferred to another hospital for an angiogram, which showed he needed coronary artery bypass surgery.

 

He had another heart attack while on the coronary care unit and so took longer to recover.

He had another heart attack while on the coronary care unit and so took longer to recover.

Age at interview: 63
Sex: Male
Age at diagnosis: 63
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And I'm naturally an early riser, you know soon after five after morning and having been to have a wash and shave early before the rush started, talking to one of the nurses, I suddenly realised that the old discomfort was returning. 

And I mentioned this to the nurse who followed me back, me back to the bed put me on the ward monitors again and before I knew it I was having an ECG and all of the now familiar rigmarole of clot buster's and pain killers were being administered. 

And he said he thought I was having a second heart attack. Subsequently I was told that the ECG certainly suggested I was having a second heart attack but the blood tests did not reveal any changes in my blood, which suggested I hadn't had a second heart attack. 

So quite what happened I don't know but it was back to square one again on the routine, which was very disappointing to say at the least.  

People felt reassured by the continuity of care, professionalism and attentiveness of the coronary care teams that looked after them.
 

Both the nurse and consultant drew pictures to explained to Alan his heart attack and treatment.

Both the nurse and consultant drew pictures to explained to Alan his heart attack and treatment.

Age at interview: 62
Sex: Male
Age at diagnosis: 62
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How was the care while you were there [hospital]?
 
Alan' Oh it was very good. I mean there was always somebody there and about, you know, they were always looking after you and. Yeah very good, yeah I mean the nurse came to me and obviously I asked her what had gone wrong. And she drew me a picture and everything of what they had been doing and the, like consultant lady came and she did the same thing as well really pictures for me showing me what they had done like, you know.
 
Alan’s wife' And it was the same team which was nice. You saw the same faces every day.
 
Alan' Yeah, yeah, well it was very good yeah.

 

Once the doctor was confident that the situation was stable, people were moved out of intensive care and onto a general ward (see 'The general ward and discharge home after a heart attack').

* Since these interviews the NHS has continue to work towards ensuring that there is same-sex accommodation for patients at every stage of their care.

Last reviewed June 2017.

Last updated June 2017.

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