Early Discharge After Acute Myocardial Infarction

doi:10.1059/0003-4819-99-4-528

Early Discharge After Acute Myocardial Infarction

Durham, North Carolina

Abstract

Approximately 50% of patients hospitalized with acute myocardial infarction have an uncomplicated course and an excellent prognosis. To be considered as having an uncomplicated course, patients should not have ventricular tachycardia or fibrillation, second or third degree atrioventricular block, pulmonary edema, cardiogenic shock, infarct extension, persistent hypotension, sinus tachycardia, or sustained supraventricular tachycardia occurring within the first 4 days of hospitalization. Patients with recurrent angina in the postinfarction period may also be at increased risk. Early and rapidly progressive rehabilitation programs permit the safe discharge of patients with an uncomplicated course after 7 days. Functional exercise testing before, or soon after, early discharge may identify high-risk patients and alter their management.

Article and Author Information

▸From the Division of Cardiology, Department of Medicine, and Department of Community and Family Medicine, Duke University Medical Center; Durham, North Carolina.
Grant support: in part by grant HS 03834 and HS 04873 from the National Center for Health Services Research—OASH; research grant HL-17670 from the National Heart, Lung, and Blood Institute; training grant LM 07003 and grant LM03373 from the National Library of Medicine; and grants from the Prudential Insurance Company of America, the Kaiser Family Foundation, and the Andrew W. Mellon Foundation.
▸Requests for reprints should be addressed to David B. Pryor, M.D.; P.O. Box 3531, Duke University Medical Center; Durham, NC 27710.