Republished: from coronary care unit to acute cardiac care unit: the evolving role of specialist cardiac care.

As the United Kingdom develops services to provide 24/7 cover for primary PCI at Heart Attack Centres, the future of CCU in other acute hospitals is potentially now under threat. However, it has been clear for some time that the traditional role of CCUs has been changing, partly due to a reduction in the incidence of ST elevation Myocardial Infarction (STEMI), with a corresponding increase in the other acute coronary syndromes (ACS), and also due to an increase in presentation of other cardiac conditions with acute haemodynamic instability. These include some of the patients presenting with arrhythmias and heart failure. Services must be well organised and efficient to deal with these patients effectively, and this now presents a significant challenge for Acute NHS Trusts.