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VIEWPOINT

Cardiology and the Critical Care Crisis

A Perspective

Jason N. Katz, MD^_*,_*, Aslan T. Turer, MD^_* and Richard C. Becker, MD

^_* Division of Cardiology, Duke University Medical Center, Durham, North Carolina
Duke Clinical Research Institute, Durham, North Carolina.

Manuscript received October 26, 2006; accepted November 8, 2006.

^_* Reprint requests and correspondence: Dr. Jason N. Katz, Box 31069, Duke University Medical Center, Division of Cardiology, Durham, North Carolina 27710. (Email: jason.katz{at}duke.edu).

With an aging U.S. population and a declining physician supply, the care of critically ill patients will soon be reaching a level of crisis. At the same time, the evidence continues to mount in support of intensivist staffing to improve both patient outcomes and resource utilization in intensive care units (ICUs). Whereas the vast majority of medical and surgical ICUs are staffed by physicians trained in critical care medicine, that is not commonly the case in coronary care units (CCUs) in this country. Despite that, the breadth and diversity of comorbidities in patients that occupy our CCU beds is continuously growing. No longer is the CCU merely an observation unit for peri-infarction complications, but rather it has truly become an ICU for patients with cardiovascular disease. With this in mind, there becomes a growing need for intensivist-trained cardiologists and a push for the development of critical care training pathways in our cardiovascular fellowship programs.

Abbreviations and Acronyms   ACS = acute coronary syndrome   CCU = coronary care unit   ICU = intensive care unit   MI = myocardial infarction