Since the concept first emerged in 1961, critical care cardiology has transformed cardiac care. A new scientific statement from the American Heart Association highlights the evolution of the specialty and the challenges faced in today’s rapidly changing health care environment. The new statement serves as an update to a 2012 statement and was published Feb. 13 in the journal Circulation. 

Richard Becker, MD, a professor at the University of Cincinnati College of Medicine and director and physician-in-chief of the UC Heart, Lung and Vascular Institute, was among the first cardiologists in the country to practice critical care cardiology and to develop fellowship training programs.

“This field has evolved significantly since the 1960s, when coronary care units were first established to manage acute myocardial infarction and ventricular arrhythmias,” he recently told MedCentral. “This represented a sea change at that time.” 

These changes, including the development of specialized cardiac intensive care units (CICUs), have significantly improved patient outcomes, he added.

However, as the field has grown, so have the challenges. Patients are older, with more comorbidities, and many have non-cardiac primary diagnoses, such as sepsis, acute kidney injury and acute respiratory failure. 

That shift “has required a multidisciplinary approach to care, integrating advanced cardiovascular interventions and critical care expertise," said Becker.

Read about how Becker said primary care physicians play an integral role in critical cardiac care.