Early discharge after acute myocardial infarction

Times have changed! As a medical student in the late 1950s and as an intern in 1960 I clearly remember my resident's advice about treating a patient with acute myocardial infarction. Of course, in those days there were no coronary care units. We did, however, have oxygen, morphine, coumadin, nitrates, digitalis, and mercurial diuretics. If the patient was in heart failure, obviously such a patient was treated with digitalis and diuretics. If an arrhythmia occurred, quinidine was the common drug used. Life was simple then. The uncomplicated myocardial infarction was generally put to bed (sometimes in an oxygen tent), sometimes given coumadin, and very often heavily sedated. I can clearly remember my resident telling me to sedate the patient-so that on rounds every moming we needed to wake patients up to ask how they were feeling. In addition, patients were generally kept at bed rest for about 3 weeks, then gradually ambulated for the next 3 weeks, and finally discharged after a 6-week hospitalization.