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Multilead ST-segment monitoring in patients with acute coronary syndromes: a consensus statement for healthcare professionals. ST- Segment Monitoring Practice Guideline International Working Group.

Authors
  • Drew, B J
  • Krucoff, M W
Type
Published Article
Journal
American journal of critical care : an official publication, American Association of Critical-Care Nurses
Publication Date
Nov 01, 1999
Volume
8
Issue
6
Identifiers
PMID: 10553178
Source
Medline
License
Unknown

Abstract

Because changes in the ST segment can shift among various electrocardiographic leads in the same person over time owing to different ischemic mechanisms, 12-lead ST monitoring is recommended. Recommended monitoring times are as follows: myocardial infarction or unstable angina, 24 to 48 hours or until patient is event-free for 12 to 24 hours; chest pain prompting a visit to an emergency department, 8 to 12 hours; catheter-based interventions with less definitive interventional outcomes requiring monitoring in an intensive unit, 6 to 12 hours; and cardiac surgery or noncardiac surgery in patients with coronary disease or risk factors, 24 to 48 hours. An ST measurement point of J + 60 ms makes it unlikely that measurement will coincide with the upslope of the T wave, even in patients with sinus tachycardia. Accurate and consistent lead placement and careful electrode and skin preparation are imperative to improve the clinical usefulness of ST monitoring.

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