Acute Coronary Syndrome ST-Segment Monitoring

Pelter, Michele M.; Kozik, Teri M.; Al-Zaiti, Salah S.; Carey, Mary G.

doi:10.4037/ajcc2014847

Article navigation

ECG Puzzler| November 01 2014

Acute Coronary Syndrome ST-Segment Monitoring

Michele M. Pelter, RN, PhD;

Michele M. Pelter, RN, PhD

Michele M. Pelter is a professor at the Orvis School of Nursing, University of Nevada, Reno. Teri M. Kozik is a nurse researcher at St. Joseph’s Medical Center, Stockton, California. Salah S. Al-Zaiti is an assistant professor at the Acute and Tertiary Care Department, University of Pittsburgh, Pennsylvania. New York. Mary G. Carey is associate director for clinical nursing research, Strong Memorial Hospital, Rochester, New York.

Search for other works by this author on:

This Site

PubMed

Google Scholar

Teri M. Kozik, RN, PhD, CNS, CCRN;

Teri M. Kozik, RN, PhD, CNS, CCRN

Michele M. Pelter is a professor at the Orvis School of Nursing, University of Nevada, Reno. Teri M. Kozik is a nurse researcher at St. Joseph’s Medical Center, Stockton, California. Salah S. Al-Zaiti is an assistant professor at the Acute and Tertiary Care Department, University of Pittsburgh, Pennsylvania. New York. Mary G. Carey is associate director for clinical nursing research, Strong Memorial Hospital, Rochester, New York.

Search for other works by this author on:

This Site

PubMed

Google Scholar

Salah S. Al-Zaiti, RN, PhD, NP;

Salah S. Al-Zaiti, RN, PhD, NP

Michele M. Pelter is a professor at the Orvis School of Nursing, University of Nevada, Reno. Teri M. Kozik is a nurse researcher at St. Joseph’s Medical Center, Stockton, California. Salah S. Al-Zaiti is an assistant professor at the Acute and Tertiary Care Department, University of Pittsburgh, Pennsylvania. New York. Mary G. Carey is associate director for clinical nursing research, Strong Memorial Hospital, Rochester, New York.

Search for other works by this author on:

This Site

PubMed

Google Scholar

Mary G. Carey, RN, PhD, CNS

Michele M. Pelter is a professor at the Orvis School of Nursing, University of Nevada, Reno. Teri M. Kozik is a nurse researcher at St. Joseph’s Medical Center, Stockton, California. Salah S. Al-Zaiti is an assistant professor at the Acute and Tertiary Care Department, University of Pittsburgh, Pennsylvania. New York. Mary G. Carey is associate director for clinical nursing research, Strong Memorial Hospital, Rochester, New York.

Search for other works by this author on:

This Site

PubMed

Google Scholar

Am J Crit Care (2014) 23 (6): 503–504.

https://doi.org/10.4037/ajcc2014847

Scenario: This is an electrocardiogram (ECG) rhythm strip of lead II from a 67-year-old male who was admitted to the cardiac intensive care unit with an acute onset of chest pain after painting his home. He is being evaluated for acute coronary syndrome (ACS). The patient has a history of dilated cardiomyopathy (DCM) from alcohol and drug abuse. However, he says he has not used drugs or alcohol in more than 10 years. His initial cardiac troponin (cTnl) was 0.05 ng/mL (reference point for ACS > 0.04 ng/mL). The nurse activated the ST-segment monitoring software on the bedside electrocardiographic monitor, but is frustrated because of multiple alarms due to ST-segment changes.

This rhythm is atrial flutter/fibrillation with bigeminal premature ventricular complexes (PVCs), and is commonly seen in patients with DCM. The initial narrow QRS complexes appear to have 2 P waves in front of them, which suggests atrial flutter. Whereas,...

You do not currently have access to this content.

Don't already have an account? Register

Acute Coronary Syndrome ST-Segment Monitoring

Cited By

Email alerts

JOURNALS

Acute Coronary Syndrome ST-Segment Monitoring

Sign in

AACN Account

Sign in via your Institution

Subscribe

Short-term Access

Cited By

Email alerts

JOURNALS

This Feature Is Available To Subscribers Only